A Feminist Intervention That Hurt Women: Biological Differences, Ergonomics, and Occupational Health: Une intervention féministe qui a nui aux femmes: différences biologiques, égalité, ergonomie et santé au travail.

PubMed

Messing, Karen

2017-11-01

The University of Québec in Montréal has agreements with trade unions providing access to university resources. Researchers involved in this program worked in partnership with union women's and health and safety committees for more than twenty years. Not all studies succeeded in improving women's working conditions. One joint project involved observational studies of tasks done by health-care workers, complemented by interviews and questionnaires. We found that task assignments, movements, postures, and work-related musculoskeletal disorders varied by gender/sex and made recommendations for change. However, issues of pay equity, spending on health care, and contracting-out of "ancillary work" were salient. Researchers learned that in the absence of changes in power relationships in the workplace, women may be disadvantaged by denial as well as by exaggeration of female-male differences. Men may also be at risk when their gender is invisible. We suggest some feminist approaches to workplace solutions and some pathways for research. Résumé L'Université du Québec à Montréal a signé avec des centrales syndicales des ententes leur donnant un accès à des ressources universitaires. Des chercheures ont travaillé en partenariat avec des comités syndicaux de condition des femmes et de santé-sécurité au travail pendant plus de 25 ans, mais ce ne sont pas toutes les études qui ont abouti à des améliorations. Un projet concernait des observations du travail d'employé.e.s du secteur de la santé, dont les tâches, mouvements, et postures variaient selon le genre/sexe. Nous avons recommandé des transformations, mais des enjeux d'équité salariale, de coûts et de sous-traitance y ont fait obstacle. Les chercheures ont appris qu'en l'absence de transformation des rapports de pouvoir au travail, le déni des différences hommes-femmes, autant que leur exagération, peut désavantager les travailleuses (et les travailleurs). Nous suggérons des approches f

Utilisation de la mélatonine pour le sommeil chez les enfants en bonne santé

PubMed Central

Janjua, Irvin; Goldman, Ran D.

2016-01-01

Résumé Question Une maman a amené son garçon de 12 ans me consulter à mon bureau. Elle s’inquiète, car il a de la difficulté à s’endormir presque tous les soirs. Elle travaille par quarts et elle prend elle-même de la mélatonine pour l’aider à s’endormir. Elle m’a demandé si son garçon pouvait aussi prendre de la mélatonine. Quels sont les recommandations et les éléments à considérer avant d’utiliser la mélatonine chez les enfants et les adolescents en bonne santé? Réponse L’insomnie est rapportée chez jusqu’à un quart des enfants en bonne santé et chez les trois quarts des enfants atteints d’une affection psychiatrique ou neurodéveloppementale, ce qui entraîne des conséquences négatives. Pour les enfants atteints du syndrome de retard de phase du sommeil, la mélatonine pourrait s’avérer utile lorsque jumelée à une évaluation de l’insomnie et à un suivi régulier. La mélatonine pourrait être envisagée pour des enfants sans diagnostic d’insomnie qui ont une bonne hygiène du sommeil. Bien qu’elle semble sans danger, il n’existe pas de données probantes en faveur de l’emploi systématique de la mélatonine chez les enfants en bonne santé.

La haute fiabilité en soins de santé: la création d'une culture et d'une mentalité favorisant la sécurité des patients.

PubMed

Cochrane, Bonnie S; Hagins, Mitch; Picciano, Gino; King, John A; Marshall, David A; Nelson, Brian; Deao, Craig

2017-03-01

Les préjudices que subissent les patients recevant des soins de santé représentent un fardeau considérable et peuvent avoir de graves répercussions sur les patients et les familles ainsi que sur la capacité des systèmes de santé de gérer l'accès des patients, leurs déplacements dans le système et les temps d'attente. L'intérêt pour la science de la haute fiabilité, mise au point à l'origine dans des secteurs comme l'aviation commerciale, qui ont un bilan exceptionnel en matière de sécurité, est une nouvelle tendance en soins de santé qui pourrait aider les organisations et les systèmes à atteindre le but ultime : zéro préjudice subi par les patients. Cet article fait valoir que zéro préjudice au patient est un impératif fondamental et que la science de la haute fiabilité peut aider à accélérer et à soutenir les progrès vers ce but vital. Bien que les pratiques utilisées dans d'autres secteurs ne soient pas facilement transférables aux soins de santé et qu'il n'existe pas encore un seul modèle éprouvé pour les organisations à haute fiabilité en santé, des organisations de premier plan commencent à faire la démonstration de stratégies efficaces propres aux soins de santé. L'expérience du réseau international d'organisations partenaires du groupe Studer est utilisée pour illustrer et comprendre ces premiers efforts. Le cadre Evidence-Based Leadership SM (leadership fondé sur les données probantes) du groupe Studer est appliqué dans différents milieux de soins de santé pour transformer la culture et la gestion du changement visant à favoriser une haute fiabilité. Il propose une démarche et des ressources pour progresser vers le but zéro préjudice subi par les patients et tous les avantages liés à l'utilisation efficiente de nos précieuses ressources en soins de santé.

L'émergence de la thérapeutique de précision: de nouveaux défis et de nouvelles possibilités pour les leaders en santé du Canada.

PubMed

Slater, Jim; Shields, Laura; Racette, Ray J; Juzwishin, Donald; Coppes, Max

2015-11-01

À l'ère de la médecine personnalisée et de la médecine de précision, l'approche envers les soins est en rapide mutation. Les cliniciens exigent de plus en plus d'information génétique et moléculaire et les patients s'attendent à la fournir pour la prévention, le dépistage, le diagnostic, le pronostic, la promotion de la santé et le traitement d'un nombre croissant de maladies. Les leaders en santé canadiens doivent comprendre les changements nécessaires liés à ces technologies perturbantes et ouvrir la voie. Le présent article s'attarde sur la thérapeutique de précision, mais contient également de l'information générale sur les concepts et la terminologie liés à la médecine personnalisée et à la médecine de précision. Il explore également le leadership en santé canadien et les problèmes liés au système qui peuvent nuire à leur mise en œuvre. L'article vise à inspirer, informer et mobiliser les leaders en santé canadiens à amorcer un dialogue sur les transformations nécessaires pour préparer le système de santé à profiter des bienfaits de la thérapeutique de précision. © 2015 Collège canadien des leaders en santé

The IL-6 receptor super-antagonist Sant7 enhances antiproliferative and apoptotic effects induced by dexamethasone and zoledronic acid on multiple myeloma cells.

PubMed

Tassone, Pierfrancesco; Galea, Eulalia; Forciniti, Samantha; Tagliaferri, Pierosandro; Venuta, Salvatore

2002-10-01

Interleukin-6 (IL-6) is the major growth and survival factor for multiple myeloma (MM), and has been shown to protect MM cells from apoptosis induced by a variety of agents. IL-6 receptor antagonists, which prevent the assembly of functional IL-6 receptor complexes, inhibit cell proliferation and induce apoptosis in MM cells. We have investigated whether the IL-6 receptor super-antagonist Sant7 might enhance the antiproliferative and apoptotic effects induced by the combination of dexamethasone (Dex) and zoledronic acid (Zln) on human MM cell lines and primary cells from MM patients. Here we show that each of these compounds individually induced detectable antiproliferative effects on MM cells. Sant7 significantly enhanced growth inhibition and apoptosis induced by Dex and Zln on both MM cell lines and primary MM cells. These results indicate that overcoming IL-6 mediated cell resistance by Sant7 potentiates the effect of glucocorticoides and bisphosphonates on MM cell growth and survival, providing a rationale for therapies including IL-6 antagonists in MM.

Comprendre l'influence des facteurs contextuels sur la participation communautaire à la santé : une étude de cas dans le district sanitaire de Tenkodogo, au Burkina Faso.

PubMed

Sombié, Issa; Ilboudo, David O S; Soubeiga, André Kamba; Samuelsen, Helle

2017-09-01

Le Burkina Faso met en œuvre depuis plusieurs années la stratégie de la participation communautaire. Des comités de gestion (CoGes) ont été mis en place dans les centres de santé de la première ligne et doivent participer aux prises de décisions. L'objectif principal de cette stratégie est de favoriser l'utilisation des services de santé et une adhésion massive des communautés aux activités de promotion de la santé. Seulement, on constate que les résultats escomptés par les autorités sanitaires tardent à se réaliser. Le présent article convoque les facteurs liés au contexte socioculturel du district sanitaire, pour analyser le phénomène de la participation communautaire. L'étude s'est déroulée dans le district sanitaire de Tenkodogo, situé dans la région administrative du Centre-est, à environ 190 km de la capitale. Cette étude exclusivement qualitative, a utilisé deux méthodes de collecte : les entretiens individuels et les focus groups. Les participants à l'étude sont les chefs de ménage ( n = 48), les membres des CoGes ( n = 10), les agents de santé ( n = 8) et les agents de santé communautaire ( n = 24). La méthode de l'analyse de contenu a été utilisée pour l'analyse des données. Les résultats de l'étude montrent que plusieurs facteurs socioculturels influencent la dynamique de la participation communautaire dans le district. Ce sont les conditions économiques, la perception négative des services de santé, les inégalités sociales de sexe et d'âge, le faible ancrage social des organisations communautaires, les rivalités inter-villages et les conflits coutumiers. L'étude relève également que les communautés ne perçoivent pas leur implication dans le processus décisionnel des services de santé comme une priorité. Leurs principales attentes s'orientent vers la disponibilité de soins de qualité et à coût réduit.

Taking Account of Gender Differences When Designing Interventions in Occupational Health? Lessons from a Study of the "Healthy Enterprise" Standard in Québec: Les différences de genre sont-elles prises en compte lors de la conception des interventions de prévention en santé au travail? Résultats d une étude sur la norme "Entreprises en Santé" dans les entreprises au Québec.

PubMed

Sultan-Taïeb, Hélène; St-Hilaire, France; Lefebvre, Rébecca; Biron, Caroline; Vézina, Michel; Brisson, Chantal

2017-11-01

The literature shows substantial differences in occupational exposures between men and women, both between and within occupations, but remains very sparse on whether interventions are tailored to gender differences in the workplace. Our objective was to determine whether gender differences are taken into account when designing prevention interventions. This study is part of a project on the evaluation of interventions implemented in the framework of the "Healthy Enterprise" standard in Quebec organizations. Three sets of quantitative and qualitative data were collected in seven organizations and triangulated. Our results show that in the process of elaborating and implementing activities, the main objectives were to reach a maximum number of workers and meet the needs identified in a health and risk diagnosis. Activities were not tailored to the needs of specific subgroups of employees, such as gender or age. Not distinguishing men's and women's situations in this diagnosis may play a role in intervention design. Résumé La littérature montre des différences d'exposition au travail importantes entre les hommes et les femmes, y compris à catégories d'emploi identiques. Les études sur l'adaptation des interventions de prévention aux différences de genre dans les milieux de travail sont quasiment inexistantes dans la littérature. Notre objectif était de déterminer dans quelle mesure les différences de genre sont prises en compte lors de la conception des interventions de prévention. Cette étude fait partie d'un projet d'évaluation des interventions mises en œuvre dans le cadre de la norme «Entreprises en santéé au Québec. Trois séries de données quantitatives et qualitatives ont été collectées auprès de sept organisations et analysées par triangulation. Nos résultats montrent que lors du processus d'élaboration des activités, les principaux objectifs étaient d'atteindre un nombre maximal de travailleurs et de remplir les besoins identifi

Projet de classification de spectres stellaires IUE à basse résolution par système expert.

NASA Astrophysics Data System (ADS)

Imadache, A.

Le project d'étude porte sur l'utilisation de l'intelligence artificielle en vue d'établir une classification de spectres IUE. Pour la réalisation de ce projet, des liens de collaboration ont été établis entre l'Observatoire Astronomique de Strasbourg et l'équipe ST-ECF à l'ESO.

Les biofilms bactériens : leur importance en santé animale et en santé publique

PubMed Central

Tremblay, Yannick D.N.; Hathroubi, Skander; Jacques, Mario

2014-01-01

Résumé Les biofilms bactériens sont des amas structurés de cellules bactériennes enrobés d’une matrice polymérique et attachés à une surface. Le biofilm protège les bactéries et leur permet de survivre dans des conditions environnementales hostiles. Les bactéries du biofilm peuvent résister à la réponse immunitaire de l’hôte et sont beaucoup plus résistantes aux antibiotiques et aux désinfectants que les cellules bactériennes planctoniques. La capacité de former un biofilm est maintenant reconnue comme une caractéristique propre à plusieurs microorganismes. La présence de biofilms lors d’infections demande donc de nouvelles méthodes de prévention, de diagnostic et de traitement. De même, la présence de biofilms sur des surfaces retrouvées à la ferme, à l’abattoir ou à l’usine de transformation affectera l’efficacité du protocole de désinfection. De façon surprenante, la formation de biofilms chez les bactéries pathogènes des animaux et les bactéries zoonotiques est un sujet relativement peu étudié. Ce bref compte rendu a pour objectif de sensibiliser les intervenants en santé animale à l’importance des biofilms. PMID:24688172

The Van Sant AVHRR image projected onto a rhombicosidodecahedron

NASA Astrophysics Data System (ADS)

Baron, Michael; Morain, Stan

1996-03-01

IDEATION, a design and development corporation, Santa Fe, New Mexico, has modeled Tom Van Sant's ``The Earth From Space'' image to a rhombicosidodecahedron. ``The Earth from Space'' image, produced by the Geosphere® Project in Santa Monica, California, was developed from hundreds of AVHRR pictures and published as a Mercator projection. IDEATION, utilizing a digitized Robinson Projection, fitted the image to foldable, paper components which, when interconnected by means of a unique tabular system, results in a rhombicosidodecahedron representation of the Earth exposing 30 square, 20 triangular, and 12 pentagonal faces. Because the resulting model is not spherical, the borders of the represented features were rectified to match the intersecting planes of the model's faces. The resulting product will be licensed and commercially produced for use by elementary and secondary students. Market research indicates the model will be used in both the demonstration of geometric principles and the teaching of fundamental spatial relations of the Earth's lands and oceans.

Activités physiques libres ou encadrées et condition physique liée à la santé chez des adultes burundais: étude transversale

PubMed Central

Bizimana, Jean Berchmans; Lawani, Mansourou Mohamed; Akplogan, Barnabé; Gaturagi, Charles

2016-01-01

Introduction l’activité physique régulière a un impact positif sur la santé. Cette étude a pour objet de comparer la condition physique liée à la santé des adultes qui s’exercent librement avec celle des adultes bénéficiant d’un encadrement professionnel. Elle tente aussi d’établir une relation entre le niveau d’activité physique et les paramètres de la condition liée à la santé. Méthodes nous avons évalué le niveau d’activité physique et les paramètres de la condition physique liée à la santé. Par le test t pour échantillons indépendants, nous avons comparé les moyennes et avons par le calcul du coefficient de corrélation r de Pearson analysé la relation entre le niveau d’activité physique et les paramètres de la condition physique. Résultats des écarts significatifs (p < 0,05) de niveau d’activité physique, de souplesse, de V˙O2max et de la FC de repos ont été enregistrés en faveur du groupe encadré. Le niveau d’activité physique est positivement corrélé (p < 0,05) au V˙O2max et à la force de préhension mais négativement corrélé à la FC de repos et au cholestérol LDL. La prévalence des facteurs de risque cardiovasculaire n’est pas élevée excepté pour le cholestérol HDL. Conclusion les résultats de cette étude montrent que l’activité physique libre est aussi efficace que l’activité physique encadrée dans le maintien des profils lipidique et physiologique favorables à la santé chez l’adulte burundais. Cependant, l’activité physique encadrée apporte des bénéfices supplémentaires pour le V˙O2max, la fréquence cardiaque de repos, la souplesse antérieure et la détente verticale PMID:28203315

[A qualitative study to validate the Work and Career (Santé et Itinéraire Professionnel) statistical survey: principles and methods].

PubMed

Guiho-Bailly, Marie-Pierre; Roquelaure, Yves

2013-01-01

The population-based survey "Santé et itinéraire professionnel" (SIP) aims to investigate the relationship between health and career. A qualitative study was conducted to identify potential biases in the design of the questionnaire. The Laboratoire d'ergonomie et d'épidémiologie en santé au travail (research center on "Ergonomics and Epidemiology in Occupational Health" based at the University of Angers, France) recently conducted a study entitled "Rapport subjectif au travail, sens des trajets professionnels et construction de la santé" ("The subjective perception of work, career paths and the construction of health"). Individual interviews were conducted with thirty survey respondents (irrespective of whether they had reported any health problems or established a link between a health event and their career path) by two experts in the psychodynamics of work. The analysis of the clinical and statistical data involved four stages: a study of an initial test case, a comparison of monographs and reports drawn up by the DREES/DARES, an analysis of questionnaire responses, and an analysis of thirty monographs. MAIN RESULTS AND DISCUSSION: After an examination of the results in relation to sample composition and the method used, the study shows that the relationship between health and career is not overestimated, but also indicates that psychological and musculoskeletal disorders and "minor" work accidents tend to be underreported. The study also found a loss of information about professional mobility as a way of maintaining health. Based on a qualitative approach to validation, the proposed method provides a basis for assessing the design of the questionnaire and provides reference points for data interpretation and the direction of future research.

Profil épidémiologique et clinique de la tuberculose dans la zone de santé de Lubumbashi (RD Congo)

PubMed Central

Ngama, Christian Kakisingi; Muteya, Michel Manika; Lukusha, Yves Isango Idi; Kapend, Serge Matanda; Tshamba, Henri Mundongo; Makinko, Paul Ilunga; Mulumba, Claude Mwamba; Kalala, Liévin Kapend a

2014-01-01

Introduction L'objectif de notre travail était de déterminer la distribution sociodémographique des patients tuberculeux, les types de tuberculose en fonction de la localisation de la maladie et déterminer l'issue thérapeutique des patients en fonction de différentes localisations. Méthodes C'est une étude descriptive transversale des patients diagnostiqués et traités pour tuberculose du 1er Janvier 2010 au 30 Juin 2011 dans la zone de santé de Lubumbashi. Une de 11 zones de santé du District de Lubumbashi dans la province du Katanga(RD Congo). Ont été inclus tous les patients tuberculeux de nationalité congolaise consultés dans la zone de santé pendant la période d’étude. L’âge, le sexe, la commune de résidence, le tableau clinique à la première consultation et les résultats des examens de laboratoire des crachats par la coloration Ziehl-Neelsen ont été les paramètres d'analyse. Résultats Nous avons enregistré 708 patients tuberculeux soit une prévalence de 0.5%. Le sexe masculin représentait 58.78% contre 41.25% de sexe féminin avec un sexe ratio de 1.42 en faveur du sexe masculin. La moyenne d’âge était de 33±;15 ans. La majorité des patients soit 54.79 appartiennent à la tranche d’âge entre 21 et 40 ans. La tuberculose extra pulmonaire a représenté 51.8% contre 50.2% de tuberculose pulmonaire dont 31.9% à bacilloscopie positive. Le décès a intéressé les patients bacillifères puis qu'il y a 5 fois plus de décès liés à une tuberculose pulmonaire à microscopie positive qu'aux autres formes de tuberculose (OR (IC 95%): 5.27 (2.92-9.59, p = 0.00). La majorité des patients résidaient les communes Lubumbashi (41.7%) et Kampemba (23.2%). Conclusion La tuberculose extrapulmonaire (pleurale) a été plus rencontrée que la tuberculose pulmonaire et c'est cette dernière forme de tuberculose qui a entrainé beaucoup plus de décès. Ce qui nécessite une amélioration du système de santé de prise en charge des

Violences conjugales à Antananarivo (Madagascar): un enjeu de santé publique

PubMed Central

Gastineau, Bénédicte; Gathier, Lucy

2012-01-01

Introduction La violence conjugale a été étudiée dans beaucoup de pays développés mais peu en Afrique subsaharienne. Madagascar est un pays où ce phénomène est peu documenté. Méthodes En 2007, une enquête sur la violence conjugale à Antananarivo (ELVICA) a été menée sur la violence conjugale envers les femmes dans la capitale malgache. ELVICA a interrogé 400 femmes en union, de 15 à 59 ans. Des informations sur les caractéristiques démographiques, socioéconomiques des couples ont été collectées ainsi que sur les actes de violences physiques des hommes sur leurs épouses. L’objectif de cet article est d’identifier les facteurs de risques de la violence conjugale grave, celle qui a des conséquences sur la santé physique des femmes. Résultats Trente-cinq pour cent des femmes qui ont déclaré avoir subi au moins une forme de violence physique au cours des 12 mois précédent l’enquête. Presque la moitié (46%) des femmes violentées ont déclaré avoir déjà eu des hématomes, et environ un quart (23%) des plaies avec saignement. Vingt-deux pour cent ont déjà dû consulter un médecin. Parmi les nombreuses variables socioéconomiques et démographiques testées, quelques-unes sont associées positivement au risque de violence conjugale grave: le fait pour une femme d’être en union consensuelle et d’avoir une activité professionnelle. Il y aussi un lien entre la violence subie et l’autonomie des femmes (liberté accordée par le mari de travailler, de circuler, de voir sa famille). Conclusion A Madagascar, comme ailleurs, la lutte contre les violences conjugales est un élément majeur de l’amélioration du statut et de la santé des femmes. PMID:22514757

Evaluation of a Web-based tailored intervention (TAVIE en santé) to support people living with HIV in the adoption of health promoting behaviours: an online randomized controlled trial protocol.

PubMed

Côté, José; Cossette, Sylvie; Ramirez-Garcia, Pilar; De Pokomandy, Alexandra; Worthington, Catherine; Gagnon, Marie-Pierre; Auger, Patricia; Boudreau, François; Miranda, Joyal; Guéhéneuc, Yann-Gaël; Tremblay, Cécile

2015-10-12

Long-term use of antiretroviral therapy, normal aging, and presence of certain risk factors are associated with metabolic disorders that predispose persons living with HIV to diabetes and cardiovascular diseases. The emergence and progression of these disorders can be prevented by adopting healthy behaviours. Based on the theory of planned behaviour, the Web-based tailored intervention TAVIE en santé was developed. The aim of this study is to evaluate the effectiveness of TAVIE en santé in order to support people living with HIV in the adoption of health promoting behaviours. An online randomized controlled trial with parallel-groups will be conducted across Canada. To participate in this study, people living with HIV must be: ≥ 18 years, able to read/understand French or English, have access to the Internet. A convenience sample of 750 participants will be randomly assigned either to an experimental group (TAVIE en santé, n = 375) or to a control group (websites, n = 375) (1:1 allocation ratio). The TAVIE en santé intervention is composed of seven interactive computer sessions, lasting between 5 and 10 min. The sessions, hosted by a virtual nurse, aim to develop and strengthen skills required for behaviour change. The control group will receive a validated list of five predetermined conventional health-related Websites. The adoption of health behaviour (smoking cessation or physical activity or healthy eating) is the principal outcome. Cognitions (intention, attitude, perceived behavioral control) are the secondary outcomes. Health indicators will also be assessed. All outcomes will be measured with a self-administered online questionnaire and collected three times: at baseline, 3 and 6 months after. The principal analyses will focus on differences between the two trial groups using Intention-to-Treat analysis. This study will yield new results about the efficacy of Web-based tailored health behaviours change interventions in the context of chronic

Les expériences de victimisation, la santé mentale et le bien-être de jeunes trans au Québec

PubMed Central

Raymond, Guillaume; Blais, Martin; Bergeron, Félix-Antoine; Hébert, Martine

2016-01-01

Résumé Les normes traditionnelles de genre prescrivent l’adéquation de l’expression de la masculinité et de la féminité au sexe anatomique de naissance. Les personnes qui présentent des variations dans l’expression de genre sont sujettes à diverses formes de réactions sociales suggérant la réprobation (des regards désapprobateurs aux violences physiques) susceptibles d’influencer négativement leur santé mentale. Trente-sept (37) jeunes se décrivant comme trans ou en questionnement sur leur identité de genre ont été recrutés dans le cadre de l’enquête sur les Parcours Amoureux des Jeunes de minorités sexuelles du Québec. Leurs expériences de victimisation parentale et de victimisation basée sur la non-conformité de genre ainsi que des indicateurs de santé mentale (détresse psychologique, estime de soi) ont été mesurés. Afin de comparer les expériences de victimisation et l’état de santé mentale des jeunes trans, ils ont été appariés à 37 garçons et 37 filles cisgenres sur la base de leurs caractéristiques sociodémographiques. Des analyses de prévalence et un modèle acheminatoire ont été réalisés. Les résultats mettent en évidence que les jeunes trans sont plus susceptibles de présenter des scores cliniques de détresse psychologique et de faible estime d’eux-mêmes que leurs pairs cisgenres. La violence verbale parentale et la victimisation basée sur la non-conformité de genre influencent négativement l’estime de soi, ce qui en retour augmente la probabilité de vivre de la détresse psychologique. Les résultats appuient l’importance des interventions de soutien à la diversité sexuelle et de genre. PMID:26966849

L’offre des services de vaccination en milieu urbain, au Cameroun: étude de cas du District de Santé de Djoungolo

PubMed Central

Ngomba, Armelle Viviane; Kollo, Basile; Bita, André Fouda; Djouma, Fabrice Nembot; Edengue, Jean Marie; Elongue, Marie Josée; Adiogo, Dieudonné

2016-01-01

Introduction Les métropoles camerounaises concentrent un nombre croissant d'enfants cibles, non atteints par les services de vaccination de routine. Méthodes Une étude transversale descriptive, basée sur échantillonnage exhaustif des formations sanitaires légales offrant en routine des services de vaccination a été réalisée dans le district de santé de Djoungolo, (ville de Yaoundé). L'évaluation de l'offre des services de vaccination a été calquée sur l'approche « Atteindre Chaque District ». Résultats Des 70 formations sanitaires ayant participé à l'étude, 3 (4,3%) disposaient d'un micro plan actualisé pour la vaccination de routine. Des 63 (89,4%) formations sanitaires possédant un réfrigérateur fonctionnel, 12 (19,0%) vaccinaient au quotidien en stratégie fixe. Cinquante-sept (81,0%) formations sanitaires ne conduisaient pas des sessions de vaccination en stratégies avancées. La participation des membres de la communauté aux activités de vaccination de routine étaient effective dans 1 aire de santé sur les 12 que compte le district. Une courbe de suivi des couvertures vaccinales correctement renseignée étaient disponible dans 6 (8,5%) formations sanitaires. Conclusion L'approche « Atteindre Chaque District » telle que mise en œuvre dans le district de santé de Djoungolo limite l'atteinte d'un maximum d'enfants cibles. L'effectivité d'une micro planification réaliste, la régularité des sessions de vaccination en stratégie fixes et avancées, le suivi des données orienté vers l'action, la redynamisation communautaire en faveur de la vaccination sont des voies d'amélioration des prestations des services de vaccination, dans ce district. PMID:28292168

Les perceptions des femmes tunisiennes selon le modèle des croyances liées à la santé et leurs pratiques relativement à l'ostéoporose

PubMed Central

Belgacem, Amina; Nouira, Amel; Soussi, Sonia

2016-01-01

Introduction L'étude a pour objectif de décrire les croyances des femmes et leurs pratiques liées à la santé et à l'ostéoporose, afin d'élaborer des interventions efficaces et ciblées pour la prévention de cette maladie dans le contexte tunisien. Méthodes Une étude descriptive transversale a été effectuée auprès de 100 femmes tunisiennes, âgées de 45 ans et plus, qui consultent au centre de santé de base d'une zone périurbaine de la région de Sousse (Tunisie). La collecte de l'information a été réalisée à l'aide de « l'échelle des croyances relatives à la santé sur l'ostéoporose» développée par Kim et ses collègues traduit en arabe et validé en Tunisie et le questionnaire de «Calcul des apports calciques quotidiens» développé par Fardellone Patrice. L'interprétation des résultants s'est basée sur le «Health Belief Model ». Résultats La perception des participantes pourrait être considérée comme au dessus de la moyenne pour la vulnérabilité de l'ostéoporose (58%), la gravité de la maladie, les avantages de la pratique de l'activité physique, les avantages de l'apport en calcium et la motivation à la santé; par contre, elle pourrait être considérée comme modérée concernant les obstacles à la prévention. Cependant, les pratiques exposant au risque de la maladie sont relativement fréquentes et ceci essentiellement en rapport avec des facteurs socio-économiques et culturels. Conclusion Les programmes de promotion doivent viser la création d'un environnement physique et social favorable à l'adoption des comportements à moindre risque et viser l'éducation ciblée de la population. PMID:27217868

Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV.

PubMed

Côté, José; Cossette, Sylvie; Ramirez-Garcia, Pilar; Rouleau, Geneviève; Auger, Patricia; Boudreau, François; Gagnon, Marie-Pierre

2017-01-01

Background . In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé , to support people living with HIV in the adoption of healthy behaviors. Methods . This intervention was developed through an Intervention Mapping (IM) framework and is based on the theory of planned behavior. Results . Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients). The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention), the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion . TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge.

Improving Health and Reducing Comorbidity Associated with HIV: The Development of TAVIE en santé, a Web-Based Tailored Intervention to Support the Adoption of Health Promoting Behaviors among People Living with HIV

PubMed Central

Cossette, Sylvie; Ramirez-Garcia, Pilar; Rouleau, Geneviève; Auger, Patricia; Boudreau, François; Gagnon, Marie-Pierre

2017-01-01

Background. In the domain of health behavior change, the deployment and utilization of information and communications technologies as a way to deliver interventions appear to be promising. This article describes the development of a web-based tailored intervention, TAVIE en santé, to support people living with HIV in the adoption of healthy behaviors. Methods. This intervention was developed through an Intervention Mapping (IM) framework and is based on the theory of planned behavior. Results. Crucial steps of IM are the selection of key determinants of behavior and the selection of useful theory-based intervention methods to change the targeted determinants (active ingredients). The content and the sequence of the intervention are then created based on these parameters. TAVIE en santé is composed of 7 interactive web sessions hosted by a virtual nurse. It aims to develop and strengthen skills required for behavior change. Based on an algorithm using individual cognitive data (attitude, perceived behavioral control, and intention), the number of sessions, theory-based intervention methods, and messages contents are tailored to each user. Conclusion. TAVIE en santé is currently being evaluated. The use of IM allows developing intervention with a systematic approach based on theory, empirical evidence, and clinical and experiential knowledge. PMID:28393077

Hysteroscopic diagnosis of uterine sarcomas at the Department of Gynaecology, Sant Joan de Déu University Hospital.

PubMed

Gonzalez-Bosquet, E; Suñol, M; Torralba, A; Lozada, C; Miñano, J; Lailla, J M

2011-01-01

Uterine sarcomas are rare and the clinical diagnosis of sarcoma is difficult. Diagnostic and surgical hysteroscopy is a minimally invasive outpatient procedure that makes an accurate diagnosis of malignant intrauterine pathology and could play a role in the diagnosis of the uterine sarcomas. Uterine sarcomas diagnosed at the Department of Gynecology of Sant Joan University Hospital by hysteroscopy between January 2004 and August 2010 are described. In this period 2,441 hysteroscopies were performed; a total of 67 adenocarcinomas of the endometrium and five sarcomas were diagnosed by hysteroscopy. The data are presented with a review of the literature, focusing on the diagnostic value of hysteroscopy in these tumors.

Promoting physical activity, healthy eating and gross motor skills development among preschoolers attending childcare centers: Process evaluation of the Healthy Start-Départ Santé intervention using the RE-AIM framework.

PubMed

Ward, Stéphanie; Chow, Amanda Froehlich; Humbert, M Louise; Bélanger, Mathieu; Muhajarine, Nazeem; Vatanparast, Hassan; Leis, Anne

2018-06-01

The Healthy Start-Départ Santé intervention was developed to promote physical activity, gross motor skills and healthy eating among preschoolers attending childcare centers. This process evaluation aimed to report the reach, effectiveness, adoption, implementation and maintenance of the Healthy Start-Départ Santé intervention. The RE-AIM framework was used to guide this process evaluation. Data were collected across 140 childcare centers who received the Healthy Start-Départ Santé intervention in the provinces of Saskatchewan and New Brunswick, Canada. Quantitative data were collected through director questionnaires at 10 months and 2 years after the initial training and analyzed using descriptive statistics. Qualitative data were collected throughout the intervention. The intervention was successful in reaching a large number of childcare centres and engaging both rural and urban communities across Saskatchewan and New Brunswick. Centres reported increasing opportunities for physical activity and healthy eating, which were generally low-cost, easy and quick to implement. However, these changes were rarely transformed into formal written policies. A total of 87% of centers reported using the physical activity resource and 68% using the nutrition resource on a weekly basis. Implementation fidelity of the initial training was high. Of those centers who received the initial training, 75% participated in the mid-point booster session training. Two year post-implementation questionnaires indicated that 47% of centers were still using the Active Play Equipment kit, while 42% were still using the physical activity resource and 37% were still using the nutrition resource. Key challenges to implementation and sustainability identified during the evaluation were consistent among all of the REAIM elements. These challenges included lack of time, lack of support from childcare staff and low parental engagement. Findings from this study suggest the implementation of

Le leadership en santé et la philosophie appliquée : une ressource essentielle.

PubMed

Fistein, Elizabeth; Malloy, David Cruise

2017-07-01

En qualité de professionnels de la santé, nous sommes déterminés à assurer l'exploitation efficiente et efficace de nos établissements. Les outils dont nous disposons sont les structures bureaucratiques, les règles, les règlements, les politiques et, bien sûr, les mesures. Il n'y a rien de foncièrement pernicieux à avoir des établissements efficients, efficaces et mesurés, mais nous soutenons que l'humanité et l'authenticité manquent cruellement dans cet environnement, au prix d'un travail significatif. Les solutions que nous proposons appartiennent au milieu de la philosophie, et particulièrement au secteur qui repose sur des principes fondamentaux : qu'est-ce qu'une infirmière, qu'est-ce qu'un patient, qu'est-ce qu'un hôpital?

[Choroid plexus tumours in childhood: Experience in Sant Joan de Déu hospital].

PubMed

Del Río-Pérez, Clara Maria; Suñol-Capella, Mariona; Cruz-Martinez, Ofelia; Garcia-Fructuoso, Gemma

2016-01-01

Choroid plexus tumours are rare, with a peak incidence in the first two years of life. The most common location is the lateral ventricle in children, while in adults it is the fourth ventricle. The most common clinical manifestation is the signs and symptoms of intracranial hypertension. They are histologically classified as plexus papilloma, atypical plexus papilloma, and plexus carcinoma. A review is presented on choroid plexus tumours treated in the Hospital Sant Joan de Déu between 1980 and 2014. A total of 18 patients have been treated. An analysis was made of the demographic, clinical, histological data, treatment, and recurrences. The treatment of choice is complete resection, accompanied by adjuvant therapy in carcinomas. In atypical papillomas, the use of adjuvant therapies is controversial, reserving radiation therapy for recurrences. Papillomas have a good outcome, whereas atypical papillomas and carcinomas outcome is poor. Copyright © 2015 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

Dietary intakes and diet quality according to levels of organic food consumption by French adults: cross-sectional findings from the NutriNet-Santé Cohort Study.

PubMed

Baudry, Julia; Allès, Benjamin; Péneau, Sandrine; Touvier, Mathilde; Méjean, Caroline; Hercberg, Serge; Galan, Pilar; Lairon, Denis; Kesse-Guyot, Emmanuelle

2017-03-01

We aimed to assess dietary profiles of adults from the NutriNet-Santé cohort according to different levels of organic food consumption using detailed self-reported data on organic food intakes. Food intakes were obtained using an organic food frequency questionnaire (Org-FFQ). The participants were ranked into five groups (quintiles, Q) according to the proportion of organic foods in their diet. To determine diet quality, two scores were computed reflecting adherence to food-based recommendations (mPNNS-GS) and the probability of adequate nutrient intake (PANDiet). Relationships between levels of organic food consumption and dietary characteristics were assessed using multivariable-adjusted ANCOVA models. The NutriNet-Santé Study. French adults from the NutriNet-Santé Study (n 28 245). Intakes of foods of plant origin increased along with the contribution of organic foods to the diet while a reverse trend was identified for dairy products, cookies and soda (P-trend<0·0001). The diet quality scores increased from Q1 (mPNNS-GS, 7·89 (se 0·02); PANDiet: 63·04 (se 0·11)) to Q5 (mPNNS-GS, 8·78 (se 0·02); PANDiet, 69·37 (se 0·10)). Overall, high organic food consumers exhibited better diet quality, although intermediate organic food consumers showed better adherence to specific nutritional recommendations related to animal products. The study provides new insights into the understanding of organic food consumption as a part of a healthy diet and sheds some light on the dietary profiles of different categories of organic food consumers. These results underline strong dietary behaviour correlates associated with organic food consumption that should be controlled for in future aetiological studies on organic foods and health.

NATO Force Health Protection Requirements from Pre- to Post-Deployment: Population Health for the Military (Les besoins des forces de l’OTAN en matiere de soins de sante du pre-deploiement jusqu’au post-deploiement: la sante des populations militaires)

DTIC Science & Technology

2003-12-01

la dangerosité résultant d’un certain niveau d’exposition à un agent, ainsi que l’estimation des effets sur les populations après une exposition...grand que ce que peut accepter la société. 5) La phase de contrôle du risque se focalise sur les différentes mesures à prendre afin soit « de... les sections précédentes. Sur base de ce schéma, on peut envisager une stratégie globale de gestion des risques de santé au sein des Forces Armées

The copy of the Essays of Jean Rey, used by Bayen and Gobet, at the BIU Sante, pole Pharmacie.

PubMed

Lafont, Olivier

2016-06-01

The copy of the innovative book written by Jean Rey in 1630, entitied : The Essays on the reasons why the weight of stain and lead increased when they were burnt, which is nowadays kept in the BIU Sante, pole Pharmacie, proved to be the authentic copy which had been used by Pierre Bayer when he rediscovered Jean Rey's Works. It was also the same copy that Gobey used when he real- ized his new edition of the Essays in 1777. This copy first belonged to M. de Villars from La Rochelle, and then was acquired by M. de Villiers, who accepted to lend it to Bayen. The probes for this identification were detailed in the article.

Déterminants de l'utilisation des méthodes contraceptives dans la zone de santé Mumbunda à Lubumbashi, République Démocratique du Congo

PubMed Central

Matungulu, Charles Matungulu; Kandolo, Simon Ilunga; Mukengeshayi, Abel Ntambue; Nkola, Angèle Musau; Mpoyi, Dorcas Ilunga; Mumba, Sylvie Katanga; Kabamba, Julie Ndayi; Cowgill, Karen; Kaj, Françoise Malonga

2015-01-01

Introduction Augmenter la prévalence contraceptive s'incarne dans les objectifs des tous les acteurs des programmes qui visent de réduire la mortalité maternelle et infantile, d'améliorer la santé reproductive des adolescents, de lutter contre le VIH/SIDA et les infections sexuellement transmissible (IST), de promouvoir le bien-être familial et de ralentir la croissance démographique. L'objectif de cette étude était de déterminer la prévalence contraceptive moderne et identifier les facteurs qui sont liés à l'utilisation des méthodes contraceptives dans la zone de santé de Mumbunda. Méthodes Une étude transversale à visé analytique a été effectuée auprès des femmes âgées de 15 à 49 ans en union maritale, de Mai à Juin 2014. Grâce à un questionnaire pré testé et validé, nous avons récolté les données par interview sur les caractéristiques sociodémographiques, obstétricales ainsi que sur la pratique contraceptive. Le logiciel SPSS version 21 nous a permis d'analyser les données. Résultats Au total 500 femmes ont été incluses dans cette étude dont l’âge moyen était de 27,9±6,1 ans. La prévalence contraceptive moderne était de 27,6%. L'attitude (ORa= 4,79; IC95%: 1,59-14,43; p<0,001), le niveau de connaissance des méthodes contraceptives (ORa=1,87; IC95%: 1,22-2,87; p<0,001), le soutien du conjoint (ORa=1,87; IC95%: 1,22-2,87; p<0,001) étaient significativement associés à l'utilisation des méthodes contraceptives modernes. Conclusion Tout effort d'augmentation de la prévalence contraceptive devrait cibler l'attitude, le niveau de connaissance de méthodes et le soutien du conjoint afin d'optimiser l'utilisation de la contraception moderne dans la zone de santé (ZS) Mumbunda. PMID:26977237

A multilevel intervention to increase physical activity and improve healthy eating and physical literacy among young children (ages 3-5) attending early childcare centres: the Healthy Start-Départ Santé cluster randomised controlled trial study protocol.

PubMed

Bélanger, Mathieu; Humbert, Louise; Vatanparast, Hassan; Ward, Stéphanie; Muhajarine, Nazeem; Chow, Amanda Froehlich; Engler-Stringer, Rachel; Donovan, Denise; Carrier, Natalie; Leis, Anne

2016-04-12

Childhood obesity is a growing concern for public health. Given a majority of children in many countries spend approximately 30 h per week in early childcare centers, this environment represents a promising setting for implementing strategies to foster healthy behaviours for preventing and controlling childhood obesity. Healthy Start-Départ Santé was designed to promote physical activity, physical literacy, and healthy eating among preschoolers. The objectives of this study are to assess the effectiveness of the Healthy Start-Départ Santé intervention in improving physical activity levels, physical literacy, and healthy eating among preschoolers attending early childcare centers. This study follows a cluster randomized controlled trial design in which the childcare centers are randomly assigned to receive the intervention or serve as usual care controls. The Healthy Start-Départ Santé intervention is comprised of interlinked components aiming to enable families and educators to integrate physical activity and healthy eating in the daily lives of young children by influencing factors at the intrapersonal, interpersonal, organizational, community, physical environment and policy levels. The intervention period, spanning 6-8 months, is preceded and followed by data collections. Participants are recruited from 61 childcare centers in two Canadian provinces, New Brunswick and Saskatchewan. Centers eligible for this study have to prepare and provide meals for lunch and have at least 20 children between the ages of 3 and 5. Centers are excluded if they have previously received a physical activity or nutrition promoting intervention. Eligible centers are stratified by province, geographical location (urban or rural) and language (English or French), then recruited and randomized using a one to one protocol for each stratum. Data collection is ongoing. The primary study outcomes are assessed using accelerometers (physical activity levels), the Test of Gross Motor

Facteurs de risque de l'infection par le VIH dans le district de santé de Meyomessala au Cameroun

PubMed Central

Mbopi-Keou, Francois-Xavier; Nguefack-Tsague, Georges; Kalla, Ginette Claude Mireille; Abessolo, Stéphanie Abo'o; Angwafo, Fru; Muna, Walinjom

2014-01-01

Introduction L'objectif de ce travail était de déterminer les facteurs de risque de l'infection par le VIH dans le district de santé de Meyomessala (Région du Sud) au Cameroun. Méthodes Il s'agissait d'une étude transversale, descriptive et analytique qui s'est déroulée de Février à Mai 2011. Pour cette étude, nous avons obtenu une clairance éthique. Résultats L’échantillon était constitué de 315 participants dont 181 (57,46%) hommes et 134 (42,54%) femmes. L’âge moyen était de 24,5±8ans (extrême: 15-45ans). Quarante personnes (40) étaient séropositifs, soit une prévalence de l'infection par le VIH de 12,7%. Cette prévalence augmentait significativement (p = 0) avec le nombre de partenaires occasionnels au cours des douze derniers mois, allant de 2,7% chez ceux n'ayant eu aucun partenaire occasionnel à 21,25% chez ceux ayant plus de trois partenaires occasionnels (RC = 9,72; IC = 1,27-74,14; P = 0,03). le fait d’être âgé entre 20 et 24 ans (RC = 4,88; IC = 1,74-13,67; p = 0), avoir plus de trois partenaires sexuels au cours des douze derniers mois (RC = 9,72; IC = 1,27-74,14; p = 0,03), avoir les rapports sexuels avec les prostitués (RC = 2,86; IC = 1,42-5,76; p = 0), avoir eu le chlamydia (RC = 3,00; IC = 1,07-8,39; p = 0,04), avoir eu la syphilis (RC = 3,35; IC = 1,57-7,14; p = 0), avoir des avantages sociaux lors du premier rapport sexuel (RC = 2,57; IC = 1,03-6,43; p = 0,04) constituaient des potentiels facteurs de risque du VIH. Conclusion Il apparait urgent d'intensifier les campagnes de sensibilisation au risque d'infection par le VIH et les maladies sexuellement transmissibles dans le district de santé de Meyomessala PMID:25419299

Sante De Sanctis (1862-1935), a forerunner of the 20th century research on sleep and dreaming.

PubMed

Foschi, Renato; Lombardo, Giovanni Pietro; Morgese, Giorgia

2015-01-01

This article aims to reconstruct the elements of continuity and/or discontinuity in Sante De Sanctis' (1862-1935) contributions in the scientific understanding of sleep and dreaming as compared to the scientific research of his time. An Italian psychologist and psychiatrist, De Sanctis, in his work conducted between the 19th and 20th centuries, has framed the study of dreams using multi-methodology. In addition, De Sanctis experimentally established the correspondence between the deep and desynchronization phases of sleep with respect to dreaming. In this context, De Sanctis' subjects described the periodicity of sleep and consciousness, influencing the explanations of the themes that modern sleep research has, after decades, systematically studied. We demonstrate that De Sanctis' work has been underestimated, and in our opinion, deserves to be reconsidered as a source of the psychophysiological explanation of dreams and sleep. Finally, we present a graphical representation of De Sanctis' psycho- and neurophysiological model of dreaming. Copyright © 2014 Elsevier B.V. All rights reserved.

Utilisation des méthodes contraceptives modernes en République Démocratique du Congo: prévalence et barrières dans la zone de santé de Dibindi à Mbuji-Mayi

PubMed Central

Ntambue, Abel Mukengeshayi; Tshiala, Rachel Ngalula; Malonga, Françoise Kaj; Ilunga, Tabitha Mpoyi; Kamonayi, Josaphat Mulumba; Kazadi, Simon Tshimankinda; Matungulu, Charles Matungu; Musau, Angel Nkola; Mulamba, Diese; Dramaix-Wilmet, Michèle; Donnen, Philippe

2017-01-01

Introduction l’objectif de cette étude était de déterminer la prévalence contraceptive moderne et les barrières à l’utilisation des méthodes contraceptives modernes chez les couples de la Zone de Santé Dibindi, à Mbuji-Mayi en République Démocratique du Congo. Méthodes de Mai à Juin 2015, nous avons réalisé une étude descriptive transversale. Nous avons inclus les femmes âgées de 15 à 49 ans, en union maritale, non enceinte au moment de l’enquête, qui habitaient la Zone de santé Dibindi depuis deux ans et ayant consenti librement de participer à l’étude. La collecte des données a été réalisée par interview libre des femmes. La prévalence contraceptive moderne se référait aux femmes en cours d’utilisation, au moment de l’enquête, des contraceptifs modernes. La comparaison des proportions a été réalisée au seuil de signification de 5%. Le test de Bonferroni a été utilisé pour comparer, deux à deux, les proportions des barrières à l’utilisation des contraceptifs modernes. Résultats la prévalence contraceptive moderne à Dibindi, en 2015, était de 18,4%. Elle était faible eu égard aux services de planification familiale disponibles dans cette Zone de santé. Plusieurs femmes refusaient d’utiliser les méthodes contraceptives modernes malgré l’information dont elles disposaient à cause de leur désir de maternité, l’interdiction religieuse, l’opposition du conjoint et la crainte des effets secondaires. Conclusion l’information suffisante et centrée sur chaque cliente ou son couple, sur la planification familiale, devrait être renforcée de façon à éliminer les fausses croyances, ce qui accroitrait l’utilisation des méthodes contraceptives modernes. PMID:28674592

Healthy Start - Départ Santé: A pilot study of a multilevel intervention to increase physical activity, fundamental movement skills and healthy eating in rural childcare centres.

PubMed

Froehlich Chow, Amanda; Leis, Anne; Humbert, Louise; Muhajarine, Nazeem; Engler-Stringer, Rachel

2016-10-20

In order to improve healthy behaviours among rural children in their early years, a physical activity and healthy eating intervention (Healthy Start - Départ Santé) was implemented in rural childcare centres throughout Saskatchewan. The objective of the current study was to evaluate the impact of a multimodal physical activity and healthy eating intervention on educators' provision of opportunities for children to improve their physical activity levels, fundamental movement skills and healthy eating behaviours. Six childcare centres (three Francophone and three Anglophone) located in five different rural and semi-rural communities in Saskatchewan participated in this intervention. A total of 69 children with a mean age of 4 years 9 months, and 19 female early childhood educators. Guided by an ecological framework, we implemented a population health controlled intervention, using a wait list control design (48 weeks delayed intervention), and evaluated its impact in rural childcare centres. Mixed methods were employed to determine the effectiveness of the intervention. Overall, educators felt that the intervention supported the provision of physical activity and healthy eating opportunities for children. Increases in children's physical activity levels were reported following the intervention. The lessons learned in this study can be used to improve the Healthy Start - Départ Santé intervention so that its implementation can be effectively expanded to childcare centres within and outside Saskatchewan, in turn, supporting the healthy development of early years (0-5) children in the province and beyond.

First 2 years of Atmospheric CO2 measurements in the Estany Llong plain (2100 masl, Parc Nacional d'Aigüestortes i Estany de Sant Maurici, Pyrenees, Catalonia, Spain).

NASA Astrophysics Data System (ADS)

Curcoll, Roger; Recolons, Montserrat; Font, Anna; Agraz, Laura; Parga, Elena; Bacardit, Montse; Camarero, Lluís.; Pueyo, Salva; Rodó, Xavier; Morguí, Josep Anton

2010-05-01

Since April 2009, air samples are being taken bi-weekly at 10 GMT in the plain of the Estany Llong at 2100 masl. Estany Llong air sampling site (ELL, 42°34'29''N 0°57'17''E) is a remote site situated in the SW principal valley of the Parc Nacional d'Aigüestortes i Estany de Sant Maurici. New Flask-sampling equipment for Remote Mountain Sites was developed by the Institut Català de Ciències del Clima (IC3) to allow flask sampling in extreme weather conditions and carrying the sampling equipment for more than 10 km without damaging flasks. Dry Air analysis for CO2 are done at the Laboratory of IC3 using two coupled modified IRGA Licor-7000, where both pressure and flow are externally controlled. Far away from populated areas, ELL site acts as a remote site, but it is also responding to discrete events as snow melting, summer cattle breeding on pastures and trekking frequentation. Series of CO2 obtained are included as part of Long Term Ecological Research (LTER) at the Parc Nacional d'Aigüestortes i Estany de Sant Maurici. In the long term, these measurements show the mountain ecosystems contribution and geomorphologic influence on the CO2 budget of the air masses crossing a mountain range.

Associations between motives for dish choice during home-meal preparation and diet quality in French adults: findings from the NutriNet-Santé study.

PubMed

Ducrot, Pauline; Méjean, Caroline; Fassier, Philippine; Allès, Benjamin; Hercberg, Serge; Péneau, Sandrine

2017-03-01

A number of motives such as constraints or pleasure have been suggested to influence dish choices during home-meal preparation. However, no study has evaluated how the importance conferred to these motives potentially influence diet quality. The present study aims at investigating the difference in diet quality according to the importance attached by individuals to various dish choice motives. The importance of twenty-seven criteria related to dish choices on weekdays was evaluated among 48 010 French adults from the NutriNet-Santé study. ANCOVA and logistic regression models, adjusted for sociodemographic and lifestyle factors, were used to evaluate the association between the importance attached to dish choice motives (yes v. no) and energy and food group intakes, as well as adherence to French nutritional guidelines (modified Programme National Nutrition Santé-Guideline Score (mPNNS-GS)). A higher adherence to nutritional guidelines was observed in individuals attaching importance to a healthy diet (mPNNS-GS score 7·87 (sd 0·09) v. 7·39 (sd 0·09)) and specific diets (mPNNS-GS score 7·73 (sd 0·09) v. 7·53 (sd 0·09)), compared with those who attached little/no importance (all P<0·0001). These individuals also exhibited higher intakes of fruits and vegetables, but a lower consumption of meat, milk and cheese, sugary products and convenience foods compared with their respective counterparts (all P<0·0001). For other motives, that is, constraints, pleasure and organisation, only small differences were observed. The main difference in diet quality was related to the importance placed on a healthy diet. Although a causal link should be demonstrated, our findings suggested that strategies aiming at enabling people to take into account diet quality during home-meal preparation might be effective levers to promote healthy eating.

The clinical differential approach of Sante De Sanctis in Italian "scientific" psychology.

PubMed

Lombardo, Giovanni Pietro; Cicciola, Elisabetta

2006-01-01

Sante De Sanctis, a psychiatrist and psychologist, is one of the most representative figures of Italian "scientific" psychology. He is considered one of the founders of the discipline as well as one of its main protagonists in the years between the two World Wars. Both with his extensive scientific productions (which include more than three hundred works) and with his uninterrupted institutional activity, he has left his significant mark on the history of Italian psychology. He was the first professor of Experimental Psychology and was internationally known: some of his works have been published in French, Swiss, American, German, Scandinavian, and English journals, and some of his volumes have been translated into English and German. Together with the other psychologists of the second generation (Binet, Külpe, Münsterberg, Stern, Claparède, Ebbinghaus), he was the Italian psychologist who decided to enrich the classical paradigm of Wundt's physiological psychology, by developing during the twentieth century the program of methodological and epistemological enlargement of the discipline. In his fundamental treatise Psicologia Sperimentale, written in 1929-30, a clear modern conception of psychology emerged: it jointly included both the generalist aspect (with some studies on psychophysical proportionality, thought mimicry, dreams, attention, emotions, etc.) and the applicative one, which included psychopathology, labor psychology, educational psychology, and criminal psychology, all seen in a general experimental framework. The present paper aims precisely to highlight the originality of De Sanctis' experimentalism that applied the differential clinical approach to the discipline of psychology, causing it for the first time in Italy to be seen in a unitary way as both general and applied psychology.

Success factors for implementing and sustaining a mature electronic medical record in a low-resource setting: a case study of iSanté in Haiti.

PubMed

deRiel, E; Puttkammer, N; Hyppolite, N; Diallo, J; Wagner, S; Honoré, J G; Balan, J G; Celestin, N; Vallès, J S; Duval, N; Thimothé, G; Boncy, J; Coq, N R L; Barnhart, S

2018-03-01

Electronic health information systems, including electronic medical records (EMRs), have the potential to improve access to information and quality of care, among other things. Success factors and challenges for novel EMR implementations in low-resource settings have increasingly been studied, although less is known about maturing systems and sustainability. One systematic review identified seven categories of implementation success factors: ethical, financial, functionality, organizational, political, technical and training. This case study applies this framework to iSanté, Haiti's national EMR in use in more than 100 sites and housing records for more than 750 000 patients. The author group, consisting of representatives of different agencies within the Haitian Ministry of Health (MSPP), funding partner the Centers for Disease Control and Prevention (CDC) Haiti, and implementing partner the International Training and Education Center for Health (I-TECH), identify successes and lessons learned according to the seven identified categories, and propose an additional cross-cutting category, sustainability. Factors important for long-term implementation success of complex information systems are balancing investments in hardware and software infrastructure upkeep, user capacity and data quality control; designing and building a system within the context of the greater eHealth ecosystem with a plan for interoperability and data exchange; establishing system governance and strong leadership to support local system ownership and planning for system financing to ensure sustainability. Lessons learned from 10 years of implementation of the iSanté EMR system are relevant to sustainability of a full range of increasingly interrelated information systems (e.g. for laboratory, supply chain, pharmacy and human resources) in the health sector in low-resource settings. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene

Surveillance urinaire des professionnels de la santé exposés aux antinéoplasiques dans le cadre de leur travail: revue de la littérature de 2010 à 2015

PubMed Central

Poupeau, Céline; Roland, Christel; Bussières, Jean-François

2016-01-01

RÉSUMÉ Contexte Il existe de plus en plus de données sur la présence de traces de médicaments dangereux dans l’urine des professionnels de la santé exposés à ces médicaments. Objectif Présenter une revue de la littérature scientifique concernant la surveillance urinaire de professionnels de la santé exposés aux anti-néoplasiques dans le cadre de leur travail. Sources de données Recherche sur PubMed avec les Medical Subject Headings (MeSH) « occupational exposure » et « antineoplastic agents » ainsi que sur Google Scholar avec les termes « antineoplastic », « urine » et « occupational exposure ». Sélection des études et extraction des données L’examen a porté sur tous les articles en anglais et en français ayant trait aux professionnels de la santé exposés à des médicaments dangereux dans le cadre de leur travail, publiés entre le 1er janvier 2010 et le 31 décembre 2015. Les articles ne comportant pas de résultats urinaires et ceux concernant les vétérinaires ainsi que les revues de littérature, les éditoriaux, les lettres à la rédaction et les résumés de congrès ont été exclus. Synthèse des données Vingt-quatre articles ont été retenus. Les études ont été menées dans 52 établissements de santé provenant de sept pays. Elles regroupaient 826 travailleurs exposés à des médicaments dangereux et 175 témoins, notamment des infirmiers (n = 16 études), des pharmaciens (n = 10), des assistants techniques en pharmacie (n = 8), des médecins (n = 7), des aides-soignants (n = 2) et autres (n = 8). Différentes méthodes analytiques ont été utilisées pour quantifier la présence de 13 médicaments dangereux, principalement le cyclophosphamide (n = 16 études), les platines (n = 7) et l’alpha-fluoro-béta-alanine, un métabolite urinaire du 5-fluorouracile (n = 3). La proportion de travailleurs qui ont étés déclarés positifs s’étendait de 0 % (n = 10 études) à 100 % (n = 4). Si l’on ne retient que

La prise en charge des troubles de santé mentale par les omnipraticiens du Québec

PubMed Central

Fleury, Marie-Josée; Farand, Lambert; Aubé, Denise; Imboua, Armelle

2012-01-01

Résumé Objectif Cette recherche vise à documenter la prise en charge des troubles mentaux (TM) par les omnipraticiens. Type d’étude Il s’agit d’une étude mixte intégrant un questionnaire auto-administré et des entrevues qualitatives. La banque de données administratives des actes médicaux de la Régie de l’assurance maladie du Québec a aussi été analysée. Contexte La province de Québec. Participants Un total de 1415 omnipraticiens de différents lieux de pratiques ont été sollicités pour le questionnaire; 970 ont été rejoints. Un sous-groupe de 60 omnipraticiens a été rejoint pour les entrevues. Principaux paramètres à l'étude La prévalence annuelle des consultations reliées à des TM courants (TMC) ou graves (TMG), les pratiques cliniques, les pratiques de collaboration, les facteurs facilitant ou entravant la prise en charge des TM, ainsi que les recommandations pour l’amélioration du système de soins. Résultats Le taux de réponse a été de 41% (n = 398 omnipraticiens) pour le questionnaire et de 63% (n = 60) pour les entrevues. Environ 25 % des visites chez les omnipraticiens sont associées à des TM. Presque tous les omnipraticiens prennent en charge des TMC et se sentent compétents pour le faire, à l’inverse de la situation retrouvée pour les TMG. Près de 20 % des TMC sont référés (principalement à des intervenants psychosociaux), alors que près de 75 % des TMG sont référés (surtout en psychiatrie et à l’urgence). Plus de 50 % des omnipraticiens affirment n’entretenir aucun contact avec l’une ou l’autre des ressources de santé mentale. Plusieurs facteurs influencent la prise en charge des TM: les profils des patients (complexité des TM, troubles concomitants); les caractéristiques des omnipraticiens (réseau informel, formation); la culture professionnelle (travail en silo, mécanismes cliniques formalisés); le milieu institutionnel (multidisciplinarité, salariat); l’organisation des

[A "people dump": marks of suffering and transformations at the former Hospital Colônia Sant'Ana and in psychiatric care in Santa Catarina, 1970-1996].

PubMed

Borges, Viviane Trindade

2013-10-01

The article explores transformations to psychiatric care in Santa Catarina starting in the 1970s, when the state's longtime asylum, Hospital Colônia Sant'Ana, reached the height of overcrowding. To this end, along with other sources, it analyzes interviews that had been conducted with professionals who worked at the hospital in that era, sourced from the facility's Center for Documentation and Research. The goal was to problematize these testimonies, examining the texture of the accounts and approaching them as memories that weave a history of the hospital through recollections marked by suffering. Within this proposed framework, suffering is understood as a historical event that can give rise to new social arrangements.

Assessment of response consistency and respective participant profiles in the Internet-based NutriNet-Santé Cohort.

PubMed

Andreeva, Valentina A; Galan, Pilar; Julia, Chantal; Castetbon, Katia; Kesse-Guyot, Emmanuelle; Hercberg, Serge

2014-04-01

Whereas the feasibility and effectiveness of Internet-based epidemiologic research have been established, methodological support for the quality of such data is still accumulating. We aimed to identify sociodemographic differences among members of a French cohort according to willingness to provide part of one's 15-digit national identification number (personal Social Security number (PSSN)) and to assess response consistency based on information reported on the sociodemographic questionnaire and that reflected in the PSSN. We studied 100,118 persons enrolled in an Internet-based prospective cohort study, the NutriNet-Santé Study, between 2009 and 2013. Persons aged 18 years or more who resided in France and had Internet access were eligible for enrollment. The sociodemographic profiles of participants with discordant data were compared against those of participants with concordant data via 2-sided polytomous logistic regression. In total, 84,442 participants (84.3%) provided the first 7 digits of their PSSN, and among them 5,141 (6.1%) had discordant data. Our multivariate analysis revealed differences by sex, age, education, and employment as regards response consistency patterns. The results support the quality of sociodemographic data obtained online from a large and diverse volunteer sample. The quantitative description of participant profiles according to response consistency patterns could inform future methodological work in e-epidemiology.

Dietary supplement use among cancer survivors of the NutriNet-Santé cohort study.

PubMed

Pouchieu, Camille; Fassier, Philippine; Druesne-Pecollo, Nathalie; Zelek, Laurent; Bachmann, Patrick; Touillaud, Marina; Bairati, Isabelle; Hercberg, Serge; Galan, Pilar; Cohen, Patrice; Latino-Martel, Paule; Touvier, Mathilde

2015-04-28

Dietary supplements (DS) may influence cancer prognosis. Their use in cancer patients has been described in the United States, but data are largely lacking in Europe and notably in France. The present study's objectives were (1) to assess DS use and its sociodemographic, lifestyle, and dietary correlates in a large sample of French cancer survivors; (2) to evaluate the involvement of physicians in such DS use; and (3) to assess the extent of potentially harmful practices. Data were collected by self-administered web-based questionnaires among participants of the NutriNet-Santé cohort. Data on DS use was available for 1081 cancer survivors. DS users were compared to non-users with unconditional logistic regressions. DS use was reported by 62% of women and 29% of men. Vitamins D, B6, C and Mg were the most frequently consumed nutrients. 14% of cancer survivors initiated DS use after diagnosis. For 35% of the DS consumed, subjects did not inform their attending physician. DS use was associated with a healthier lifestyle (normal weight, never smoking and better diet) and substantially contributed to nutrient intake. 18% of DS users had potentially harmful DS use practices, such as the simultaneous use of vitamin E and anticoagulant/antiplatelet agents, the use of β-carotene and smoking or the use of phyto-oestrogens in hormone-dependent cancer patients. The present study suggests that DS use is widespread among cancer survivors, a large amount of that use is performed without any medical supervision and a substantial proportion of that use involves potentially harmful practices. Physicians should be encouraged to more routinely discuss DS use with their cancer patients.

Tuberculose chez le personnel de santé du secteur public au Burundi: fréquence et facteurs de risque

PubMed Central

Mukuku, Olivier; Ruhindiza, Bienvenu Mukuku; Mupepe, Alexis Kumba; Sawadogo, Michel

2013-01-01

Introduction Le but de cette étude était de déterminer la fréquence de la tuberculose (TB) chez le personnel de santé du secteur public en charge des patients tuberculeux et d’évaluer les facteurs de risque de contracter la tuberculose chez ce personnel au Burundi. Méthodes Il s’agit d’une étude transversale à visée analytique réalisée auprès de 300 travailleurs prestant dans 30 centres de dépistage et de traitement de la TB (CDT) au Burundi du 16 octobre au 15 novembre 2012. Les paramètres sociodémographiques et professionnels ainsi que l’antécédent de vaccination BCG de travailleurs ayant été touché par la TB ont été analysé et comparé à ceux de travailleurs qui ne l’ont pas été. Le seuil de signification a été fixé à p < 0,05. Résultats La fréquence de la TB chez le personnel de santé est de 15%. Le risque de souffrir de la TB est de près de 4 fois chez les travailleurs âgés d’au moins 50 ans (OR=3,73; 1,53-9,08), chez ceux qui n’ont jamais reçu de vaccin de BCG (OR=3,73; 1,24-11,03), chez ceux qui n’ont pas de cicatrice vaccinale de BCG (OR=3,80; 1,67-8,62) et chez ceux qui travaillent depuis au moins 6 ans dans un CDT (OR=3,79; 1,44-9,96); ce risque est de 9 fois chez ceux qui sont mariés (OR=9,42; 1,26-70,23), de 8 fois chez ceux qui n’aèrent pas leurs salles de travail (OR=8,20; 1,48-48,23) et de 6 fois chez ceux qui ont comme profession nettoyeur ou aide-soignant (OR=6,12; 2,92-12,82). Par contre, aucune corrélation statistiquement significative n’a été observée entre le fait de souffrir de la TB et le sexe mais aussi le nombre d’heures de contact d’un travailleur avec un patient tuberculeux (p>0,05). Conclusion L’âge, l’antécédent de vaccination de BCG ainsi que la majorité de paramètres professionnels sont en association avec la maladie TB des travailleurs de CDT. D’où, la maîtrise de certains facteurs de risque s’avère important pour faire face au fardeau de la TB parmi

Family Violence Among Older Adult Patients Consulting in Primary Care Clinics: Results From the ESA (Enquête sur la santé des aînés) Services Study on Mental Health and Aging

PubMed Central

Préville, Michel; Mechakra-Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Mathieu, Véronique; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

2014-01-01

Objective To document the reliability and construct validity of the Family Violence Scale (FVS) in the older adult population aged 65 years and older. Method: Data came from a cross-sectional survey, the Enquête sur la santé des aînés et l’utilisation des services de santé (ESA Services Study), conducted in 2011–2013 using a probabilistic sample of older adults waiting for medical services in primary care clinics (n = 1765). Family violence was defined as a latent variable, coming from a spouse and from children. Results: A model with 2 indicators of violence; that is, psychological and financial violence, and physical violence, adequately fitted the observed data. The reliability of the FVS was 0.95. According to our results, 16% of older adults reported experiencing some form of family violence in the past 12 months of their interview, and 3% reported a high level of family violence (FVS > 0.36). Our results showed that the victim’s sex was not associated with the degree of violence (β = 0.02). However, the victim’s age was associated with family violence (β = −0.12). Older adults, aged 75 years and older, reported less violence than those aged between 65 and 74 years. Conclusion: Our results lead us to conclude that family violence against older adults is common and warrants greater public health and political attention. General practitioners could play an active role in the detection of violence among older adults. PMID:25161067

The SANT domain of human MI-ER1 interacts with Sp1 to interfere with GC box recognition and repress transcription from its own promoter.

PubMed

Ding, Zhihu; Gillespie, Laura L; Mercer, F Corinne; Paterno, Gary D

2004-07-02

To gain insight into the regulation of hmi-er1 expression, we cloned a human genomic DNA fragment containing one of the two hmi-er1 promoters and consisting of 1460 bp upstream of the translation initiation codon of hMI-ER1. Computer-assisted sequence analysis revealed that the hmi-er1 promoter region contains a CpG island but lacks an identifiable TATA element, initiator sequence and downstream promoter element. This genomic DNA was able to direct transcription of a luciferase reporter gene in a variety of human cell lines, and the minimal promoter was shown to be located within-68/+144 bp. Several putative Sp1 binding sites were identified, and we show that Sp1 can bind to the hmi-er1 minimal promoter and increase transcription, suggesting that the level of hmi-er1 expression may depend on the availability of Sp1 protein. Functional analysis revealed that hMI-ER1 represses Sp1-activated transcription from the minimal promoter by a histone deacetylase-independent mechanism. Chromatin immunoprecipitation analysis demonstrated that both Sp1 and hMI-ER1 are associated with the chromatin of the hmi-er1 promoter and that overexpression of hMI-ER1 in cell lines that allow Tet-On-inducible expression resulted in loss of detectable Sp1 from the endogenous hmi-er1 promoter. The mechanism by which this occurs does not involve binding of hMI-ER1 to cis-acting elements. Instead, we show that hMI-ER1 physically associates with Sp1 and that endogenous complexes containing the two proteins could be detected in vivo. Furthermore, hMI-ER1 specifically interferes with binding of Sp1 to the hmi-er1 minimal promoter as well as to an Sp1 consensus oligonucleotide. Deletion analysis revealed that this interaction occurs through a region containing the SANT domain of hMI-ER1. Together, these data reveal a functional role for the SANT domain in the action of co-repressor regulatory factors and suggest that the association of hMI-ER1 with Sp1 represents a novel mechanism for the negative

Gestion des déchets ménagers dans l’aire de santé Bulaska à Mbuji-Mayi en République Démocratique du Congo

PubMed Central

Kangoy, Kasangye; Ngoyi, John; Mudimbiyi, Olive

2016-01-01

Introduction La présence des déchets ménagers dans les voies publiques a une influence sur l’hygiène de l’environnement, ils entrainent l’insalubrité et peuvent être facteurs des certaines maladies dont quelques-unes peuvent être épidémiques. Au cours des deux dernières décennies, la question de la gestion des déchets est devenue de plus en plus complexe autant pour les pays développés que ceux sous-développés. L’objectif de cette étude était de déterminer les types de déchets et le mode de gestion des déchets génère par les ménages. Méthodes Cette étude est descriptive transversale, réalisée dans l’aire de sante Bulaska, Kasaï oriental, c’est une approche prospective appuyée par l’interview et l’observation active. Le questionnaire a été adressé au responsable du ménage ou au délègue, du 21 au 25 juin 2010, sur 170 ménages ce qui constituent un échantillon de convenance. Résultats Cette étude a révélé ce qui suit: 94,7% des enquêtes qui avaient répondu a notre questionnaire étaient de sexe féminin; 47% des enquêtes avaient un niveau d’étude primaire; 41,1% des enquêtes étaient des ménagères; la taille médiane de ménage était de 7 personnes par ménage; dans 83,5% des cas les déchets génères étaient solides; 50% des ménages de l’aire de sante utilisent la voie publique comme poubelle. Conclusion Eu égard au résultat de cette étude, développer plus les programmes de sensibilisation sur l’assainissement de l’environnement s’avère nécessaire. PMID:27800105

Bronchiolitis Score of Sant Joan de Déu: BROSJOD Score, validation and usefulness.

PubMed

Balaguer, Mònica; Alejandre, Carme; Vila, David; Esteban, Elisabeth; Carrasco, Josep L; Cambra, Francisco José; Jordan, Iolanda

2017-04-01

To validate the bronchiolitis score of Sant Joan de Déu (BROSJOD) and to examine the previously defined scoring cutoff. Prospective, observational study. BROSJOD scoring was done by two independent physicians (at admission, 24 and 48 hr). Internal consistency of the score was assessed using Cronbach's α. To determine inter-rater reliability, the concordance correlation coefficient estimated as an intraclass correlation coefficient (CCC) and limits of agreement estimated as the 90% total deviation index (TDI) were estimated. An expert opinion was used to classify patients according to clinical severity. A validity analysis was conducted comparing the 3-level classification score to that expert opinion. Volume under the surface (VUS), predictive values, and probability of correct classification (PCC) were measured to assess discriminant validity. About 112 patients were recruited, 62 of them (55.4%) males. Median age: 52.5 days (IQR: 32.75-115.25). The admission Cronbach's α was 0.77 (CI95%: 0.71; 0.82) and at 24 hr it was 0.65 (CI95%: 0.48; 0.7). The inter-rater reliability analysis was: CCC at admission 0.96 (95%CI 0.94-0.97), at 24 h 0.77 (95%CI 0.65-0.86), and at 48 hr 0.94 (95%CI 0.94-0.97); TDI 90%: 1.6, 2.9, and 1.57, respectively. The discriminant validity at admission: VUS of 0.8 (95%CI 0.70-0.90), at 24 h 0.92 (95%CI 0.85-0.99), and at 48 hr 0.93 (95%CI 0.87-0.99). The predictive values and PCC values were within 38-100% depending on the level of clinical severity. There is a high inter-rater reliability, showing the BROSJOD score to be reliable and valid, even when different observers apply it. Pediatr Pulmonol. 2017;52:533-539. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Effets potentiels d’un modèle rationnel de prescription sur les dépenses nationales en santé

PubMed Central

Littman, Jordan; Halil, Roland

2016-01-01

Résumé Objectif Estimer les économies que pourrait engendrer la mise en œuvre d’un modèle rationnel de prescription pour des classes de médicaments équivalents sur les plans de l’efficacité, de la toxicité et de la commodité. Conception L’Institut canadien d’information sur la santé a fourni des renseignements sur les 10 principales classes de médicaments en fonction des dépenses annuelles qui leur sont attribuables. Ces classes ont été examinées en vue de leur inclusion potentielle dans l’étude selon qu’il était possible de comparer les médicaments à l’intérieur d’une même classe. Lorsqu’à la suite d’une recherche documentaire, une équivalence a été établie en fonction de l’efficacité, de la toxicité et de la commodité des médicaments, les données annuelles sur les prescriptions ont été recueillies à partir de la base de données du Système national d’information sur l’utilisation des médicaments prescrits. Les économies potentielles de coûts ont ensuite été calculées en comparant les parts de marché actuelles avec les parts potentielles futures de ce marché. Contexte Le Canada. Principaux paramètres à l’étude Les différences estimées dans les dépenses que produirait un modèle rationnel de prescription. Résultats Une équivalence a été établie sur les plans de l’efficacité, de la toxicité et de la commodité dans les classes de statines, d’inhibiteurs de la pompe à protons, d’inhibiteurs de l’enzyme de conversion de l’angiotensine et d’inhibiteurs sélectifs du recaptage de l’angiotensine. Les dépenses annuelles totales dans ces classes se situent à 856 millions $ dans les programmes publics de médicaments et à 1,97 milliard $ environ à l’échelle nationale. Grâce à des prescriptions rationnelles, on estime que les économies annuelles pourraient atteindre 222 millions $ pour les programmes publics et 521 millions $ à l’échelle nationale. Conclusion La

Potential uses of pumped urban groundwater: a case study in Sant Adrià del Besòs (Spain)

NASA Astrophysics Data System (ADS)

Jurado, Anna; Vázquez-Suñé, Enric; Pujades, Estanislao

2017-09-01

Urban groundwater has often been over-exploited for industrial uses. Now, this usage tends to be reduced or the resource abandoned due to pollution and/or changes in land use. The use and the subsequent disuse of groundwater has resulted in rising water tables that damage underground structures (e.g., building basements and underground car parks and tunnels), leading to the need for additional pumping in urban areas. In the case of the underground parking lot of Sant Adrià del Besòs (Barcelona, NE Spain), large amounts of urban groundwater are pumped to avoid seepage problems. Can this pumped groundwater be used for other purposes (e.g., drinking water and urban irrigation) instead of wasting this valuable resource? To answer this question, it was necessary to quantify the groundwater recharge and to assess the evolution of groundwater quality. The limiting factor at this study site is the groundwater quality because ammonium and some metals (iron and manganese) are present at high concentrations. Hence, further treatment would be needed to meet drinking water requirements. The pumped groundwater could also be used for supplementing river flow for ecological benefit and/or for mitigating seawater intrusion problems. Currently, only a small amount of this urban groundwater is used for cleaning public areas and watering public gardens. This situation highlighted the urgent need to manage this resource in a responsible and more efficient manner, especially in moments of high water demand such as drought periods.

Contribution of Organic Food to the Diet in a Large Sample of French Adults (the NutriNet-Santé Cohort Study).

PubMed

Baudry, Julia; Méjean, Caroline; Allès, Benjamin; Péneau, Sandrine; Touvier, Mathilde; Hercberg, Serge; Lairon, Denis; Galan, Pilar; Kesse-Guyot, Emmanuelle

2015-10-21

In developed countries, the demand for organic products continues to substantially increase each year. However, little information is available regarding the level of consumption of organic food and its relative share of the whole diet. Our aim was to provide, using individual consumption data, a detailed description of organic food consumption among French adults. Conventional and organic intakes were assessed using an organic food frequency questionnaire administered to 28,245 French adults participating in the NutriNet-Santé study. P values of Student t-test or Chi-square for the difference between genders were reported. Less than 12% of the respondents reported never consuming organic food in the past year. Women consumed on average 20% organic food in their whole diet per day while men consumed an average of 18%. The proportion of vegetables consumed that came from organic sources was 31% among women and 28% among men. Overall, the estimate of the contribution of organic food from products of plant origin was higher than that from products of animal origin. Our study provides a framework for the exploration of organic consumption and its correlates and can serve as a basis for future studies investigating relationships between the level of organic food consumption and health outcomes.

Contribution of Organic Food to the Diet in a Large Sample of French Adults (the NutriNet-Santé Cohort Study)

PubMed Central

Baudry, Julia; Méjean, Caroline; Allès, Benjamin; Péneau, Sandrine; Touvier, Mathilde; Hercberg, Serge; Lairon, Denis; Galan, Pilar; Kesse-Guyot, Emmanuelle

2015-01-01

In developed countries, the demand for organic products continues to substantially increase each year. However, little information is available regarding the level of consumption of organic food and its relative share of the whole diet. Our aim was to provide, using individual consumption data, a detailed description of organic food consumption among French adults. Conventional and organic intakes were assessed using an organic food frequency questionnaire administered to 28,245 French adults participating in the NutriNet-Santé study. P values of Student t-test or Chi-square for the difference between genders were reported. Less than 12% of the respondents reported never consuming organic food in the past year. Women consumed on average 20% organic food in their whole diet per day while men consumed an average of 18%. The proportion of vegetables consumed that came from organic sources was 31% among women and 28% among men. Overall, the estimate of the contribution of organic food from products of plant origin was higher than that from products of animal origin. Our study provides a framework for the exploration of organic consumption and its correlates and can serve as a basis for future studies investigating relationships between the level of organic food consumption and health outcomes. PMID:26506372

Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort

PubMed Central

Fiolet, Thibault; Sellem, Laury; Kesse-Guyot, Emmanuelle; Allès, Benjamin; Méjean, Caroline; Deschasaux, Mélanie; Fassier, Philippine; Latino-Martel, Paule; Beslay, Marie; Hercberg, Serge; Lavalette, Céline; Monteiro, Carlos A; Julia, Chantal; Touvier, Mathilde

2018-01-01

Abstract Objective To assess the prospective associations between consumption of ultra-processed food and risk of cancer. Design Population based cohort study. Setting and participants 104 980 participants aged at least 18 years (median age 42.8 years) from the French NutriNet-Santé cohort (2009-17). Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items. These were categorised according to their degree of processing by the NOVA classification. Main outcome measures Associations between ultra-processed food intake and risk of overall, breast, prostate, and colorectal cancer assessed by multivariable Cox proportional hazard models adjusted for known risk factors. Results Ultra-processed food intake was associated with higher overall cancer risk (n=2228 cases; hazard ratio for a 10% increment in the proportion of ultra-processed food in the diet 1.12 (95% confidence interval 1.06 to 1.18); P for trend<0.001) and breast cancer risk (n=739 cases; hazard ratio 1.11 (1.02 to 1.22); P for trend=0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (lipid, sodium, and carbohydrate intakes and/or a Western pattern derived by principal component analysis). Conclusions In this large prospective study, a 10% increase in the proportion of ultra-processed foods in the diet was associated with a significant increase of greater than 10% in risks of overall and breast cancer. Further studies are needed to better understand the relative effect of the various dimensions of processing (nutritional composition, food additives, contact materials, and neoformed contaminants) in these associations. Study registration Clinicaltrials.gov NCT03335644. PMID:29444771

Health and dietary traits of organic food consumers: results from the NutriNet-Santé study.

PubMed

Baudry, Julia; Méjean, Caroline; Péneau, Sandrine; Galan, Pilar; Hercberg, Serge; Lairon, Denis; Kesse-Guyot, Emmanuelle

2015-12-28

The dietary and health traits of organic food (OF) consumers have not been comprehensively described. The aim of this study was to identify factors associated with OF consumption. Data were collected from 54 283 participants from the NutriNet-Santé cohort using self-administered web-based questionnaires. Occasional organic food consumers and regular organic food consumers (ROFC) were compared with non-organic food consumers (NOFC) using logistical regression providing an OR and 95 % CI. Adherence to the French food-based guidelines and interactions between nutritional knowledge and OF consumption in adherence to dietary guidelines were investigated. Medical history was also assessed in relation to OF consumption. Compared with NOFC, ROFC were more likely to be vegetarian (OR 9·93; 95 % CI 7·42, 13·29 in women; OR 13·07; CI 7·00, 24·41 in men) and were less likely to be aware of nutritional guidelines regarding meat consumption (OR 0·37; CI 0·34, 0·40 in women; OR 0·41; CI 0·36, 0·47 in men). Compared with NOFC, ROFC had a lower risk of type II diabetes, hypertension and CVD; however, this effect was only significant for men. In contrast, organic consumers were more likely to report food allergies. Consuming OF appeared to affect the relationship between nutritional knowledge and adequate intake of meat/poultry/seafood/eggs and starchy food among both sexes. Our study provides new insights into the diet- and health-related behaviours of OF consumers in a large sample of participants residing in France. This should be taken into account in future studies investigating relationships between health and OF consumption.

Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study.

PubMed

Ducrot, Pauline; Fassier, Philippine; Méjean, Caroline; Allès, Benjamin; Hercberg, Serge; Péneau, Sandrine

2016-07-05

Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., "nutritional balance of the dish"), constraints (e.g., "my cooking skills"), pleasure (e.g., "originality of the dish"), specific diets (e.g., "my health status"), and organization (e.g., "what I planned to eat"). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62-0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10-1.19)) and specific diets (OR = 1.19 (95% CI: 1.17-1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking.

Design of the monitoring system at the Sant'Alessio induced riverbank filtration plant (Lucca, Italy)

NASA Astrophysics Data System (ADS)

Rossetto, Rudy; Barbagli, Alessio; Borsi, Iacopo; Mazzanti, Giorgio; Picciaia, Daniele; Vienken, Thomas; Bonari, Enrico

2015-04-01

In Managed Aquifer Recharge (MAR) schemes the monitoring system, for both water quality and quantity issues, plays a key role in assuring that a groundwater recharge plant is really managed. Considering induced Riverbank Filtration (RBF) schemes, while the effect of the augmented filtration consists in an improvement of the quality and quantity of the water infiltrating the aquifer, there is in turn the risk for groundwater contamination, as surface water bodies are highly susceptible to contamination. Within the framework of the MARSOL (2014) EU FPVII-ENV-2013 project, an experimental monitoring system has been designed and will be set in place at the Sant'Alessio RBF well field (Lucca, Italy) to demonstrate the sustainability and the benefits of managing induced RBF versus the unmanaged option. The RBF scheme in Sant'Alessio (Borsi et al. 2014) allows abstraction of an overall amount of about 0,5 m3/s groundwater providing drinking water for about 300000 people of the coastal Tuscany. Water is derived by ten vertical wells set along the Serchio River embankments inducing river water filtration into a high yield (10-2m2/s transmissivity) sand and gravel aquifer. Prior to the monitoring system design, a detailed site characterization has been completed taking advantage of previous and new investigations, the latter performed by means of MOSAIC on-site investigation platform (UFZ). A monitoring network has been set in place in the well field area using existing wells. There groundwater head and the main physico-chemical parameters (temperature, pH, dissolved oxygen, electrical conductivity and redox potential) are routinely monitored. Major geochemical compounds along with a large set of emerging pollutants are analysed (in cooperation with IWW Zentrum Wasser, Germany) both in surface-water and ground-water. The experimental monitoring system (including sensors in surface- and ground-water) has been designed focusing on managing abstraction efficiency and safety at

Middle-Late Pleistocene marine terraces and fault activity in the Sant'Agata di Militello coastal area (north-eastern Sicily)

NASA Astrophysics Data System (ADS)

Giunta, Giuseppe; Gueli, Anna M.; Monaco, Carmelo; Orioli, Silvia; Ristuccia, Gloria M.; Stella, Giuseppe; Troja, Sebastiano O.

2012-04-01

The coastal sector of Sant'Agata di Militello (north-eastern Sicily) is characterized by a flight of raised Middle-Upper Pleistocene marine terraces occurring at different heights with respect to present sea level. In particular, the geomorphological survey and the analysis of stereo-pairs of aerial photographs allowed to recognize at least five main orders of well preserved Quaternary surfaces and relative deposits mostly located at the hanging wall and at the footwall of the Pleistocene northwest-dipping Capo d'Orlando normal fault, which controlled the geomorphological evolution of the coastal area. The marine terraces show an overall good morphological continuity and are formed by marine platforms overlain by littoral deposits made up of yellow littoral sand and gravels in a sandy matrix. The continental sedimentary cover of the 3rd order terrace contains mammal-bearing deposits that were previously dated 200 ± 40 ka BP by isoleucine epimerization method, allowing to relate them to MIS 7.1 high-stand. In order to better define the whole terrace chronology, deposit samples were analyzed by Optically Stimulated Luminescence (OSL) methodology, a conventional SAR protocol used with sand-sized quartz. New datings, together with the detailed morphostructural analysis, allow to relate the 2nd and 4th order terraces to MIS 5.5 and 8.5, respectively, and to reconstruct the tectonic evolution of this coastal area, constraining the activity of the Capo d'Orlando fault.

Association between Mindfulness and Weight Status in a General Population from the NutriNet-Santé Study

PubMed Central

Camilleri, Géraldine M.; Méjean, Caroline; Bellisle, France; Hercberg, Serge; Péneau, Sandrine

2015-01-01

Background Mindfulness is defined as non-judgmental awareness of the present moment. There is some evidence of the efficacy of mindfulness-based interventions in weight loss. However, this psychological concept has only been rarely explored in observational studies, and no study to date has examined the association between dispositional mindfulness and weight status in a large population-based sample. Objective We aimed to examine the relationship between mindfulness scores and weight status in a large sample of the adult general population in France. Design and Methods A total of 14,400 men and 49,228 women aged ≥18 y participating in the NutriNet-Santé study were included in this cross-sectional analysis. We collected mindfulness data using the Five Facet Mindfulness Questionnaire as well as self-reported weight and height. The association between weight status and dispositional mindfulness, as well as its subscales (observing, describing, acting with awareness, non-judging and non-reactivity), was assessed using multinomial logistic regression models adjusted for socio-demographic and lifestyle factors. Results Women with higher dispositional mindfulness scores were less likely to be overweight (excluding obesity) (OR quartile 4 vs. 1 = 0.84, 95% CI: 0.79-0.90) and obese (OR quartile 4 vs. 1 = 0.71, 95% CI: 0.65-0.78). In addition, overall, in this group, all subscales were inversely associated with weight status, with the strongest association found for the “observing” subscale. In men, higher mindfulness was associated only with lower odds of obesity (OR quartile 4 vs. 1 = 0.81 (0.69, 0.96)), and only the “observing” and “non-reactivity” subscales were significantly inversely associated with weight status. Conclusion Results support the interest of a shift in perspective that takes into account positive psychological and cognitive factors such as dispositional mindfulness in the investigation of obesity and its associated factors. PMID:26038824

Circadian nutritional behaviours and cancer risk: New insights from the NutriNet-Santé prospective cohort study.

PubMed

Srour, Bernard; Plancoulaine, Sabine; Andreeva, Valentina A; Fassier, Philippine; Julia, Chantal; Galan, Pilar; Hercberg, Serge; Deschasaux, Mélanie; Latino-Martel, Paule; Touvier, Mathilde

2018-05-09

Circadian disruption has been classified as probably carcinogenic to humans by the World Health Organization's International Agency for Research on Cancer. The circadian clock is subject to environmental factors, particularly light exposure and food intake rhythms. However, the association between nutritional circadian behaviours and cancer is not well understood. We investigated the longitudinal associations between number of eating episodes, night-time fasting duration, time of first and last eating episodes, as well as nutritional quality of last eating episode, respectively, with breast and prostate cancer risks, the two main cancer locations in women and men respectively. This prospective study included 41389 day-working adults in the French NutriNet-Santé cohort (2009-2016) who completed at least three 24h dietary records during the first two years of follow-up. Multivariable Cox models were computed. 1732 first primary incident cancer cases were diagnosed during the follow-up, among which 428 breast and 179 prostate cancers. After adjustment for covariates including sleep duration, late eaters (last eating episode after 9:30 pm) had an increased risk of breast (HR=1.48 (1.02-2.17), p=0.03) and prostate (HR=2.20 (1.28-3.78), p=0.004) cancers. However, no association was observed between cancer risk and number of eating episodes, night-time fasting duration, time of first eating episode or macronutrient composition of the last eating episode. This large cohort study suggests that circadian perturbations resulting from late time of last food intake may be involved in carcinogenesis at different locations. Beyond nutritional quality of food intake, nutritional circadian regulation should be further investigated in the context of cancer prevention. This article is protected by copyright. All rights reserved. © 2018 UICC.

Association between Motives for Dish Choices during Home Meal Preparation and Weight Status in the NutriNet-Santé Study

PubMed Central

Ducrot, Pauline; Fassier, Philippine; Méjean, Caroline; Allès, Benjamin; Hercberg, Serge; Péneau, Sandrine

2016-01-01

Although home cooking has been associated with a lower body mass index in a few studies, no data exists on the motives behind food dish choices during home meal preparation and on their association with overweight. This study aimed to evaluate this association in 50,003 participants from the NutriNet-Santé cohort. Dimensions underlying the importance of 27 criteria possibly influencing dish choices were determined using an exploratory factor analysis. The association between dish choice motives and overweight (including obesity) was estimated using logistic regression models adjusted for sociodemographic and lifestyle characteristics. Five dimensions of dishes choice motives emerged: healthy diet (e.g., “nutritional balance of the dish”), constraints (e.g., “my cooking skills”), pleasure (e.g., “originality of the dish”), specific diets (e.g., “my health status”), and organization (e.g., “what I planned to eat”). A negative association was observed between the healthy diet factor and being overweight (OR = 0.65 (95% CI (confidence interval): 0.62–0.67)), whereas a positive association appeared for factors regarding pleasure (OR = 1.14 (95% CI: 1.10–1.19)) and specific diets (OR = 1.19 (95% CI: 1.17–1.22)). No significant associations were observed for constraints and organization. The significant associations between dish choice motives and overweight suggested the interest of focusing on these motives in order to promote healthier food choices during home cooking. PMID:27399764

Evaluation of the methodological quality of two contradictory guidelines recently published by the Haute autorité de santé.

PubMed

Watine, Joseph; Wils, Julien; Augereau, Christine

2017-02-01

Two clinical practice guidelines published in 2012 and in 2013 by the Haute autorité de santé (HAS) respectively entitled "Adult chronic kidney disease" (clinical pathway guidelines) and "Clinical utility of vitamin D measurements" (Health technology assessment) contradict each other on a notable point: in 2012 the HAS recommend to measure blood concentrations of vitamin D once a year in all patients with chronic kidney disease whereas in 2013 the HAS recommend to use this test only for the ambulatory follow-up of patients three months after kidney transplantation. This contradiction encouraged us to evaluate the methodological quality of these two guidelines with the help of the AGREE (Appraisal of Guidelines for Research and Evaluation) instrument which is consensual at an international level, in particular at the WHO (World Health Organization) and at the European Union. At the end of this comparative evaluation this preliminary hypothesis might be proposed: a more rigorous development (AGREE domain n̊3) as well as a higher editorial independence (AGREE domain n̊6) in 2013 than in 2012 (scores respectively are 57% and 56% in 2013 versus 24% and 25% in 2012) ensure a higher validity to the 2013 recommendations than to the 2012 recommendations. However this hypothesis is weakened by the subjective intrinsic value of the AGREE tool, and by various methodological shortcomings in these two guidelines. Therefore we conclude, using the AGREE terminology, that the methods for developing those guidelines are too uncertain, above all in 2012, for recommending their use without modifications.

Typology of eaters based on conventional and organic food consumption: results from the NutriNet-Santé cohort study.

PubMed

Baudry, Julia; Touvier, Mathilde; Allès, Benjamin; Péneau, Sandrine; Méjean, Caroline; Galan, Pilar; Hercberg, Serge; Lairon, Denis; Kesse-Guyot, Emmanuelle

2016-08-01

Limited information is available on large-scale populations regarding the socio-demographic and nutrient profiles and eating behaviour of consumers, taking into account both organic and conventional foods. The aims of this study were to draw up a typology of consumers according to their eating habits, based both on their dietary patterns and the mode of food production, and to outline their socio-demographic, behavioural and nutritional characteristics. Data were collected from 28 245 participants of the NutriNet-Santé study. Dietary information was obtained using a 264-item, semi-quantitative, organic FFQ. To identify clusters of consumers, principal component analysis was applied on sixteen conventional and sixteen organic food groups followed by a clustering procedure. The following five clusters of consumers were identified: (1) a cluster characterised by low energy intake, low consumption of organic food and high prevalence of inadequate nutrient intakes; (2) a cluster of big eaters of conventional foods with high intakes of SFA and cholesterol; (3) a cluster with high consumption of organic food and relatively adequate nutritional diet quality; (4) a group with a high percentage of organic food consumers, 14 % of which were either vegetarians or vegans, who exhibited a high nutritional diet quality and a low prevalence of inadequate intakes of most vitamins except B12; and (5) a group of moderate organic food consumers with a particularly high intake of proteins and alcohol and a poor nutritional diet quality. These findings may have implications for future aetiological studies investigating the potential impact of organic food consumption.

Mental Health and Service Issues Faced by Older Immigrants in Canada: A Scoping Review.

PubMed

Guruge, Sepali; Thomson, Mary Susan; Seifi, Sadaf Grace

2015-12-01

RÉSUMÉ Une population vieillissante et la croissance de la population sur la base de l'immigration nécessitent que la recherche, la pratique et la politique doivent se concentrer sur la santé mentale des immigrants âgés, surtout parce que leur santé mentale semble se détériorer au fil du temps. Cette revue se concentre sur: Qu'est-ce que l'on sait sur les déterminants sociaux de la santé mentale chez les immigrants âgés, et quels sont les obstacles à l'accès aux services de santé mentale confrontés par les immigrants âgés? Les résultats révèlent que (1) les déterminants sociaux décisifs de la santé mentale sont la culture, le sexe et les services de santé; (2) que les immigrants plus âgés utilisent les services de santé mentale de moins que leurs homologues nés au Canada à cause des obstacles tels que, par exemple, les croyances et les valeurs culturelles, un manque de services culturellement et linguistiquement appropriées, des difficultés financières, et l'âgisme; et (3) quelles que soient les sous-catégories dans cette population, les immigrants âgés éprouvent des inégalités en matière de la santé mentale. La preuve des recherches disponibles indique que de combler les lacunes des service de santé mentale devrait devenir une priorité pour la politique et la pratique du système de soins de santé au Canada.

Food Choice Motives When Purchasing in Organic and Conventional Consumer Clusters: Focus on Sustainable Concerns (The NutriNet-Santé Cohort Study).

PubMed

Baudry, Julia; Péneau, Sandrine; Allès, Benjamin; Touvier, Mathilde; Hercberg, Serge; Galan, Pilar; Amiot, Marie-Josèphe; Lairon, Denis; Méjean, Caroline; Kesse-Guyot, Emmanuelle

2017-01-24

The purpose of this study was to examine food choice motives associated with various organic and conventional dietary patterns among 22,366 participants of the NutriNet-Santé study. Dietary intakes were estimated using a food frequency questionnaire. Food choice motives were assessed using a validated 63-item-questionnaire gathered into nine food choice motive dimension scores: "absence of contaminants", "avoidance for environmental reasons", "ethics and environment", "taste", "innovation", "local and traditional production", "price", "health" and "convenience". Five consumers' clusters were identified: "standard conventional food small eaters", "unhealthy conventional food big eaters", "standard organic food small eaters", "green organic food eaters" and "hedonist moderate organic food eaters". Relationships between food choice motive dimension scores and consumers' clusters were assessed using analysis of covariance (ANCOVA) models adjusted for sociodemographic factors. "Green organic food eaters" had the highest mean score for the "health" dimension, while "unhealthy conventional food big eaters" obtained the lowest mean score for the "absence of contaminants" dimension. "Standard organic food small eaters", "green organic food eaters" and "hedonist moderate organic food eaters" had comparable scores for the "taste" dimension. "Unhealthy conventional food big eaters" had the highest mean score for the "price" dimension while "green organic food eaters" had the lowest mean scores for the "innovation" and "convenience" dimensions. These results provide new insights into the food choice motives of diverse consumers' profiles including "green" and "hedonist" eaters.

Contribution of ultra-processed foods in the diet of adults from the French NutriNet-Santé study.

PubMed

Julia, Chantal; Martinez, Lucien; Allès, Benjamin; Touvier, Mathilde; Hercberg, Serge; Méjean, Caroline; Kesse-Guyot, Emmanuelle

2018-01-01

Concerns have been raised about the potential health impact of ultra-processed foods (UPF) in the diet. Our objective was to investigate the contribution of UPF in the diet in a large French population and its association with sociodemographic factors and dietary patterns. Cross-sectional analysis of dietary data from 74 470 participants in the web-based NutriNet-Santé cohort. UPF were identified in repeated 24 h records and the proportion (in weight) of UPF in the total diet (UPFp) was computed for each participant. Associations of sociodemographic characteristics and UPFp in quartiles were assessed using multivariate multinomial logistic regression. Food group consumption and nutrient intakes across quartiles of UPFp were estimated using linear regression adjusted for sociodemographic factors and energy intake. France. UPF contributed 18·4 % of the foods consumed in weight and 35·9 % of total energy intake. Higher UPFp consumption was independently associated with male gender, younger age, lower education, smoking, and overweight and obesity (all P<0·0001). Participants in the highest UPFp quartile consumed lower amounts of fruit and vegetables (difference between quartile 4 and quartile 1 of UPFp, Δ=-180·3 g/d) and higher amounts of sweet products (Δ=68·5 g/d) and soft drinks (Δ=98·6 g/d; all P<0·0001). They had higher intakes of energy (Δ=610 kJ/d (145·7 kcal/d)) and added sugar (Δ=17·1 g/d), and lower intakes of fibre (Δ=-4·04 g/d), β-carotene (Δ=-1019·6 μg/d) and Ca (Δ=-87·8 mg/d; all P<0·0001). UPF represent an important part of the diet in adults from the French general population and are associated with unbalanced nutritional intakes.

Association between organic food consumption and metabolic syndrome: cross-sectional results from the NutriNet-Santé study.

PubMed

Baudry, Julia; Lelong, Hélène; Adriouch, Solia; Julia, Chantal; Allès, Benjamin; Hercberg, Serge; Touvier, Mathilde; Lairon, Denis; Galan, Pilar; Kesse-Guyot, Emmanuelle

2017-08-02

Metabolic syndrome (MetS), a multicomponent condition, is a cardiovascular disease predictor. Although exposure to agricultural pesticides has been suggested as a potential contributor to the rising rates of obesity, type 2 diabetes, and other features of metabolic disorders, no studies have focused on the association between consumption of organic food (produced without synthetic pesticides) and MetS. We aimed to investigate the cross-sectional association between organic food consumption and MetS in French adults to determine whether it would be worth conducting further studies, particularly large prospective and randomised trials. A total of 8174 participants from the NutriNet-Santé study who attended a clinical visit and completed an organic food frequency questionnaire were included in this cross-sectional analysis. We evaluated the association between the proportion of organic food in the diet (overall and by food group) and MetS using Poisson regression models while adjusting for potential confounders. Higher organic food consumption was negatively associated with the prevalence of MetS: adjusted prevalence ratio was 0.69 (95% CI 0.61, 0.78) when comparing the third tertile of proportion of organic food in the diet with the first one (p value <0.0001). Higher consumption of organic plant-based foods was also related to a lower probability of having MetS. In addition, when stratifying by lifestyle factors (nutritional quality of the diet, smoking status, and physical activity), a significant negative association was detected in each subgroup (p values <0.05), except among smokers. Our results showed that a higher organic food consumption was associated with a lower probability of having MetS. Additional prospective studies and randomised trials are required to ascertain the relationship between organic food consumption and metabolic disorders.

Motives for dish choices during home meal preparation: results from a large sample of the NutriNet-Santé study.

PubMed

Ducrot, Pauline; Méjean, Caroline; Allès, Benjamin; Fassier, Philippine; Hercberg, Serge; Péneau, Sandrine

2015-09-30

Although culinary practices have strongly evolved over time, few data are available on contemporary dish choices during meal preparation. We therefore sought to determine individual motives when choosing dishes to be prepared during weekdays and on weekends. The importance of 27 criteria related to dish choices was assessed in 53,025 participants in the NutriNet-Santé study. Dimensions of dish choice motives were investigated using exploratory factor analysis. Mean ratings of motives during weekdays and on weekends were compared using Student's t-test. Association between socio-demographic and cooking practice characteristics, and dish choice motives were evaluated using logistic regression models. Five dimensions of dish choice motives emerged: healthy diet (explained variance: 48.3%), constraints (19.0%), pleasure (12.1%), specific diets (11.0%) and organization (9.6%). The healthy diet factor was the most important on weekdays (mean rating 3.93) and weekends (3.90). Pleasure (3.61) had a higher score than constraints (3.54) on weekends (p < 0.0001) while the opposite was observed on weekdays (3.42 vs 3.77, respectively) (p < 0.0001). Organization was more important on weekdays (2.89) than on weekends (2.75) (p < 0.0001). Dish choice motives appeared to be significantly associated with socio-demographic and cooking practice characteristics. This study highlighted factors involved in dish choices in meal preparation on weekdays and weekends, as well as individual characteristics which determine motives for dish choices. From a public health perspective, these findings might help to develop appropriate strategies for promoting home meal preparation.

Profiles of organic food consumers in a large sample of French adults: results from the Nutrinet-Santé cohort study.

PubMed

Kesse-Guyot, Emmanuelle; Péneau, Sandrine; Méjean, Caroline; Szabo de Edelenyi, Fabien; Galan, Pilar; Hercberg, Serge; Lairon, Denis

2013-01-01

Lifestyle, dietary patterns and nutritional status of organic food consumers have rarely been described, while interest for a sustainable diet is markedly increasing. Consumer attitude and frequency of use of 18 organic products were assessed in 54,311 adult participants in the Nutrinet-Santé cohort. Cluster analysis was performed to identify behaviors associated with organic product consumption. Socio-demographic characteristics, food consumption and nutrient intake across clusters are provided. Cross-sectional association with overweight/obesity was estimated using polytomous logistic regression. Five clusters were identified: 3 clusters of non-consumers whose reasons differed, occasional (OCOP, 51%) and regular (RCOP, 14%) organic product consumers. RCOP were more highly educated and physically active than other clusters. They also exhibited dietary patterns that included more plant foods and less sweet and alcoholic beverages, processed meat or milk. Their nutrient intake profiles (fatty acids, most minerals and vitamins, fibers) were healthier and they more closely adhered to dietary guidelines. In multivariate models (after accounting for confounders, including level of adherence to nutritional guidelines), compared to those not interested in organic products, RCOP participants showed a markedly lower probability of overweight (excluding obesity) (25 ≤ body mass index<30) and obesity (body mass index ≥ 30): -36% and -62% in men and -42% and -48% in women, respectively (P<0.0001). OCOP participants (%) generally showed intermediate figures. Regular consumers of organic products, a sizeable group in our sample, exhibit specific socio-demographic characteristics, and an overall healthy profile which should be accounted for in further studies analyzing organic food intake and health markers.

Associations between transition to retirement and changes in dietary intakes in French adults (NutriNet-Santé cohort study).

PubMed

Si Hassen, Wendy; Castetbon, Katia; Lelièvre, Eva; Lampuré, Aurélie; Hercberg, Serge; Méjean, Caroline

2017-05-30

Few studies have focused on the influence of retirement on dietary behaviors. Our study aimed at assessing the associations between transition to retirement and changes in dietary intake in French adults, particularly according to spousal retirement and baseline income. This prospective study included 577 French participants from the NutriNet-Santé cohort who retired over a 5-year follow-up (2009-2014 or 2010-2015). At baseline and every year, dietary intakes were assessed using 24 h records. Repeated measures of dietary intake were analysed using mixed models adjusted for energy with random effects of time and period (before and after retirement) to assess changes following retirement for each gender. After retirement, intakes of saturated fatty acids and sodium increased in both genders. Women showed specific changes after retirement: decrease in the score of adherence to recommendations and in intakes of fruits, proteins, vitamins; increase in intakes of fatty sweet products. In men with the lowest income at baseline, specific changes in intake were associated with retirement such as decrease in intake of dairy products and increase in intake of lipids. Transition to retirement was associated with unhealthier dietary intakes. These results may help defining interventions during this vulnerable life-period. This study was conducted according to guidelines laid down in the Declaration of Helsinki and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB Inserm No. 0000388FWA00005831) and the French Data Protection Authority (Commission Nationale Informatique et Libertés No. 908450 and No. 909216). Electronic informed consents were obtained from all participants.

Association Between Ultra-Processed Food Consumption and Functional Gastrointestinal Disorders: Results From the French NutriNet-Santé Cohort.

PubMed

Schnabel, Laure; Buscail, Camille; Sabate, Jean-Marc; Bouchoucha, Michel; Kesse-Guyot, Emmanuelle; Allès, Benjamin; Touvier, Mathilde; Monteiro, Carlos A; Hercberg, Serge; Benamouzig, Robert; Julia, Chantal

2018-06-15

Ultra-processed foods (UPF) consumption has increased over the last decades and is raising concerns about potential adverse health effects. Our objective was to assess the association between UPF consumption and four functional gastrointestinal disorders (FGIDs): irritable bowel syndrome (IBS), functional constipation (FC), functional diarrhea (FDh), and functional dyspepsia (FDy), in a large sample of French adults. We analyzed dietary data of 33,343 participants from the web-based NutriNet-Santé cohort, who completed at least three 24 h food records, prior to a Rome III self-administered questionnaire. Proportion (in weight) of UPF in the diet (UPFp) was computed for each subject. The association between UPFp quartiles and FGIDs was estimated by multivariable logistic regression. Participants included in the analysis were mainly women (76.4%), and the mean age was 50.4 (SD = 14.0) years. UPF accounted for 16.0% of food consumed in weight, corresponding to 33.0% of total energy intake. UPF consumption was associated with younger age, living alone, lower incomes, higher BMI, and lower physical activity level (all p < 0.0001). A total of 3516 participants reported IBS (10.5%), 1785 FC (5.4%), 1303 FDy (3.9%), and 396 FDh (1.1%). After adjusting for confounding factors, an increase in UPFp was associated with a higher risk of IBS ( a OR Q4 vs. Q1 [95% CI]: 1.25 [1.12-1.39], p-trend < 0.0001). This study suggests an association between UPF and IBS. Further longitudinal studies are needed to confirm those results and understand the relative impact of the nutritional composition and specific characteristics of UPF in this relationship.

PubMed

Belaid, Loubna; Cloos, Patrick; Ridde, Valéry

2017-04-20

Cette étude vise à décrire la mobilisation des représentations ethnoculturelles par des agents et des gestionnaires de santé pour expliquer l'échec partiel d'une politique de santé maternelle et discuter des conséquences potentielles de ces représentations sur l'accès aux soins de santé des populations.MÉTHODES : Il s'agit d'une recherche qualitative de type socio-anthropologique mobilisant des entretiens approfondis, des discussions informelles, des observations non participantes menées dans les centres de santé et une analyse documentaire. Les entretiens ont été menés auprès de 16 agents de santé et de 10 gestionnaires. Les entretiens ont été enregistrés sous support numérique et transcrits. L'étude s'est déroulée dans le district sanitaire de Djibo au Burkina Faso.RÉSULTATS : L'identification ethnique, les coutumes relatives à l'accouchement (pudeur, discrétion, présence féminine), le statut social des femmes (le faible pouvoir décisionnel), le nomadisme et l'organisation sociale des populations et leurs résistances au changement sont érigés comme des obstacles « culturels » à la politique de santé. L'usage largement répandu de ces représentations par les agents et les gestionnaires de santé contribue à réprimander les populations et à masquer les facteurs structurels qui ont pourtant une influence plus importante sur l'utilisation des services de santé maternelle. Cette recherche met en lumière le danger de l'usage excessif des représentations ethnoculturelles teintées de culturalisme dans les pratiques et les politiques de santé publique en véhiculant des stéréotypes à l'égard de certains groupes de population. Pour comprendre le succès ou l'échec des politiques sanitaires, il demeure important de considérer la qualité du contact avec le système de santé, les facteurs structurels notamment les capacités des ménages à faire face aux dépenses des soins de santé et des distances entre les villages

Tensions entre rationalité technique et intérêts politiques : l’exemple de la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux au Québec

PubMed Central

Contandriopoulos, D.; Hudon, Raymond; Martin, Elisabeth; Thompson, Daniel

2013-01-01

Sommaire L’objet de cet article est constitué par les processus décisionnels entourant la mise en œuvre de la Loi sur les agences de développement de réseaux locaux de services de santé et de services sociaux (Loi 25). Nous entendons mettre en lumière les stratégies des groupes ou institutions de diverses natures qui ont fait valoir leurs préférences et ont tenté, avec un succès inégal, d’influencer les décisions relatives à cette réforme majeure de la structure du système de santé québécois. Au plan théorique, nous nous appuyons principalement sur les modèles d’analyse du lobbying qui, depuis les travaux fondateurs de Milbrath (1960, 1963), présentent cette pratique comme un processus fondamental d’échange d’information. Selon les données colligées dans les retranscriptions d’entrevues, les stratégies observées correspondent effectivement aux caractéristiques constitutives du lobbying et, dans quelques situations, à celles du patronage. La combinaison de ces divers éléments révèle que la mise en œuvre de la Loi 25 s’avère être avant tout un processus proprement politique. Ainsi, furent relégués au second plan les arguments techniques qui composaient initialement les objectifs de la Loi. PMID:23509412

The role of socio-economic status and neighborhood social capital on loneliness among older adults: evidence from the Sant Boi Aging Study.

PubMed

Domènech-Abella, Joan; Mundó, Jordi; Lara, Elvira; Moneta, Maria Victoria; Haro, Josep Maria; Olaya, Beatriz

2017-10-01

The aim of the present study is to analyze the role of age in the association between socio-economic status (SES) and loneliness as well as the role of neighborhood social capital (NSC) in the association between individual social capital and loneliness. Data include a representative population-based sample from Sant Boi de Llobregat (a suburb of Barcelona) of 1124 adults aged 50 and over. Logistic regression models were used to analyze the survey data. Interactions between SES and age, and NSC and individual social capital were explored. Among the poorest older adults, older individuals showed a lower likelihood of loneliness (OR 0.09, 95% CI 0.02, 0.30, p < 0.05) compared with the youngest cohort after adjusting for covariates, while among the richest individuals there were no significant differences among age cohorts. Individuals living in an area with high NSC and high individual social capital showed a lower likelihood of loneliness (OR 0.36, 95% CI 0.17, 0.73, p < 0.05) compared with those with low individual social capital after adjusting for covariates. The effect of individual social capital was not significant among individuals living in an area with low NSC. Interventions focusing on low SES middle-aged (50-59 years old) individuals and those aiming to increase NSC could be effective strategies to reduce the prevalence of loneliness in older people.

How Computer Literacy and Socioeconomic Status Affect Attitudes Toward a Web-Based Cohort: Results From the NutriNet-Santé Study

PubMed Central

Méjean, Caroline; Andreeva, Valentina A; Kesse-Guyot, Emmanuelle; Fassier, Philippine; Galan, Pilar; Hercberg, Serge; Touvier, Mathilde

2015-01-01

Background In spite of the growing literature in the field of e-epidemiology, clear evidence about computer literacy or attitudes toward respondent burden among e-cohort participants is largely lacking. Objective We assessed the computer and Internet skills of participants in the NutriNet-Santé Web-based cohort. We then explored attitudes toward the study demands/respondent burden according to levels of computer literacy and sociodemographic status. Methods Self-reported data from 43,028 e-cohort participants were collected in 2013 via a Web-based questionnaire. We employed unconditional logistic and linear regression analyses. Results Approximately one-quarter of participants (23.79%, 10,235/43,028) reported being inexperienced in terms of computer use. Regarding attitudes toward participant burden, women tended to be more favorable (eg, “The overall website use is easy”) than were men (OR 0.65, 95% CI 0.59-0.71, P<.001), whereas better educated participants (>12 years of schooling) were less likely to accept the demands associated with participation (eg, “I receive questionnaires too often”) compared to their less educated counterparts (OR 1.62, 95% CI 1.48-1.76, P<.001). Conclusions A substantial proportion of participants had low computer/Internet skills, suggesting that this does not represent a barrier to participation in Web-based cohorts. Our study also suggests that several subgroups of participants with lower computer skills (eg, women or those with lower educational level) might more readily accept the demands associated with participation in the Web cohort. These findings can help guide future Web-based research strategies. PMID:25648178

Effectiveness of Front-Of-Pack Nutrition Labels in French Adults: Results from the NutriNet-Santé Cohort Study

PubMed Central

Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold; Hercberg, Serge; Péneau, Sandrine

2015-01-01

Background To date, no consensus has emerged on the most appropriate front-of-pack (FOP) nutrition label to help consumers in making informed choices. We aimed to compare the effectiveness of the label formats currently in use: nutrient-specific, graded and simple summary systems, in a large sample of adults. Methods The FOP label effectiveness was assessed by measuring the label acceptability and understanding among 13,578 participants of the NutriNet-Santé cohort study, representative of the French adult population. Participants were exposed to five conditions, including four FOP labels: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), and a “no label” condition. Acceptability was evaluated by several indicators: attractiveness, liking and perceived cognitive workload. Objective understanding was assessed by the percentage of correct answers when ranking three products according to their nutritional quality. Five different product categories were tested: prepared fish dishes, pizzas, dairy products, breakfast cereals, and appetizers. Differences among the label effectiveness were compared with chi-square tests. Results The 5-CNL was viewed as the easiest label to identify and as the one requiring the lowest amount of effort and time to understand. GDA was considered as the least easy to identify and to understand, despite being the most attractive and liked label. All FOP labels were found to be effective in ranking products according to their nutritional quality compared with the “no label” situation, although they showed differing levels of effectiveness (p<0.0001). Globally, the 5-CNL performed best, followed by MTL, GDA and Tick labels. Conclusions The graded 5-CNL label was considered as easy to identify, simple and rapid to understand; it performed well when comparing the products’ nutritional quality. Therefore, it is likely to present advantages in real shopping situations where

Effectiveness of Front-Of-Pack Nutrition Labels in French Adults: Results from the NutriNet-Santé Cohort Study.

PubMed

Ducrot, Pauline; Méjean, Caroline; Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Fezeu, Léopold; Hercberg, Serge; Péneau, Sandrine

2015-01-01

To date, no consensus has emerged on the most appropriate front-of-pack (FOP) nutrition label to help consumers in making informed choices. We aimed to compare the effectiveness of the label formats currently in use: nutrient-specific, graded and simple summary systems, in a large sample of adults. The FOP label effectiveness was assessed by measuring the label acceptability and understanding among 13,578 participants of the NutriNet-Santé cohort study, representative of the French adult population. Participants were exposed to five conditions, including four FOP labels: Guideline Daily Amounts (GDA), Multiple Traffic Lights (MTL), 5-Color Nutrition Label (5-CNL), Green Tick (Tick), and a "no label" condition. Acceptability was evaluated by several indicators: attractiveness, liking and perceived cognitive workload. Objective understanding was assessed by the percentage of correct answers when ranking three products according to their nutritional quality. Five different product categories were tested: prepared fish dishes, pizzas, dairy products, breakfast cereals, and appetizers. Differences among the label effectiveness were compared with chi-square tests. The 5-CNL was viewed as the easiest label to identify and as the one requiring the lowest amount of effort and time to understand. GDA was considered as the least easy to identify and to understand, despite being the most attractive and liked label. All FOP labels were found to be effective in ranking products according to their nutritional quality compared with the "no label" situation, although they showed differing levels of effectiveness (p<0.0001). Globally, the 5-CNL performed best, followed by MTL, GDA and Tick labels. The graded 5-CNL label was considered as easy to identify, simple and rapid to understand; it performed well when comparing the products' nutritional quality. Therefore, it is likely to present advantages in real shopping situations where choices are usually made quickly.

Profiles of Organic Food Consumers in a Large Sample of French Adults: Results from the Nutrinet-Santé Cohort Study

PubMed Central

Kesse-Guyot, Emmanuelle; Péneau, Sandrine; Méjean, Caroline; Szabo de Edelenyi, Fabien; Galan, Pilar; Hercberg, Serge; Lairon, Denis

2013-01-01

Background Lifestyle, dietary patterns and nutritional status of organic food consumers have rarely been described, while interest for a sustainable diet is markedly increasing. Methods Consumer attitude and frequency of use of 18 organic products were assessed in 54,311 adult participants in the Nutrinet-Santé cohort. Cluster analysis was performed to identify behaviors associated with organic product consumption. Socio-demographic characteristics, food consumption and nutrient intake across clusters are provided. Cross-sectional association with overweight/obesity was estimated using polytomous logistic regression. Results Five clusters were identified: 3 clusters of non-consumers whose reasons differed, occasional (OCOP, 51%) and regular (RCOP, 14%) organic product consumers. RCOP were more highly educated and physically active than other clusters. They also exhibited dietary patterns that included more plant foods and less sweet and alcoholic beverages, processed meat or milk. Their nutrient intake profiles (fatty acids, most minerals and vitamins, fibers) were healthier and they more closely adhered to dietary guidelines. In multivariate models (after accounting for confounders, including level of adherence to nutritional guidelines), compared to those not interested in organic products, RCOP participants showed a markedly lower probability of overweight (excluding obesity) (25≤body mass index<30) and obesity (body mass index ≥30): −36% and −62% in men and −42% and −48% in women, respectively (P<0.0001). OCOP participants (%) generally showed intermediate figures. Conclusions Regular consumers of organic products, a sizeable group in our sample, exhibit specific socio-demographic characteristics, and an overall healthy profile which should be accounted for in further studies analyzing organic food intake and health markers. PMID:24204721

Red and processed meat intake and cancer risk: Results from the prospective NutriNet-Santé cohort study.

PubMed

Diallo, Abou; Deschasaux, Mélanie; Latino-Martel, Paule; Hercberg, Serge; Galan, Pilar; Fassier, Philippine; Allès, Benjamin; Guéraud, Françoise; Pierre, Fabrice H; Touvier, Mathilde

2018-01-15

The International Agency for Research on Cancer (WHO-IARC) classified red meat and processed meat as probably carcinogenic and carcinogenic for humans, respectively. These conclusions were mainly based on studies concerning colorectal cancer, but scientific evidence is still limited for other cancer locations. In this study, we investigated the prospective associations between red and processed meat intakes and overall, breast, and prostate cancer risk. This prospective study included 61,476 men and women of the French NutriNet-Santé cohort (2009-2015) aged ≥35 y and who completed at least three 24 hrs dietary records during the first year of follow-up. The risk of developing cancer was compared across sex-specific quintiles of red and processed meat intakes by multivariable Cox models. 1,609 first primary incident cancer cases were diagnosed during follow-up, among which 544 breast cancers and 222 prostate cancers. Red meat intake was associated with increased risk of overall cancers [HR Q5 vs. Q1 =1.31 (1.10-1.55), p trend  = 0.01) and breast cancer (HR Q5 vs. Q1  = 1.83 (1.33-2.51), p trend  = 0.002]. The latter association was observed in both premenopausal [HR Q5 vs. Q1 =2.04 (1.03-4.06)] and postmenopausal women [HR Q5 vs. Q1 =1.79 (1.26-2.55)]. No association was observed between red meat intake and prostate cancer risk. Processed meat intake was relatively low in this study (cut-offs for the 5th quintile = 46 g/d in men and 29 g/d in women) and was not associated with overall, breast or prostate cancer risk. This large cohort study suggested that red meat may be involved carcinogenesis at several cancer locations (other than colon-rectum), in particular breast cancer. These results are consistent with mechanistic evidence from experimental studies. © 2017 UICC.

Food Choice Motives When Purchasing in Organic and Conventional Consumer Clusters: Focus on Sustainable Concerns (The NutriNet-Santé Cohort Study)

PubMed Central

Baudry, Julia; Péneau, Sandrine; Allès, Benjamin; Touvier, Mathilde; Hercberg, Serge; Galan, Pilar; Amiot, Marie-Josèphe; Lairon, Denis; Méjean, Caroline; Kesse-Guyot, Emmanuelle

2017-01-01

The purpose of this study was to examine food choice motives associated with various organic and conventional dietary patterns among 22,366 participants of the NutriNet-Santé study. Dietary intakes were estimated using a food frequency questionnaire. Food choice motives were assessed using a validated 63-item-questionnaire gathered into nine food choice motive dimension scores: “absence of contaminants”, “avoidance for environmental reasons”, “ethics and environment”, “taste”, “innovation”, “local and traditional production”, “price”, “health” and “convenience”. Five consumers’ clusters were identified: “standard conventional food small eaters”, “unhealthy conventional food big eaters”, “standard organic food small eaters”, “green organic food eaters” and “hedonist moderate organic food eaters”. Relationships between food choice motive dimension scores and consumers’ clusters were assessed using analysis of covariance (ANCOVA) models adjusted for sociodemographic factors. “Green organic food eaters” had the highest mean score for the “health” dimension, while “unhealthy conventional food big eaters” obtained the lowest mean score for the “absence of contaminants” dimension. “Standard organic food small eaters”, “green organic food eaters” and “hedonist moderate organic food eaters” had comparable scores for the “taste” dimension. “Unhealthy conventional food big eaters” had the highest mean score for the “price” dimension while “green organic food eaters” had the lowest mean scores for the “innovation” and “convenience” dimensions. These results provide new insights into the food choice motives of diverse consumers’ profiles including “green” and “hedonist” eaters. PMID:28125035

[Headache and immigration. A study in the outpatient department of the Hospital de la Santa Creu i Sant Pau in Barcelona].

PubMed

Vidal-Jordana, A; Barroeta-Espar, I; Sainz-Pelayo, M P; Sala, I; Roig, C

2011-09-01

The immigrant population (IP) is visiting neurology departments on an increasingly more frequent basis. Research has still not made it clear whether there are geographical differences in the prevalence of primary headaches and the possible influence of emigration. We conducted a retrospective (12 months) and prospective study (18 months) of the first visits to the Headache Unit at the Hospital de la Santa Creu i Sant Pau. Data collected included the country of birth, time parameters of the headache and of the immigration, diagnoses according to the criteria of the IHS and treatments that had been used. Related headaches were considered to be those that began within one year of having immigrated. The IP represents 13.6% (n = 142) of the total number of first visits because of headaches (n = 1044). Immigrants came mostly from Latin America (83.9%). Headaches began after immigration in 40.1% of cases without the existence of any temporal relation with immigration. The distribution of the diagnoses of headache is similar to those of the local population, the most frequent being migraine (57.7%) and tension-type headache (15.5%). On comparing treatments prior to and following immigration, we find differences in the use of triptans (2.1% versus 46.2%), ergotamine (9.8% versus 2.1%) and in the use of preventive treatments (2% versus 45%). The IP accounts for 13% of all first visits due to headaches and their diagnoses are similar to those of the local population. Emigration is neither a precipitating nor an aggravating factor for headaches in our series. There is a significant difference in symptomatic and preventive treatment between the period prior to immigration and afterwards.

Soins primaires aux adultes ayant une déficience développementale

PubMed Central

Sullivan, William F.; Berg, Joseph M.; Bradley, Elspeth; Cheetham, Tom; Denton, Richard; Heng, John; Hennen, Brian; Joyce, David; Kelly, Maureen; Korossy, Marika; Lunsky, Yona; McMillan, Shirley

2011-01-01

Résumé Objectif Mettre à jour les lignes directrices canadiennes de 2006 sur les soins primaires aux adultes ayant une déficience développementale (DD) et présenter des recommandations pratiques fondées sur les connaissances actuelles pour traiter des problèmes de santé particuliers chez des adultes ayant une DD. Qualité des preuves Des professionnels de la santé expérimentés participant à un colloque et un groupe de travail subséquent ont discuté et convenu des révisions aux lignes directrices de 2006 en se fondant sur une recherche documentaire exhaustive, la rétroaction obtenue des utilisateurs du guide de pratique et les expériences cliniques personnelles. La plupart des preuves disponibles dans ce domaine viennent de l’opinion d’experts ou de déclarations consensuelles publiées (niveau III). Message principal Les adultes ayant une DD ont des problèmes de santé complexes, dont plusieurs diffèrent de ceux de la population en général. De bons soins primaires permettent d’identifier les problèmes de santé particuliers dont souffrent les adultes ayant une DD pour améliorer leur qualité de vie et leur accès aux soins de santé et prévenir la morbidité et le décès prématuré. Ces lignes directrices résument les problèmes de santé générale, physique, comportementale et mentale des adultes ayant une DD que devraient connaître les professionnels des soins primaires et présentent des recommandations pour le dépistage et la prise en charge en se basant sur les connaissances actuelles que les cliniciens peuvent mettre en pratique. En raison de l’interaction des facteurs biologiques, psychoaffectifs et sociaux qui contribuent à la santé et au bien-être des adultes ayant une DD, ces lignes directrices insistent sur la participation des aidants, l’adaptation des interventions, au besoin, et la consultation auprès de divers professionnels de la santé quand ils sont accessibles. Elles mettent aussi en évidence la

Combat Identification (15au): Project Summary and Closeout Report

DTIC Science & Technology

2009-07-01

represented by the Minister of National Defence, 2009 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la...l’interface homme -machine pour amener une utilisation en confiance plus appropriée de l’aide automatisée à la décision. D’autre part, le projet a...examen des objectifs du projet, ainsi qu’une mise en perspective sur ce qui rend le travail nécessaire. Il y a un résumé des réussites du projet et

Connaissances et comportements au regard de la santé reproductive: enquête chez les marocains en zone rurale

PubMed Central

Sebbani, Majda; Adarmouch, Latifa; Azzahiri, Isam; Quiddi, Wafa; Cherkaoui, Mohamed; Amine, Mohamed

2016-01-01

Introduction Décrire les connaissances, attitudes et pratiques (CAP) des hommes d'une population enclavée à l'égard de la santé reproductive. Méthodes Il s'agissait d'une étude mixte (focus group et étude CAP) menée dans une région montagneuse prés de Marrakech. L'enquête descriptive a recruté 74 hommes par deux méthodes d'échantillonnage (visiteurs du souk hebdomadaire et accompagnateurs à une compagne sanitaire). La collecte des données (Mars - Avril 2014) était par questionnaire traduit en dialectale et administré par des enquêteurs formés parlant Amazigh. L'analyse des données quantitatives était descriptive et bivariée (seuil de signification statistique à 5%). Le focus group était analysé après enregistrement et retranscription. Résultats La médiane de l'âge était de 38 ans [19 à 80 ans]. Parmi 64 hommes vivant en couple (86,5%), la moitié (55,4%) optait pour la pilule. Les 2 tiers ont reconnu l'intérêt de surveiller la grossesse, tandis que 37% des maris ignoraient la fréquence du suivi. Le non recours à la consultation prénatale était de 56,9% (N=58), dont 42,4% sans raison. Le niveau d'instruction était associé au suivi de la grossesse par la conjointe (p=0,015) et à l'attitude positive à l'égard de son intérêt (p=0,011). La méconnaissance de la possibilité de complications (35,1% des répondants) était un facteur de non recours à la consultation post-natale par la conjointe (p=0,021). Les barrières relevées de l'analyse du focus group étaient d'ordre culturel, géographique et socioéconomique. Conclusion Des actions d'information, d'éducation et de communication devraient viser d'avantage l'implication du sexe masculin dans des contextes similaires. PMID:28292148

Stratigraphic and structural controls on groundwater flow in an outcropping fossil fan delta: the case of Sant Llorenç del Munt range (NE Spain)

NASA Astrophysics Data System (ADS)

Anglés, Marc; Folch, Albert; Oms, Oriol; Maestro, Eudald; Mas-Pla, Josep

2017-12-01

Hydrogeological models of mountain regions present the opportunity to understand the role of geological factors on groundwater resources. The effects of sedimentary facies and fracture distribution on groundwater flow and resource exploitation are studied in the ancient fan delta of Sant Llorenç de Munt (central Catalonia, Spain) by integrating geological field observations (using sequence stratigraphy methods) and hydrogeological data (pumping tests, hydrochemistry and environmental isotopes). A comprehensive analysis of data portrays the massif as a single unit, constituted by different compartments determined by specific layers and sets of fractures. Two distinct flow systems—local and regional—are identified based on pumping test analysis as well as hydrochemical and isotopic data. Drawdown curves derived from pumping tests indicate that the behavior of the saturated layers, whose main porosity is given by the fracture network, corresponds to a confined aquifer. Pumping tests also reflect a double porosity within the system and the occurrence of impervious boundaries that support a compartmentalized model for the whole aquifer system. Hydrochemical data and associated spatial evolution show the result of water-rock interaction along the flow lines. Concentration of magnesium, derived from dolomite dissolution, is a tracer of the flow-path along distinct stratigraphic units. Water stable isotopes indicate that evaporation (near a 5% loss) occurs in a thick unsaturated zone within the massif before infiltration reaches the water table. The hydrogeological analysis of this outcropping system provides a methodology for the conceptualization of groundwater flow in similar buried systems where logging and hydrogeological information are scarce.

Weathering of gilding decorations investigated by SR: development and distribution of calcium oxalates in the case of Sant Benet de Bages (Barcelona, Spain)

NASA Astrophysics Data System (ADS)

Lluveras, A.; Boularand, S.; Roqué, J.; Cotte, M.; Giráldez, P.; Vendrell-Saz, M.

2008-01-01

In this paper seventeenth century gilded paintings from the crypt of Sant Benet de Bages, a medieval monastery in the Catalonia region of Spain, near Barcelona, have been studied. Cross sections from two different gilded decorations were studied by means of optical microscopy and electron microscopy and EDS to determine the statigraphy and elemental composition, and by means of FTIR coupled to a microscope to determine the binding media associated to each layer. These preliminary results demonstrated that gilded decorations were made by the application of a gold foil on a mordant substrate on a gypsum base, while the mouldings of the vaults seem to be gilded on a bol with a glaze on top of the gold leaf. It is interesting to notice that the first remained unaltered, while the gilded vault mouldings look almost black, due to the darkening of the organic material. To elucidate the causes involved in the darkening of the sample from the vaults a set of synchrotron μXRD and μFTIR experiments have been carried out on these samples at the ESRF (ID18F and ID21, respectively). High brightness and small spot working conditions revealed the development and distribution of calcium oxalates in the binding media, which seem to be responsible for the darkening. Results point out the fact that weddellite (CaC2O4·2H2O) is the phase formed in those layers where organic material has also been identified or at least it would be supposed to be by bibliographic sources and not necessarily those superficial as it would have been suggested due to the similarities with patinas formation.

Participant profiles according to recruitment source in a large Web-based prospective study: experience from the Nutrinet-Santé study.

PubMed

Kesse-Guyot, Emmanuelle; Andreeva, Valentina; Castetbon, Katia; Vernay, Michel; Touvier, Mathilde; Méjean, Caroline; Julia, Chantal; Galan, Pilar; Hercberg, Serge

2013-09-13

Interest in Internet-based epidemiologic research is growing given the logistic and cost advantages. Cohort recruitment to maximally diversify the sociodemographic profiles of participants, however, remains a contentious issue. The aim of the study was to characterize the sociodemographic profiles according to the recruitment mode of adult volunteers enrolled in a Web-based cohort. The French NutriNet-Santé Web-based cohort was launched in 2009. Recruitment is ongoing and largely relies on recurrent multimedia campaigns. One month after enrollment, participants are asked how they learned about the study (eg, general newscast or a health program on television, radio newscast, newspaper articles, Internet, personal advice, leaflet/flyers) The sociodemographic profiles of participants recruited through operative communication channels (radio, print media, Internet, advice) were compared with the profiles of those informed through television by using polytomous logistic regression. Among the 88,238 participants enrolled through the end of 2011, 30,401 (34.45%), 16,751 (18.98%), and 14,309 (16.22%) learned about the study from television, Internet, and radio newscasts, respectively. Sociodemographic profiles were various, with 14,541 (16.5%) aged ≥60 years, 20,166 (22.9%) aged <30 years, 27,766 (32.1%) without postsecondary education, 15,397 (19.7%) with household income <€1200/month, and 8258 (10.6%) with household income €3700/month. Compared to employed individuals, unemployed and retired participants were less likely to be informed about the study through other sources than through television (adjusted ORs 0.56-0.83, P<.001). Participants reporting up to secondary education were also less likely to have learned about the study through radio newscasts, newspaper articles, Internet, and advice than through television (adjusted ORs 0.60-0.77, P<.001). Television broadcasts appear to permit the recruitment of e-cohort participants with diverse sociodemographic

Severe Weather Guide - Mediterranean Ports. 5. Cagliari

DTIC Science & Technology

1988-03-01

Point 1) is located on radial 170" about 2 to 3 n mi from Scoglio Sant’ Elia (Figure 3-3) in a depth of 82 to 98 ft (25 to 30 m). Holding is...affects the Port. The swell is highest near Sarroch, but also affects the anchorage south of Scoglio Sant’ Eli a. Southeasterly swell tends to reflect...problems in the harbor, but anchor dragging is possible for vessels anchored in the harbor or south of Scoglio Sant’ Elia. Because the wind is offshore

The steam laboratory of the Institut de Médecine Navale du Service de Santé des Armées: a set of tools in the service of the French Navy.

PubMed

Desruelle, Anne-Virginie; Schmid, Bruno

2004-09-01

Accidental exposure to hot water steam is a potential risk in the French Navy, and particularly on nuclear submarines or ships. Direct human exposure to this extreme environment during an accident leads to death in a short time. In order to protect the crew members of the French Navy, a laboratory was created at the Institut de Médecine Navale du Service de Santé des Armées (IMNSSA). A set of tools was developed to study the effects of exposure to hot water steam atmospheres on human physiology and on the protective capacities of textile fabrics and equipment. A testing device allows the quantification of the protective capacities of fabrics under steam stresses. A thermal manikin and a steam climatic chamber allow the evaluation of the protective capacities of equipment. The tests on fabrics and on garments were in good agreement. Water vapour impermeable fabrics and garments provide greater protection in steamy conditions. Moreover, the thicker the sample or garment, the higher the protection it gives. Care should be taken to verify that fabrics keep their thermal characteristics under steam stress. These characteristics, measured under standard comfortable conditions, are not always indicative of the protective abilities of the fabrics under steamy conditions.

Practical Verification & Safeguard Tools for C/C++

DTIC Science & Technology

2007-11-01

735; RDDC Valcartier; novembre 2007. Ce document est le rapport final d’un projet de recherche qui a été mené en 2005-2006. Le but de ce projet... 13 2.8 On Defects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 2.9 Memory Management Problems... 13 2.9.1 Use of Freed Memory . . . . . . . . . . . . . . . . . . . . . . . . . 13 2.9.2 Underallocated Memory for a

Comparison of Sociodemographic and Nutritional Characteristics between Self-Reported Vegetarians, Vegans, and Meat-Eaters from the NutriNet-Santé Study

PubMed Central

Baudry, Julia; Méjean, Caroline; Péneau, Sandrine; Hercberg, Serge

2017-01-01

Background: There is a growing trend for vegetarian and vegan diets in many Western countries. Epidemiological evidence suggesting that such diets may help in maintaining good health is rising. However, dietary and sociodemographic characteristics of vegetarians and vegans are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of self-reported, adult vegetarians and vegans, compared to meat-eaters, from the French NutriNet-Santé study. Methods: Participants were asked if they were following a specific diet. They were then classified into three self-reported diet groups: 90,664 meat-eaters, 2370 vegetarians, and 789 vegans. Dietary data were collected using three repeated 24-h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex and age for micronutrients, as well as by type of self-reported diet. Results: Compared with meat-eaters, vegetarians were more likely to have a higher educational level, whereas vegans had a lower education level. Compared with meat-eaters, vegetarians were more likely to be women, younger individuals, and to be self-employed or never employed rather than managerial staff. Vegetarians and vegans substituted animal protein-dense products with a higher consumption of plant protein-dense products (e.g., soy-based products or legumes). Vegetarians had the most balanced diets in terms of macronutrients, but also had a better adherence to French dietary guidelines. Vegetarians exhibited a lower estimated prevalence of inadequacies for micronutrients such as antioxidant vitamins (e.g., for vitamin E, 28.9% for vegetarian women <55 years of age vs. 41.6% in meat-eaters) while vegans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men

Comparison of Sociodemographic and Nutritional Characteristics between Self-Reported Vegetarians, Vegans, and Meat-Eaters from the NutriNet-Santé Study.

PubMed

Allès, Benjamin; Baudry, Julia; Méjean, Caroline; Touvier, Mathilde; Péneau, Sandrine; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2017-09-15

There is a growing trend for vegetarian and vegan diets in many Western countries. Epidemiological evidence suggesting that such diets may help in maintaining good health is rising. However, dietary and sociodemographic characteristics of vegetarians and vegans are not well known. The aim of this cross-sectional study was to describe sociodemographic and nutritional characteristics of self-reported, adult vegetarians and vegans, compared to meat-eaters, from the French NutriNet-Santé study. Participants were asked if they were following a specific diet. They were then classified into three self-reported diet groups: 90,664 meat-eaters, 2370 vegetarians, and 789 vegans. Dietary data were collected using three repeated 24-h dietary records. Multivariable polytomic logistic regression models were perfomed to assess the association between the sociodemographic characteristics and type of diet. The prevalence of nutrient intake inadequacy was estimated, by sex and age for micronutrients, as well as by type of self-reported diet. Compared with meat-eaters, vegetarians were more likely to have a higher educational level, whereas vegans had a lower education level. Compared with meat-eaters, vegetarians were more likely to be women, younger individuals, and to be self-employed or never employed rather than managerial staff. Vegetarians and vegans substituted animal protein-dense products with a higher consumption of plant protein-dense products (e.g., soy-based products or legumes). Vegetarians had the most balanced diets in terms of macronutrients, but also had a better adherence to French dietary guidelines. Vegetarians exhibited a lower estimated prevalence of inadequacies for micronutrients such as antioxidant vitamins (e.g., for vitamin E, 28.9% for vegetarian women <55 years of age vs. 41.6% in meat-eaters) while vegans exhibited a higher estimated prevalence of inadequacies for some nutrients, in particular vitamin B12 (69.9% in men and 83.4% in women <55 years of

Individual and Combined Effects of Dietary Factors on Risk of Incident Hypertension: Prospective Analysis From the NutriNet-Santé Cohort.

PubMed

Lelong, Helene; Blacher, Jacques; Baudry, Julia; Adriouch, Solia; Galan, Pilar; Fezeu, Leopold; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2017-10-01

Dietary intake is pointed as one of the major determinants in hypertension development. Data in the area are mostly obtained from cross-sectional studies. We aimed to investigate the prospective association between (1) individual nutritional factors and (2) adherence to the Dietary Approach to Stop Hypertension and the risk of incident hypertension in a large cohort study. We prospectively examined the incidence of hypertension among 80 426 French adults participating in the NutriNet-Santé cohort study. Self-reported sociodemographic, lifestyle health questionnaires and dietary consumption assessed by three 24-hour records were completed at baseline and yearly thereafter. Associations between quartiles (Q) of nutrients and food groups and adherence to Dietary Approach to Stop Hypertension diet and hypertension risk were assessed by multivariable Cox proportional hazards models. During a mean follow-up of 3.4±2.1 years, 2413 cases of incident hypertension were documented. Dietary intakes of sodium (Q4 versus Q1): hazard ratio (HR)=1.17 (95% confidence interval [CI], 1.02-1.35), potassium: HR=0.82 (95% CI, 0.72-0.94), animal protein: HR=1.26 (95% CI, 1.11-1.43), vegetable protein: HR=0.85 (95% CI, 0.75-0.95), fiber: HR =0.81 (95% CI, 0.71-0.93), magnesium: HR=0.77 (95% CI, 0.67-0.89), fruit and vegetables: HR=0.85 (95% CI, 0.74-0.97), whole grain: HR=0.84(95% CI, 0.76-0.93), nuts: HR=0.72 (95% CI, 0.63-0.83), and red and processed meat: HR=1.25 (95% CI, 1.11-0.42) were associated with risk of hypertension. Besides, adherence to the Dietary Approach to Stop Hypertension was strongly inversely associated with incident hypertension: (Q4 versus Q1) HR=0.66 (95% CI, 0.58-0.75). Our results confirmed the association of several nutritional factors intake and incident hypertension and highlighted that adopting a global healthy diet could strongly contribute to the prevention of hypertension. © 2017 American Heart Association, Inc.

Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2014-06-01

Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress. Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140  mmHg (SBP) or 90  mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort. We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects. Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

La prise en charge à long terme de l’asthme chez les enfants inuits et des Premières nations : un outil de transfert du savoir fondé sur les lignes directrices canadiennes pour l’asthme pédiatrique, conçu pour être utilisé par les professionnels de la santé de première ligne qui travaillent dans des communautés isolées

PubMed Central

Kovesi, Tom; Giles, Brenda Louise; Pasterkamp, Hans

L’asthme est un grave problème de santé pour les enfants inuits et des Premières nations. Chez les enfants de moins d’un an, il faut distinguer l’asthme de la bronchiolite virale, anormalement fréquente chez les enfants autochtones du Canada. Chez les enfants de moins de six ans, le diagnostic dépend de la présence de symptômes classiques, de l’absence de caractéristiques atypiques et de la consignation de la réponse au traitement, notamment la réponse rapide et transitoire aux bronchodilatateurs. Chez les enfants plus âgés, il faut, dans la mesure du possible, déterminer la présence d’une obstruction réversible des voies aériennes par spirométrie afin de confirmer le diagnostic, ainsi qu’évaluer et corriger les déclencheurs environnementaux. L’utilisation régulière de corticoïdes en aérosol est la principale mesure à prendre pour maintenir un bon contrôle de l’asthme chez les enfants asthmatiques. Les clients et leur famille devraient recevoir une formation sur l’asthme. Il faut réévaluer régulièrement le contrôle aux visites de suivi dans des centres de santé et rajuster le traitement à la dose la plus basse possible pour le maintien de ce contrôle.

Comparison Between a Self-Administered and Supervised Version of a Web-Based Cognitive Test Battery: Results From the NutriNet-Santé Cohort Study.

PubMed

Assmann, Karen E; Bailet, Marion; Lecoffre, Amandine C; Galan, Pilar; Hercberg, Serge; Amieva, Hélène; Kesse-Guyot, Emmanuelle

2016-04-05

Dementia is a major public health problem, and repeated cognitive data from large epidemiological studies could help to develop efficient measures of early prevention. Data collection by self-administered online tools could drastically reduce the logistical and financial burden of such large-scale investigations. In this context, it is important to obtain data concerning the comparability of such new online tools with traditional, supervised modes of cognitive assessment. Our objective was to compare self-administration of the Web-based NutriNet-Santé cognitive test battery (NutriCog) with administration by a neuropsychologist. The test battery included four tests, measuring, among others aspects, psychomotor speed, attention, executive function, episodic memory, working memory, and associative memory. Both versions of the cognitive battery were completed by 189 volunteers (either self-administered version first, n=99, or supervised version first, n=90). Subjects also completed a satisfaction questionnaire. Concordance was assessed by Spearman correlation. Agreement between both versions varied according to the investigated cognitive task and outcome variable. Spearman correlations ranged between .42 and .73. Moreover, a majority of participants responded that they "absolutely" or "rather" agreed that the duration of the self-administered battery was acceptable (184/185, 99.5%), that the tasks were amusing (162/185, 87.6%), that the instructions were sufficiently detailed (168/185; 90.8%) and understandable (164/185, 88.7%), and that they had overall enjoyed the test battery (182/185, 98.4%). The self-administered version of the Web-based NutriCog cognitive test battery provided similar information as the supervised version. Thus, integrating repeated cognitive evaluations into large cohorts via the implementation of self-administered online versions of traditional test batteries appears to be feasible.

Comparison Between a Self-Administered and Supervised Version of a Web-Based Cognitive Test Battery: Results From the NutriNet-Santé Cohort Study

PubMed Central

Bailet, Marion; Lecoffre, Amandine C; Galan, Pilar; Hercberg, Serge; Amieva, Hélène; Kesse-Guyot, Emmanuelle

2016-01-01

Background Dementia is a major public health problem, and repeated cognitive data from large epidemiological studies could help to develop efficient measures of early prevention. Data collection by self-administered online tools could drastically reduce the logistical and financial burden of such large-scale investigations. In this context, it is important to obtain data concerning the comparability of such new online tools with traditional, supervised modes of cognitive assessment. Objective Our objective was to compare self-administration of the Web-based NutriNet-Santé cognitive test battery (NutriCog) with administration by a neuropsychologist. Methods The test battery included four tests, measuring, among others aspects, psychomotor speed, attention, executive function, episodic memory, working memory, and associative memory. Both versions of the cognitive battery were completed by 189 volunteers (either self-administered version first, n=99, or supervised version first, n=90). Subjects also completed a satisfaction questionnaire. Concordance was assessed by Spearman correlation. Results Agreement between both versions varied according to the investigated cognitive task and outcome variable. Spearman correlations ranged between .42 and .73. Moreover, a majority of participants responded that they “absolutely” or “rather” agreed that the duration of the self-administered battery was acceptable (184/185, 99.5%), that the tasks were amusing (162/185, 87.6%), that the instructions were sufficiently detailed (168/185; 90.8%) and understandable (164/185, 88.7%), and that they had overall enjoyed the test battery (182/185, 98.4%). Conclusions The self-administered version of the Web-based NutriCog cognitive test battery provided similar information as the supervised version. Thus, integrating repeated cognitive evaluations into large cohorts via the implementation of self-administered online versions of traditional test batteries appears to be feasible. PMID

Evaluation of mist-net sampling as an index to productivity in Kirtland's Warblers

USGS Publications Warehouse

Bart, J.; Kepler, C.; Sykes, P.; Bocetti, Carol I.

1999-01-01

Many applied and theoretical investigations require information on how productivity varies in time and space (Temple and Wiens 1989. DeSante 1995). Examples include studies of habitat quality, population trends, life-history tactics, and metapopulation dynamics. From a demographic perspective, productivity is the number of young counted at a given time of year, produced per adult (e.g. Caswell 1989). Various measures have been used to estimate productivity. One of the most attractive is mist netting during the summer after young have left the nest, but ideally before they have left the study area. Several programs use this approach, including the Constant Effort Sites Scheme of the British Trust for Ornithology (Baillie et al. 1986, Bibby et al. 1992) and the Monitoring Avian Productivity and Survivorship (MAPS) program (DeSante et al. 1993) in North America.Hatching-year (HY) and after-hatching-year (AHY) birds are widely believed to have different susceptibilities to netting (DeSante et al. 1995, Peach et al. 1996), so the ratio of HY's to AHY's obtained from netting is not used as an estimate of productivity. Instead, investigators hope that the relative susceptibility to capture is about the same among the samples being compared so that the age ratios in mistnet samples provide a reliable index to productivity (DeSante 1995, DeSante et al. 1995).

Three-Dimensional Structural and Hydrologic Evolution of Sant Corneli Anticline, a Fault-Cored Fold in the Central Spanish Pyrenees

NASA Astrophysics Data System (ADS)

Shackleton, J. R.; Cooke, M. L.

2005-12-01

The Sant Corneli Anticline is a well-exposed example of a fault-cored fold whose hydrologic evolution and structural development are directly linked. The E-W striking anticline is ~ 5 km wide with abrupt westerly plunge, and formed in response to thrusting associated with the upper Cretaceous to Miocene collision of Iberia with Europe. The fold's core of fractured carbonates contains a variety of west dipping normal faults with meter to decameter scale displacement and abundant calcite fill. This carbonate unit is capped by a marl unit with low angle, calcite filled normal faults. The marl unit is overlain by clastic syn-tectonic strata whose sedimentary architecture records limb rotation during the evolution of the fold. The syn-tectonic strata contain a variety of joint sets that record the stresses before, during, and possibly after fold growth. Faulting in the marl and calcite-filled joints in the syn-tectonic strata suggest that normal faults within the carbonate core of the fold eventually breached the overlying marl unit. This breach may have connected the joints of the syn-tectonic strata to the underlying carbonate reservoir and eliminated previous compartmentalization of fluids. Furthermore, breaching of the marl units probably enhanced joint formation in the overlying syn-tectonic strata. Future geochemical studies of calcite compositions in the three units will address this hypothesis. Preliminary mapping of joint sets in the syn-tectonic strata reveal a multistage history of jointing. Early bed-perpendicular joints healed by calcite strike NE-SW, parallel to normal faults in the underlying carbonates, and may be related to an early regional extensional event. Younger healed bed-perpendicular joints cross cut the NE-SW striking set, and are closer to N-S in strike: these joints are interpreted to represent the initial stages of folding. Decameter scale, bed perpendicular, unfilled fractures that are sub-parallel to strike probably represent small joints

Effect of Promotional Initiatives on Visits to a Dedicated Website for Physical Activity and Non-Communicable Disease in Luxembourg: An Event Study

PubMed Central

Lion, Alexis; Thornton, Jane S.; Vaillant, Michel; Pertuy, Juliette; Besenius, Eric; Hardy, Cyrille; Delagardelle, Charles; Seil, Romain; Urhausen, Axel; Theisen, Daniel

2017-01-01

The Sport-Santé project and its website (www.sport-sante.lu) promote physical activity for individuals with non-communicable diseases (NCDs) in Luxembourg. Our purpose was to perform an event study analysis to evaluate the effects of communication and promotional initiatives on the number of visits to the Sport-Santé website. Between September 2015 and May 2016, the Sport-Santé website was promoted during different initiatives, including participation in health-related events or publication of articles in local journals. The daily number of visits to www.sport-sante.lu website (i.e., our outcome) was recorded using Google Analytics and compared to a counterfactual collected with its benchmarking tool. The counterfactual was defined as the daily number of visits to websites in the same field. A model was created to evaluate the relationship between the number of visits to www.sport-sante.lu website and the number of visits to similar websites during a control period with no promotional initiatives (from July 2015 to September 2015). The effect of promotional initiatives was subsequently tested, by comparing the actual number of visits to our website (up to 2 days after each event) with the theoretical number of visits predicted by the model. Twenty-two initiatives were identified, of which 11 were participations at major health-related events and 11 publications of popular science articles. Of these 22 initiatives, the event study identified 2 popular science articles and 1 interactive workshop that significantly increased the daily number of visits to the www.sport-sante.lu website. One of the two articles was published on the day before the workshop was held, which did not allow us to distinguish its specific impact. The second article was published in the main national newspaper. This is the first time to our knowledge that an event study analysis has been used to evaluate the impact of promotional initiatives on the number of visits to a dedicated website

Prospective association between consumption frequency of organic food and body weight change, risk of overweight or obesity: results from the NutriNet-Santé Study.

PubMed

Kesse-Guyot, Emmanuelle; Baudry, Julia; Assmann, Karen E; Galan, Pilar; Hercberg, Serge; Lairon, Denis

2017-01-01

A lower BMI has been reported among consumers of organic foods, but this relationship has never been examined in a prospective design study. Our aim was to prospectively investigate the association between frequency of organic food consumption and weight change. We analysed data from 62 224 participants of the NutriNet-Santé cohort (78 % women, mean age=45 years) with information on consumption frequency of organic foods, dietary intake and repeated anthropometric data. For sixteen products, participants reported their consumption frequency of labelled organic foods (never, occasionally, most of the time). An organic score (OS) with a maximum of thirty-two points was computed. The associations of the OS (modeled as quartiles (Q)) with change in BMI during follow-up (on average 3·1 years) and with the risk of overweight and obesity were estimated by ANCOVA and multivariable logistic regression. A lower BMI increase was observed across quartiles of the OS (mean difference Q4 v. Q1=-0·16 (95 % CI -0·32, -0·01). An increase in the OS was associated with a lower risk of overweight and obesity (among non-overweight and non-obese participants at inclusion): OR for Q4 v. Q1 were 0·77 (95 % CI 0·68, 0·86) and 0·69 (95 % CI 0·58, 0·82), respectively. Concerning obesity risk, the association was stronger among participants with higher adherence to nutritional guidelines. This study supports a strong protective role of consumption frequency of organic foods with regard to the risk of overweight and obesity that depends on overall dietary quality. Upon confirmation, these results may contribute to fine-tune nutritional guidelines by accounting for farming practices in food production.

Etudes Asymptotiques en Filtrage Non Lineaire Avec Petit Bruit D’Observation (Asymptotic Studies in Nonlinear Time Filtering with Small Observation Noise)

DTIC Science & Technology

1990-09-26

Tentugal Valente, pour la maniire enthousiaste avtc laquelle il a soutenu ce projet . Je ne dois pas oublier de remercier If, Groupe de Math 6matiques...oial sur un travectie csimue d~veloppement au sein du projet MEFISTO, i. lINRIA - centre de Sophia - Antipolis. 56 Dans cette 6tude asymptotique de...Control and Information Sciences, 83, Springer 1986. 58 [Picard] Picard, J. : Nonlinear filtering and smoothing with high sig - nal-to-noise ratio

MulVAL Extensions for Dynamic Asset Protection

DTIC Science & Technology

2006-04-01

called Skybox Security and an AI-based project called CycSecure were identified as interesting and relatively mature projects, which deserve closer...dynamic asset protection solution. A critique of the Skybox Security and CycSecure solutions, with respect to the requirements of dynamic asset...particulièrement, un produit du commerce appelé Skybox Security et un projet d’IA appelé CycSecure ont été désignés comme étant des projets

Prescription d’examens de santé préventifs par des résidents en médecine familiale

PubMed Central

Fung, Daisy; Schabort, Inge; MacLean, Catherine A.; Asrar, Farhan M.; Khory, Ayesha; Vandermeer, Ben; Michael Allan, G.

2015-01-01

Résumé Objectif Déterminer quels sont les examens de dépistage prescrits par les résidents en médecine familiale dans le cadre des soins de santé préventifs. Conception Une enquête transversale. Contexte Alberta et Ontario. Participants Résidents en médecine familiale de première et de deuxième année à l’Université de l’Alberta à Edmonton, à l’Université de Calgary en Alberta et à l’Université McMaster à Hamilton en Ontario, durant l’année universitaire 2011–2012. Principaux paramètres d’évaluation Données démographiques, scores à l’échelle de Likert évaluant les habitudes de prescription et sélections parmi une liste de 38 examens pouvant être prescrits en soins préventifs à un échantillon de patients de sexe féminin et masculin de 38 et de 55 ans. Les statistiques descriptives et comparatives ont été calculées. Résultats Au total, 318 résidents sur 482 (66 %) ont répondu au sondage. Les examens recommandés ou appropriés ont été prescrits par 82 % (pour la cytologie cervicale) à 95 % (pour la glycémie à jeun) des résidents. Parmi les différents patients de l’échantillon, les résidents ont prescrit en moyenne 3,3 à 5,7 examens inappropriés par patient, et 58 à 92 % ont prescrit au moins 1 examen inapproprié par patient. Les coûts excédentaires moyens ont été estimés à 38,39 $ pour un homme de 38 ans et à 106,46 $ pour une femme de 55 ans. Le recours plus fréquent à une grille de référence des examens médicaux périodiques n’a pas amélioré la situation (p = 0,88). Conclusion En général, les résidents ont raisonnablement bien prescrit les examens médicaux préventifs appropriés, mais ils ont aussi prescrit en moyenne 3,3 à 5,7 examens inappropriés à chaque patient. Les programmes de formation doivent mieux préparer les étudiants à reconnaître le dépistage approprié et doivent s’efforcer d’inculquer des comportements de prescription exemplaires avant que les r

Pollution Atmosphérique et Santé: Corrélation ou Causalité? Le Cas de la Relation entre l'Exposition aux Particules et la Mortalité Cardio-pulmonaire.

PubMed

Dab, William; Ségala, Claire; Dor, Frédéric; Festy, Bernard; Lameloise, Philippe; Moullec, Yvon Le; Tertre, Alain Le; Médina, Sylvia; Quénel, Philippe; Wallaert, Benoît; Zmirou, Et Denis

2001-02-01

De nombreuses études épidémiologiques ont observé dans des contextes différents une faible relation à court terme entre les particules et la mortalité cardio-pulmonaire, même quand les normes de qualité de l'air n'étaient pas dépassées. La causalité de cette relation est un enjeu de santé publique en raison de l'importance de la population exposée. Notre objectif est de faire l'inventaire critique des arguments utilisés dans 15 revues de la littérature publiées. Nous expliquons l'importance de distinguer la validité de la causalité et analysons de façon systématique les différents critères de jugement dans le contexte des études écologiques temporelles. Notre conclusion est que la relation observée est valide et que la plupart des critères de causalité sont respectés. Diminuer le niveau d'exposition des populations aux particules est souhaitable. En Europe, en agissant à la source, notamment sur les émissions Diesel, on diminuera aussi d'autres polluants qui peuvent jouer un rôle sanitaire. Aux États-Unis, la situation est plus complexe car les particules sont surtout secondaires. Il est également indispensable de poursuivre les recherches pour mieux connaître les déterminants des expositions globales des individus et mieux comprendre le rôle toxique des différents facteurs physico-chimiques des particules.

Une étude rétrospective sur l'incidence de l'insuffisance rénale chronique dans le service de Médecine Interne et Néphrologie du Centre Hospitalier Universitaire d'Antananarivo

PubMed Central

Ramilitiana, Benja; Ranivoharisoa, Eliane Mikkelsen; Dodo, Mihary; Razafimandimby, Evanirina; Randriamarotia, Willy Franck

2016-01-01

L'insuffisance rénale chronique est un problème de santé publique au niveau mondial. Dans les pays développés, cette affection survient essentiellement chez les sujets âgés, mais en Afrique, elle s'installe plutôt chez les sujets jeunes actifs. C'est une affection de lourde prise en charge dans un pays à faible revenu à cause de ses coûts. Notre but est de décrire les aspects épidémiologiques des nouveaux cas d'insuffisance rénale chronique à Madagascar. Il s'agit d'une étude rétrospective descriptive de 3 ans partant du 1er janvier 2007 au 31 décembre 2009 dans le service de Médecine Interne et Néphrologie du Centre Hospitalier Universitaire d'Antananarivo portant sur 239 patients diagnostiqués comme une insuffisance rénale chronique. L'incidence était de 8,51% parmi les patients hospitalisés dans le service. L’âge moyen des patients était de 45,4 ans avec des extrêmes de 16 et 82 ans et un sex-ratio de 1,46. Le principal antécédent était l'hypertension artérielle (59,8%). L'insuffisance rénale chronique était terminale dans 75,31% des cas (n=180). Les causes de l'insuffisance rénale chronique étaient dominées par la glomérulonéphrite chronique (40,1%), la néphroangiosclérose (35,5%). L'hémodialyse était réalisée chez 3 patients (1,26%), aucun patient n’était pas programmé pour une greffe rénale. Le taux de mortalité dans le service était de 28,87%. L'insuffisance rénale chronique est une maladie de pronostic redoutable et handicapante qui affecte les sujets jeunes à Madagascar. Son traitement reste inaccessible dans la majorité des patients. L'accent doit donc être mis principalement sur la prévention notamment une bonne prise en charge précoce des infections, de l'hypertension artérielle et du diabète pour réduire ses impacts négatifs sur la santé communautaire et publique. Le projet de la transplantation rénale - donneur vivant, traitement efficace et moins coûteux par rapport à l

Life History and Risk of Death after 50: A Survival Analysis for Europe.

PubMed

Nicińska, Anna; Kalbarczyk-Stęclik, Małgorzata

2015-12-01

RÉSUMÉ Dans notre étude nous avons examiné l'influence des événements du passé des individus sur le risque de décès des Européens âgés de plus de 50 ans, en contrôlant autres variables pertinentes. Notre analyse était basée sur les données d'entretiens biographiques rétrospectifs, les données d'entretiens réguliers au suivi longitudinal et celles d'entretiens de fin de vie de l'Enquête européenne SHARE sur la santé, le vieillissement et la retraite en Europe. En particulier, nous relevons l'état de santé auto-déclaré pendant l'enfance; les périodes de pauvreté, de faim et de mauvaise santé éprouvées dans le passé; et aussi l'histoire des soins de santé, y compris les soins dentaires, les analyses de sang et les mesures de pression artérielle. Ces informations, avec l'age, le sexe, l'état de santé subjectif et objectif, et d'autres facteurs socio-démographiques, permettent d'expliquer le risque de décès. L'analyse de survie, en contrôlant des variables pertinentes, montre que les événements du passé ont un impact significatif sur le risque de décès des Européens âgés de plus de 50 ans.

Seeking health- and nutrition-related information on the Internet in a large population of French adults: results of the NutriNet-Santé study.

PubMed

Fassier, Philippine; Chhim, Anne-Sophie; Andreeva, Valentina A; Hercberg, Serge; Latino-Martel, Paule; Pouchieu, Camille; Touvier, Mathilde

2016-06-01

The Internet has become a major source of health and nutrition information. Little is known about the type of consulted websites (institutional v. non-institutional) and the tendency to discuss with a healthcare professional (HCP) the information found on the Internet. The aim of this cross-sectional study was to investigate health- and nutrition-related Internet use in a large French population-based study. Data were collected in 2013 using self-administered, web-based questionnaires from 42 113 participants of the NutriNet-Santé study (mean age=51·2 years, 76 % women). Unconditional multivariate logistic regression analyses and χ 2 tests were used for comparisons. In total, 85·1 % of the subjects used the Internet to search for health and/or nutrition information, and 23·6 % used the Internet to read or post messages on health/nutrition forums. Only 16·0 % discussed with a HCP the information found online. This proportion was lower in subjects with lower educational level (OR 0·77; 95 % CI 0·72, 0·82) and lower computer skills (OR 0·70; 95 % CI 0·65, 0·76). In total, 8038 health/nutrition websites were cited, with institutional websites representing only 12·9 % of that number. Only one institutional website was present in the top 10. Older subjects (OR 1·49; 95 % CI 1·28-1·74), those with lower educational level (OR 2·08; 95 % CI 1·75, 2·50) and lower nutritional knowledge (OR 1·33; 1·12, 1·59) were more likely to cite non-institutional websites. This large population-based study showed that institutional websites were infrequently accessed and that a few participants discussed the information found online with their HCP. This particular trend was especially visible among individuals who were more vulnerable regarding misleading information. This supports the need to increase awareness of high-quality websites providing reliable health/nutrition information.

PubMed

Vila Masse, Samantha

2018-01-22

Examiner le lien entre les conditions de travail et la santé mentale des travailleurs-euses de la restauration.MÉTHODE : L'échantillon se compose de 652 travailleurs-euses de la restauration issus de l'ESCC-SM de 2012. Des analyses de régression linéaire hiérarchique sont effectuées et ajustées en fonction de divers facteurs sélectionnés (sociodémographiques, habitudes de vie). Les conditions de travail sont mesurées en partie selon le Job Content Questionnaire (JCQ) de Karasek et Theorell. La détresse psychologique est mesurée à partir de l'échelle K6 de Kessler. La santé mentale positive est mesurée à partir du Continuum de santé mentale-version abrégée (MHC-SF) de Keyes.RÉSULTATS : Les fortes exigences psychologiques, le travail à temps partiel et les fortes exigences physiques sont associés de façon positive à la détresse psychologique des travailleurs-euses de la restauration, alors que le soutien social des collègues y est associé de façon inverse. Pour la santé mentale positive des travailleurs-euses de la restauration, l'insécurité d'emploi, les fortes exigences psychologiques et la faible latitude décisionnelle sont associées de façon négative tandis que le soutien social des collègues y est associé inversement. Cette étude souligne l'importance de considérer à la fois les aspects positifs et négatifs de la santé mentale. En effet, les facteurs associés à la santé mentale positive et à la détresse psychologique des travailleurs-euses de la restauration sont différents, voire associés en direction inverse.

Sclerosing Angiomatoid Nodular Transformation: Laparoscopic Splenectomy as Therapeutic and Diagnostic Approach at the Same Time.

PubMed

Cipolla, Calogero; Florena, Ada Maria; Ferrara, Gabriella; Di Gregorio, Riccardo; Unti, Elettra; Giannone, Antonino G; Lazzaro, Luigi A; Graceffa, Giuseppa; Pantuso, Gianni

2018-01-01

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiopathogenesis and with definite features of imaging, histopathology, and immunohistochemistry. It was first described by Martel et al. in 2004, and to date, only 151 cases have been reported. We report a case of SANT of the spleen detected in a 66-year-old Caucasian, without comorbidities, presented to our department with epigastric pain. We, also, presented a review of the literature. SANT is a benign incidentally vascular condition in the majority of cases. The wide age and gender distribution in our review is in accordance with that in previous studies in English literature. In our opinion, splenectomy is the choice treatment because it is at the same time diagnostic and therapeutic in a definitive way.

Implementation en VHDl/FPGA d'afficheur video numerique (AVN) pour des applications aerospatiales

NASA Astrophysics Data System (ADS)

Pelletier, Sebastien

L'objectif de ce projet est de developper un controleur video en langage VHDL afin de remplacer la composante specialisee presentement utilisee chez CMC Electronique. Une recherche approfondie des tendances et de ce qui se fait actuellement dans le domaine des controleurs video est effectuee afin de definir les specifications du systeme. Les techniques d'entreposage et d'affichage des images sont expliquees afin de mener ce projet a terme. Le nouveau controleur est developpe sur une plateforme electronique possedant un FPGA, un port VGA et de la memoire pour emmagasiner les donnees. Il est programmable et prend peu d'espace dans un FPGA, ce qui lui permet de s'inserer dans n'importe quelle nouvelle technologie de masse a faible cout. Il s'adapte rapidement a toutes les resolutions d'affichage puisqu'il est modulaire et configurable. A court terme, ce projet permettra un controle ameliore des specifications et des normes de qualite liees aux contraintes de l'avionique.

A case of cord capillary hemangioma of the spleen: a recently proven true neoplasm.

PubMed

Tajima, Shogo; Koda, Kenji

2015-05-01

Cord capillary hemangioma (CCH) of the spleen is an extremely rare lesion. Once classified under splenic hamartoma, CCH is now differentiated from hamartoma, as its clonality has recently been proven. Herein, we present the case of an incidentally found CCH, measuring 6 × 5.5 × 5 cm, in a 45-year-old man. He underwent splenectomy and has been recurrence-free for 8 years. Macroscopically, the cut surface of the mass showed a central stellate scar with peripheral interspersed reddish areas of variable sizes and intervening fibrous bands. Microscopically, the mass was well demarcated from the splenic tissue. The macroscopic reddish areas were found to correspond to nodules of various sizes, which were predominantly composed of CD34-expressing capillaries without the presence of CD8-expressing sinuses. The relative proportion of these two types of vessels distinguishes CCH from sclerosing angiomatoid nodular transformation (SANT), as SANT shows the apparent presence of CD8-expressing sinuses. In longstanding cases of SANT, sinuses might become ambiguous and the differences between CCH and SANT might become subtle. Nonetheless, immunohistochemistry should be performed when these conditions are suspected, since accurate distinction is usually achieved as a result. © 2015 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

The Nutrinet-Santé Study: a web-based prospective study on the relationship between nutrition and health and determinants of dietary patterns and nutritional status.

PubMed

Hercberg, Serge; Castetbon, Katia; Czernichow, Sébastien; Malon, Aurélie; Mejean, Caroline; Kesse, Emmanuelle; Touvier, Mathilde; Galan, Pilar

2010-05-11

Nutrition-related chronic diseases such as cardiovascular diseases and cancer are of multiple origin, and may be due to genetic, biologic, behavioural and environmental factors. In order to detangle the specific role of nutritional factors, very large population sample cohort studies comprising precisely measured dietary intake and all necessary information for accurately assessing potential confounding factors are needed. Widespread use of internet is an opportunity to gradually collect huge amounts of data from a large sample of volunteers that can be automatically verified and processed. The objectives of the NutriNet-Santé study are: 1) to investigate the relationship between nutrition (nutrients, foods, dietary patterns, physical activity), mortality and health outcomes; and 2) to examine the determinants of dietary patterns and nutritional status (sociological, economic, cultural, biological, cognitive, perceptions, preferences, etc.), using a web-based approach. Our web-based prospective cohort study is being conducted for a scheduled follow-up of 10 years. Using a dedicated web site, recruitment will be carried out for 5 years so as to register 500 000 volunteers aged >/= 18 years among whom 60% are expected to be included (having complete baseline data) and followed-up for at least 5 years for 240 000 participants. Questionnaires administered via internet at baseline and each year thereafter will assess socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Surveillance of health events will be implemented via questionnaires on hospitalisation and use of medication, and linkage with a national database on vital statistics. Biochemical samples and clinical examination will be collected in a subsample of volunteers. Self-administered data collection using internet as a complement to collection of biological data will enable identifying nutrition-related risks and protective factors, thereby more clearly

Sclerosing Angiomatoid Nodular Transformation: Laparoscopic Splenectomy as Therapeutic and Diagnostic Approach at the Same Time

PubMed Central

Florena, Ada Maria; Ferrara, Gabriella; Di Gregorio, Riccardo; Unti, Elettra; Giannone, Antonino G.; Lazzaro, Luigi A.; Graceffa, Giuseppa; Pantuso, Gianni

2018-01-01

Introduction Sclerosing angiomatoid nodular transformation (SANT) of the spleen is a rare benign vascular lesion with unknown etiopathogenesis and with definite features of imaging, histopathology, and immunohistochemistry. It was first described by Martel et al. in 2004, and to date, only 151 cases have been reported. Case Description We report a case of SANT of the spleen detected in a 66-year-old Caucasian, without comorbidities, presented to our department with epigastric pain. We, also, presented a review of the literature. Conclusions SANT is a benign incidentally vascular condition in the majority of cases. The wide age and gender distribution in our review is in accordance with that in previous studies in English literature. In our opinion, splenectomy is the choice treatment because it is at the same time diagnostic and therapeutic in a definitive way. PMID:29854543

Measurement of Compression Factor and Error Sensitivity Factor of the Modified READ Facsimile Coding Technique.

DTIC Science & Technology

1980-08-01

Compression factor and error sensitivity together with statistical data have also been tabulated. This TIB is a companion drcument to NCS TIB’s 79-7...vu donner la priorit6 pour lour r~alisation. Chaque application est conf ice A un " chef do projet", responsable successivoment do sa conception. de son...pilote depend des r~sultats obtenus et fait I’objet d’une d~cision- de ’.a Direction Gdnerale. Ndanmoins, le chef do projet doit dOs le d~part consid~rer

Assessment study of the nutritional status, eating habits and physical activity of the schooled population of Centelles, Hostalets de Balenyà and Sant Martí de Centelles (ALIN 2014 Study).

PubMed

Aguilà, Queralt; Ramón, Maria Àngels; Matesanz, Susana; Vilatimó, Ramon; Del Moral, Irene; Brotons, Carles; Ulied, Àngels

2017-03-01

Malnourishment can be caused by either a lack of food or an excess of low-nutrient foods. Due to several factors, this predisposes children to academic failure. The objective of this study is to estimate the prevalence of school children with eating problems, study their nutrition level, food quality in the diet, and level of physical activity. The study involved the school children between 3 months and 16.5 years of age in the municipalities of Centelles, Hostalets de Balenyà and Sant Martí de Centelles. Personal, age, nutrition and physical activity data were collected for the descriptive and bivariate analyses. A total of 1,374 children were included, of which 122 were under 3 years of age (8.9%). Obesity was recorded in 2.5%, while 17.2, 15.6 and 64.8% were overweight, underweight and of normal weight, respectively. The remaining 1,252 children were over 3 years of age (91.1%), and obesity was recorded in 8.1%, while 26.1, 11.0 and 62.9% were overweight, underweight and of normal weight, respectively. Adherence to the Mediterranean diet decreased significantly with increasing age. The maintenance of body weight was significantly correlated to the consumption of carbohydrates for breakfast before going to school, daily fruit consumption, and not having a need for care from the social services. The differences in physical activity and a sedentary lifestyle proved significant between males and females. Being underweight and overweight are factors related to eating habits and dependency upon the social services. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Artemisia scoparia extract attenuates non-alcoholic fatty liver disease in diet-induced obesity mice by enhancing hepatic insulin and AMPK signaling independently of FGF21 pathway

PubMed Central

Wang, Zhong Q.; Zhang, Xian H.; Yu, Yongmei; Tipton, Russell C.; Raskin, Ilya; Ribnicky, David; Johnson, William; Cefalu, William T.

2013-01-01

Objective Nonalcoholic fatty liver disease (NAFLD) is a common liver disease which has no standard treatment. In this regard, we sought to evaluate the effects of extracts of Artemisia santolinaefolia (SANT) and Artemisia scoparia (SCO) on hepatic lipid deposition and cellular signaling in a diet-induced obesity (DIO) animal model. Materials/Methods DIO C57/B6J mice were randomly divided into three groups, i.e. HFD, SANT and SCO. Both extracts were incorporated into HFD at a concentration of 0.5% (w/w). Fasting plasma glucose, insulin, adiponectin, and FGF21 concentrations were measured. Results At the end of the 4-week intervention, liver tissues were collected for analysis of insulin, AMPK, and FGF21 signaling. SANT and SCO supplementation significantly increased plasma adiponectin levels when compared with the HFD mice (P < 0.001). Fasting insulin levels were significantly lower in the SCO than HFD mice, but not in SANT group. Hepatic H&E staining showed fewer lipid droplets in the SCO group than in the other two groups. Cellular signaling data demonstrated that SCO significantly increased liver IRS-2 content, phosphorylation of IRS-1, IR β, Akt1 and Akt2, AMPK α1 and AMPK activity and significantly reduced PTP 1B abundance when compared with the HFD group. SCO also significantly decreased fatty acid synthase (FAS), HMG-CoA Reductase (HMGR), and Sterol regulatory element-binding protein 1c (SREBP1c), but not Carnitine palmitoyltransferase I (CPT-1) when compared with HFD group. Neither SANT nor SCO significantly altered plasma FGF21 concentrations and liver FGF21 signaling. Conclusion This study suggests that SCO may attenuate liver lipid accumulation in DIO mice. Contributing mechanisms were postulated to include promotion of adiponectin expression, inhibition of hepatic lipogenesis, and/or enhanced insulin and AMPK signaling independent of FGF21 pathway. PMID:23702383

Slash and burn versus "agronegócio". Tales of forest degradation in the maroon area of Vila Bela da SantíssimaTrindade, Mato Grosso, Brazil

NASA Astrophysics Data System (ADS)

Leite, José C.; Ferreira, António A. J.

2014-05-01

Over the last four decades, deforestation in Brazil occurred systematically in the area known as the "arcof deforestation", an extensive geographical area located in the interface of the Cerrado and the Amazon biomes. The deforestation process replaces the forest and the slash and burn agriculture systems by modern intensive agriculture systems targeted at the production of cash crops like cotton, maize or soybeans, and to graze cattle.The so called "agronegócio" system. The reduction of pristine forest areas where traditional (indigenous, maroons and riverside) population conduct slash and burn agriculture, reduces the recovery time of the abandoned fields after exhaustion by agriculture crops, reason why the return to the same spots for another cycle of slash and burn occurs before the forest recovers completely from the previous cycle. In fact, the frequency of the cycles is increasing with the expansion of farm land and the reduction of available forest. This work encompasses the reasons, causes and/or motivations of the deforestation trends in the Vila Bela da SantíssimaTrindade, near the Bolivian border of Mato Grosso in Brazil, over a time span of four decades. The arc of deforestation has passed the region in the 1980's, leaving yet a large area of pristine forest where the traditional communities kept practicing a slash and burn agriculture system. Nevertheless, due to the reduction of available area, and specially due to the exposure of traditional communities to the "western civilization culture", there is an increasing abandonment of the traditional systems and associated culture and knowledge. In this context, the traditional communities may become a deforestation/degradation factor. To prevent this situation, the GUYAGROFOR project was implemented, to value traditional knowledge, identify bottlenecks in the increase of added value to the local traditional products, and to test methodologies to maintain and if possible improve soil fertility near the

Towards an Operational Urban Modeling System for CBRN Emergency Response and Preparedness

DTIC Science & Technology

2014-05-01

sa capacité en tant que centre d’expertise et de soutien pour les d’événements CBRN au Canada : planification , évaluation en temps réel et...besoins, tels que la planification de scénarios, la préparation, l’intervention et la post- évaluation des événements CBRN. Ce projet a été un succès...canadien d’intervention d’urgence. En outre, le projet a respecté le budget et l’échéancier suite d’une planification minutieuse. Table of

Implantation des sites de soins communautaires en République Démocratique du Congo: consécration d'un double standard dans l'accès aux soins

PubMed Central

Dunia, Gisèle Mawazo Binti

2013-01-01

Depuis 2005, la République Démocratique du Congo a amorcé l'implantation des sites de soins communautaires. Cette stratégie a pour objectif de rapprocher les services de santé des populations éloignées. Bien que cela parte d'une bonne intention, elle résulte, à notre sens, en une consécration d'un système de santé à deux vitesses. En effet, les populations vivant en ville ont accès à des soins prestés par des agents de santé formés alors que celles vivant en milieu rural reculé ont pour prestataires de soins des relais communautaires. Cette situation marginalise encore plus des populations dont la situation géographique est déjà préoccupante. Pourtant, la population est prête à parcourir des kilomètres en échange d'un service qu'elle estime de qualité. PMID:23785563

Inadequate programming, insufficient communication and non-compliance with the basic principles of maternal death audits in health districts in Burkina Faso: a qualitative study.

PubMed

Congo, Boukaré; Sanon, Djénéba; Millogo, Tieba; Ouedraogo, Charlemagne Marie; Yaméogo, Wambi Maurice E; Meda, Ziemlé Clement; Kouanda, Seni

2017-09-29

écessite une bonne programmation, une bonne communication et le respect des principes fondamentaux. Des études sur le respect des principes fondamentaux existent mais ont été menées dans les zones urbaines, le 2ème ou 3ème niveau du système de santé, dans des situations expérimentales, un contexte de projets de renforcement des compétences ou de plates-formes techniques, en mettant l'accent sur la revue des «near miss». Cette étude vise à combler le manque d'information sur la programmation et le respect des principes fondamentaux concernant le milieu rural, le niveau du système de santé qui est. le district sanitaire et la situation de routine au Burkina Faso. MéTHODOLOGIE: Nous avons mené une étude de cas multiple dans 7 établissements de santé sélectionnés par échantillonnage raisonné contrasté selon 4 critères: milieu urbain ou rural, taux de mortalité maternelle dans les établissements de santé en 2013 (les données de l'année 2014 n'étant pas complètes à la rédaction du protocole), la déclaration des audits de décès maternels dans le système de surveillance nationale, le recours ou non par le district choisi à un centre hospitalier régional pour les soins complémentaires de premier niveau (normalement offerts à l'hôpital de district s'il existe). Une revue des dossiers d'audits, ainsi que des entretiens directifs, semi-directifs auprès du personnel impliqué dans les soins de maternité ont été réalisés. L'enquête s'est. déroulée du 27 Avril au 30 Mai 2015. RéSULTATS: Les résultats montrent que les revues des décès maternels ont été irrégulièrement programmées, de façon espacée et très souvent au gré des évènements. La préparation, la conduite des séances et la communication après les séances ont été défaillantes. La confidentialité au sein du groupe d'auditeurs a été respectée tandis que le niveau de respect du principe de « no name, no shame, no blame » a varié d'une structure à une autre

Strategic Shock: The Collapse of the Soviet Union: 1989

DTIC Science & Technology

2010-08-01

sécurité de l’avenir, partie 2 : Chocs du futur (ESA2), lancé par la Direction de l’analyse de la sécurité future (DASF) en décembre 2008. Le projet vise à...recenser et à évaluer les probables chocs stratégiques afin de guider et de faciliter l’élaboration des politiques et le développement des capacités...Un des éléments du projet consistait à illustrer les leçons apprises et les conséquences des chocs antérieurs. La présente étude, « Strategic

Prise de suppléments multivitaminiques pour la prévention primaire des anomalies congénitalies

PubMed Central

Morin, Pascale; Demers, Karine; Giguère, Christine; Tribble, Denise St-Cyr; Lane, Julie

2007-01-01

RÉSUMÉ OBJECTIF Déterminer si les recommandations véhiculées par les professionnels de la santé sur l’importance de l’acide folique encouragent les femmes susceptibles de procréer de prendre les suppléments d’acide folique. CONCEPTION Enquête. CONTEXTE Centre de santé et de services sociaux, Institut universitaire de gériatrie de Sherbrooke, à Sherbrooke, Qué. PARTICIPANTS 323 femmes francophones âgées entre 18 et 45 ans. PRINCIPALES MESURES DES RÉSULTATS La consommation de suppléments de vitamines et de minéraux au cours de la dernière année. Des analyses statistiques descriptives et bivariées et une modélisation par régression logistique ont été effectuées pour déterminer si l’association observée entre la recommandation d’un professionnel de la santé et la consommation de vitamines et de minéraux persistait après avoir tenu compte de l’effet des variables de contrôle (consultation de documentation, connaissances, sources d’information, perception, âge, scolarité, revenu, état matrimonial, intention de devenir enceinte). RÉSULTATS Environ 41% des femmes rapportent que leur médecin leur avait recommandé de consommer un supplément de vitamines et de minéraux. Après avoir ajusté toutes les variables dans le modèle, il est apparu que le fait de se faire recommander par un professionnel de la santé de prendre un supplément de vitamines et de minéraux était significativement associé à la consommation de vitamines et de minéraux par les femmes susceptibles de devenir enceintes. CONCLUSION Les professionnels peuvent améliorer la santé de la population par une pratique clinique préventive. Nous soulignons l’importance de soutenir ces derniers dans leurs efforts d’intégrer puis d’appliquer des connaissances scientifiques dans leur pratique. PMID:18077754

Retour vers le futur: l'expérience des patients et le lien avec la qualité, la sécurité et le rendement financier.

PubMed

Cochrane, Bonnie S; Hagins, Mitch; King, John A; Picciano, Gino; McCafferty, Maureen M; Nelson, Brian

2015-11-01

Au Canada, l'amélioration de l'expérience des patients est devenue une priorité des politiques de santé. Le perfectionnement et la normalisation des outils et systèmes pour surveiller les mesures de l'expérience des patients augmentent, tandis que la tendance vers une plus grande reddition de compte sur des améliorations durables et abordables se confirme. Pour de nombreux professionnels de la santé, ce phénomène fait foi d'un intérêt renouvelé pour les besoins et priorités fondamentaux des patients, après des décennies où les changements structurels et technologiques ont dominé les programmes de santé. Pour les leaders en santé canadiens, l'amélioration de l'expérience des patients comporte actuellement de grands défis et de belles possibilités. À cet égard, l'expérience des organisations partenaires du groupe Studer au Canada est à la fois pertinente et instructive. Ces organisations ont adopté un modèle, du nom de Evidence-Based Leadership (EBL, ou leadership fondé sur des données probantes), qui favorise et soutient l'harmonisation de l'ensemble des activités et des comportements, conformément à des objectifs organisationnels précis, y compris des améliorations mesurables de l'expérience des patients. Le présent article expose des études de cas d'organisations qui ont adopté l'EBL. Ces organisations ont réalisé des progrès rapides en matière d'indicateurs de l'expérience des patients, ainsi que dans des secteurs essentiels comme les résultats cliniques, la sécurité et le rendement financier. Les données émergentes sur les facteurs et processus qui sous-tendent ces améliorations sont également abordées. © 2015 Collège canadien des leaders en santé

Influence of postharvest treatments on qualitative and chemical parameters of Tarocco blood orange fruits to be used for fresh chilled juice.

PubMed

Pannitteri, C; Continella, A; Lo Cicero, L; Gentile, A; La Malfa, S; Sperlinga, E; Napoli, E M; Strano, T; Ruberto, G; Siracusa, L

2017-09-01

Tarocco "Sant'Alfio" is a late ripening blood orange cultivar. Blood oranges are more and more appreciated from consumers for their high nutraceutical value due to the presence of bioactive compounds including vitamin C, polyphenols, flavonoids and hydroxycinnamic acids. The aim of this work is to set up a reliable protocol for postharvest storage of the very-late Tarocco "Sant'Alfio" orange to prolong the availability of this product in the market to be used for fresh chilled orange juice production. Fruits were subjected to three storage treatments (20days at 1°C plus 50days at 4°C; 70days at 4°C; 70days at 20°C). The results indicate that cold treatments, in particular at 4°C constantly, can extend Tarocco "Sant'Alfio" shelf life enhancing total anthocyanin content. The defined protocols allow prolonging market availability of a high value product and could induce relevant benefits for the citrus industry and consumers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Entrevue avec le Dr Charley Zeanah

PubMed Central

2013-01-01

Le Dr Charles Zeanah est titulaire de la chaire de psychiatrie Mary K. Sellars-Polchow, professeur de pédiatrie clinique et vice-président de la pédopsychiatrie au département de psychiatrie et des sciences du comportement de la faculté de médecine de l’Université Tulane, à la Nouvelle-Orléans. Il est également directeur général de l’institut de la santé mentale des nourrissons et des jeunes enfants de Tulane. Il est récipiendaire de nombreux prix, notamment le prix de prévention Irving Phillips (AACAP), la mention élogieuse présidentielle pour sa recherche et son leadership exceptionnels en santé mentale des nourrissons (American Orthopsychiatric Association), le prix d’excellence clinique Sarah Haley Memorial (International Society for Traumatic Stress Studies), le prix de recherche en pédopsychiatrie Blanche F. Ittelson (APA), et le prix Serge Lebovici Award soulignant les contributions internationales à la santé mentale des nourrissons (World Association for Infant Mental Health). Le Dr Zeanah est fellow distingué de l’AACAP, fellow distingué de l’APA et membre du conseil d’administration de Zero to Three. Il est l’éditeur scientifique de Handbook of Infant Mental Health (3e édition) qui est considéré comme étant le manuel de pointe et la référence de base du domaine de la santé mentale des nourrissons.

Perspective sur les ruptures d’approvisionnement de médicaments en établissement de santé de 2006 à 2010

PubMed Central

Bussières, Jean-François; Chiveri, Andrei; Lebel, Denis

2011-01-01

marché. Toutefois, 50 % des ruptures de stocks provenaient de trois classes thérapeutiques (médicaments du système nerveux central, agents anti-infectieux et médicaments cardiovasculaires). Conclusion: Il s’agit des premières données canadiennes publiées sur l’étendue des ruptures d’approvisionnement sur le marché hospitalier. L’étude a démontré que les ruptures de stocks touchent la plupart des fabricants et la majorité des classes thérapeutiques. D’autres études sont nécessaires afin d’explorer les causes et les conséquences des ruptures d’approvisionnement en établissements de santé. PMID:22479098

Les bons conseils de la naissance à la maternelle

PubMed Central

Rourke, Leslie; Leduc, Denis; Constantin, Evelyn; Carsley, Sarah; Rourke, James; Li, Patricia

2013-01-01

Résumé Objectif Donner un aperçu de la version 2011 du Relevé postnatal Rourke (RPR), qui comporte aussi des nouveautés dans son site web et de nouvelles initiatives connexes et qui intègre les données des ouvrages scientifiques récents sur les soins de santé préventifs à l’intention des enfants de 0 à 5 ans. Qualité des données À l’instar des versions antérieures du RPR, la nouvelle édition présente des recommandations identifiées comme se fondant sur des preuves suffisantes, acceptables ou consensuelles, selon les classifications adoptées par le Groupe d’étude canadien sur les soins de santé préventifs en 2011. Message principal De nouveaux renseignements et des recommandations sont présentés concernant la surveillance de la croissance, la nutrition et la vaccination contre la varicelle, les pneumocoques, les méningocoques et le rotavirus. Il y a maintenant de bonnes données probantes en faveur de l’adaptation canadienne des courbes de croissance de l’Organisation mondiale de la Santé, du dépistage universel des problèmes d’audition chez le nouveau-né et du recours à des stratégies de réduction de la douleur liée à la vaccination. On a mis à jour les conseils anticipatoires concernant la sécurité durant le sommeil, la supervision de la santé des enfants en foyer d’accueil, le trouble du spectre de l’alcoolisation fœtale, les facteurs de risque nécessitant le dépistage du plomb et de l’anémie, les soins dentaires et la santé buccale. Parmi les nouvelles rubriques dans le site web du RPR, on peut mentionner une section présentant des ressources pour les parents, des modifications à l’intention de populations particulières, comme les personnes vivant au Nunavut, une version du RPR qui met en évidence en un coup d’œil les modifications à la version de 2009 et une expansion de la fonction d’exploration du RPR accompagnée des hyperliens connexes menant aux renseignements pertinents. On peut

Acute high dose of chlorpyrifos alters performance of rats in the elevated plus-maze and the elevated T-maze.

PubMed

López-Crespo, G A; Flores, P; Sánchez-Santed, F; Sánchez-Amate, M C

2009-11-01

Chlorpyrifos (CPF) is a broad spectrum organophosphate (OP) pesticide widely used in agriculture, industry and household. Several animal studies indicate emotional disturbances after CPF exposure, although the results are sometimes puzzling. Thus, both anxiolytic and anxiogenic effects of CPF have been reported in different animal models of anxiety [Sánchez-Amate MC, Flores P, Sánchez-Santed F. Effects of chlorpyrifos in the plus-maze model of anxiety. Behav Pharmacol 2001;12:285-92; Sánchez-Amate MC, Dávila E, Cañadas F, Flores P, Sánchez-Santed F. Chlorpyrifos shares stimulus properties with pentilenetetrazol as evaluated by and operant drug discrimination task. Neurotoxicology 2002;23:795-803; López-Crespo G, Carvajal F, Flores P, Sánchez-Santed F, Sánchez-Amate MC. Time-course of biochemical and behavioural effects of a single high dose of chlorpyrifos. Neurotoxicology 2007;28:541-7]. On the other hand, other behavioural effects of CPF are time-dependent [López-Crespo G, Carvajal F, Flores P, Sánchez-Santed F, Sánchez-Amate MC. Time-course of biochemical and behavioural effects of a single high dose of chlorpyrifos. Neurotoxicology 2007;28:541-7], raising the question that the effects of CPF could be task and post-administration time dependent. To test this hypothesis, three groups of rats were treated with a single high dose of CPF (250 mg/kg); one of the groups was tested on day 5 on the elevated plus-maze, to complete our previous study on day 2 [Sánchez-Amate MC, Flores P, Sánchez-Santed F. Effects of chlorpyrifos in the plus-maze model of anxiety. Behav Pharmacol 2001;12:285-92]. The remaining groups were tested on the elevated T-maze on days 2 and 5. CPF produced an increased open arm activity on the elevated plus-maze on day 5, an increased escape latency on the elevated T-maze on day 2 and an impaired inhibitory avoidance on day 5. Data are discussed taking together all studies carried out in our laboratory, confirming that CPF effects on

Therapeutic efficacy of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome.

PubMed

Kajiwara, Mitsuru; Inoue, Shougo; Kobayashi, Kanao; Ohara, Shinya; Teishima, Jun; Matsubara, Akio

2014-04-01

Narrow band imaging cystoscopy can increase the visualization and detection of Hunner's lesions. A single-center, prospective clinical trial was carried out aiming to show the effectiveness of narrow band imaging-assisted transurethral electrocoagulation for ulcer-type interstitial cystitis/painful bladder syndrome. A total of 23 patients (19 women and 4 men) diagnosed as having ulcer-type interstitial cystitis/painful bladder syndrome were included. All typical Hunner's lesions and suspected areas identified by narrow band imaging were electrocoagulated endoscopically after the biopsy of those lesions. Therapeutic efficacy was assessed prospectively by using visual analog scale score of pain, O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score. The mean follow-up period was 22 months. All patients (100%) experienced a substantial improvement in pain. The average visual analog scale pain scores significantly decreased from 7.3 preoperatively to 1.2 1 month postoperatively. A total of 21 patients (91.3%) who reported improvement had at least a 50% reduction in bladder pain, and five reported complete resolution. Daytime frequency was significantly decreased postoperatively. O'Leary-Sant's symptom index, O'Leary-Sant's problem index and overactive bladder symptom score were significantly decreased postoperatively. However, during the follow-up period, a total of six patients had recurrence, and repeat narrow band imaging-assisted transurethral electrocoagulation of the recurrent lesions was carried out for five of the six patients, with good response in relieving bladder pain. Our results showed that narrow band imaging-assisted transurethral electrocoagulation could be a valuable therapeutic alternative in patients with ulcer-type interstitial cystitis/painful bladder syndrome, with good efficacy and reduction of recurrence rate. © 2014 The Japanese Urological Association.

Utilisation de lignes directrices dans le cadre de l’implantation de cabinets automatisés décentralisés en établissement de santé

PubMed Central

Brisseau, Lionel; Bussières, Jean-François; Lebel, Denis; Atkinson, Suzanne; Robinette, Louise; Fortin, Sylvie; Lemay, Michel

2011-01-01

RÉSUMÉ Contexte : Il existe peu de données sur les conséquences de l’utilisation des cabinets automatisés décentralisés (CAD) en établissements de santé. Méthode : Il s’agit d’une étude descriptive de la conformité des pratiques par rapport à des lignes directrices publiées dans le cadre de l’implantation de CAD. L’objectif principal de l’étude est d’évaluer la conformité globale et celle de chaque processus du circuit du médicament. L’étude se déroule au sein du Centre hospitalier universitaire (CHU) Sainte-Justine, un établissement mère–enfant de 500 lits. À partir des lignes directrices portant sur l’utilisation sécuritaire des CAD de l’Institute for Safe Medication Practice (aux États-Unis) (2008) et de son outil d’autoévaluation (2009), nous avons évalué la conformité de la pratique à 30 jours et à 120 jours après l’implantation. Résultats : Nous avons procédé de novembre 2009 à avril 2010 à l’implantation de sept stations de CAD au sein du CHU Sainte-Justine. Le profil de conformité est passé de 66 % à 74 % de janvier à avril 2010. Pour chaque processus relatif à l’utilisation sécuritaire des CAD, nous présentons une brève description des critères ainsi que les éléments de non-conformité liés à la technologie ou aux aspects organisationnels. Pour chaque élément de non-conformité, nous avons déterminé les actions requises auprès du fabricant afin de modifier l’équipement (c. à .d. aspects technologiques) et auprès de l’établissement afin de modifier les modalités d’utilisation (aspects organisationnels) en précisant le ou les processus impliqués. Conclusion : Cette étude décrit la conformité des pratiques au CHU Sainte-Justine par rapport à des lignes directrices publiées par l’Institute for Safe Medication Practices. L’utilisation de lignes directrices dans le cadre de l’implantation de cabinets automatisés décentralisés en établissement peut

The Saskatchewan/New Brunswick Healthy Start-Départ Santé intervention: implementation cost estimates of a physical activity and healthy eating intervention in early learning centers.

PubMed

Sari, Nazmi; Muhajarine, Nazeem; Froehlich Chow, Amanda

2017-01-19

Participation in daily physical activity and consuming a balanced diet high in fruits and vegetables and low in processed foods are behaviours associated with positive health outcomes during all stages of life. Previous literature suggests that the earlier these behaviours are established the greater the health benefits. As such, early learning settings have been shown to provide an effective avenue for exploring and influencing the physical activity and healthy eating behaviours of children before school entry. However, in addition to improving individual level health of children, such interventions may also result in a number of social benefits for the society. In fact, research among adult populations has shown that sufficient participation in physical activity can significantly lower hospital stays and physician visits, in turn leading to positive economic outcomes. To our knowledge there is very limited literature about economic evaluations of interventions implemented in early learning centers to increase physical activity and healthy eating behaviours among children. The primary purpose of this paper is to identify inputs and costs needed to implement a physical activity and healthy eating intervention (Healthy Start-Départ Santé (HS-DS)) in early learning centres throughout Saskatchewan and New Brunswick over the course of three years. In doing so, implementation cost is estimated to complete the first phase of a social return on investment analysis of this intervention. In order to carry out this evaluation the first step was to identify the inputs and costs needed to implement the intervention, along with the corresponding outputs. With stakeholder interviews and using existing database, we estimated the implementation cost by measuring, valuing and monetizing each individual input. Our results show that the total annual cost of implementing HS-DS was $378,753 in the first year, this total cost decreased slightly in the second year ($356,861) and again

Relevé postnatal Rourke 2014

PubMed Central

Riverin, Bruno; Li, Patricia; Rourke, Leslie; Leduc, Denis; Rourke, James

2015-01-01

Résumé Objectif Mettre à jour la version de 2011 du Relevé postnatal Rourke (RPR) à la suite d’une révision des meilleures données probantes récentes sur le suivi de la santé des nourrissons et des enfants de la naissance jusqu’à l’âge de 5 ans. Qualité des données La qualité des données a été cotée en fonction de l’ancien système de classification du Groupe d’étude canadien sur les soins de santé préventifs (jusqu’à 2006) et l’approche de détermination, d’élaboration et d’évaluation des recommandations (GRADE). Message principal De nouveaux faits scientifiques ont été pris en compte dans les recommandations du RPR 2014 en ce qui a trait au suivi de la croissance, à la nutrition, à l’éducation et aux conseils, au développement, à l’examen physique et à l’immunisation. La croissance est surveillée à l’aide des courbes de l’Organisation mondiale de la Santé qui ont été révisées en 2014. On devrait introduire les aliments solides en fonction de l’état de préparation du nourrisson et ces produits devraient contenir du fer. Il n’est actuellement plus recommandé de retarder l’introduction des allergènes alimentaires courants pour prévenir les allergies. Il faut promouvoir l’utilisation d’une tasse sans couvercle au lieu d’une tasse à bec dès l’âge de 12 mois. La section sur l’éducation et les conseils porte sur les blessures causées par du mobilier instable, ainsi que l’utilisation d’un siège d’auto orienté vers l’arrière jusqu’à 2 ans. Elle comporte aussi de l’information sur les saines habitudes de sommeil, la prévention de la maltraitance des enfants, la vie saine et active et la sédentarité de la famille, de même que l’hygiène buccale. On a aussi ajouté à cette section une nouvelle catégorie consacrée à la santé environnementale pour tenir compte des effets des dangers environnementaux sur la santé des enfants. Le RPR a recours à une

PubMed

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie

2017-04-01

Mettre à la disposition des fournisseurs de soins des lignes directrices concernant le recours à des méthodes contraceptives pour prévenir la grossesse et la promotion d'une sexualité saine. Efficacité globale des méthodes contraceptives citées : évaluation de l'innocuité, des effets indésirables et de la baisse du taux de grossesse; effet des méthodes contraceptives citées sur la santé sexuelle et le bien-être général; disponibilité des méthodes contraceptives citées au Canada. RéSULTATS: Des recherches ont été effectuées dans MEDLINE et la base de données Cochrane afin d'en tirer les articles en anglais publiés entre janvier 1994 et décembre 2015 traitant de sujets liés à la contraception, à la sexualité et à la santé sexuelle, dans le but de mettre à jour le consensus canadien sur la contraception paru de février à avril 2004. Nous avons également passé en revue les publications pertinentes du gouvernement canadien, ainsi que les déclarations de principes issues d'organisations compétentes vouées à la santé et à la planification familiale. La qualité des résultats a été évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs. Les recommandations quant à la pratique sont classées en fonction de la méthode décrite dans le rapport du Groupe. DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2017. Published by Elsevier Inc.

Reflections on Serving Remote Mountain Communities: Mobile Hospitals and Women's and Children's Health Care in Northern Haiti.

PubMed

Chierici, Rose-Marie; Voltaire, Thony Michelet

2016-12-01

In 2003 Alyans Sante Borgne's (ASB) conducted the first week-long mobile hospital in Molas, a poor mountain community a 10-h walk from the main hospital in the town of Borgne in North Haiti. ASB is a partnership between Haiti Outreach-Pwoje Espwa (H.O.P.E.), a US-based NGO, and Haiti's Ministry of Health. The paper reflects on this first experience and the evolution of an indigenous model of health care delivery, Sante Nan Lakou (SNL)/Health at the Extended Family Level, a model that prioritizes the needs of patients over those of the institution. It highlights the challenges of providing quality care to a much neglected segment of our population and documents the impact of this event for the community and for ASB. Lessons learned during that week shaped ASB's response to the root causes of women and children's poor health in the commune of Borgne. The response is articulated in a holistic grassroots program called Sante/Health, Edikasyon/Education, Ekonomi/Economy for Fanm/Women (SEE Fanm). SEE Fanm is a constellation of programs and initiatives that together brings quality care to women and seeks to empower them to take charge of their health and wellbeing and, by extension, that of their families and communities.

[Prevalence of trauma-related disorders in the French WHO study: Santé mentale en population générale (SMPG)].

PubMed

Vaiva, G; Jehel, L; Cottencin, O; Ducrocq, F; Duchet, C; Omnes, C; Genest, P; Rouillon, F; Roelandt, J-L

2008-12-01

Trauma-related disorders are disabling affections of which epidemiological data change according to the country, population and measuring instruments. The prevalence of posttraumatic stress disorder (PTSD) appears to have increased over the past 15 years, but one cannot tell whether it has indeed increased or whether the standardized procedure has improved. Moreover, very few epidemiologic studies among the general population have been conducted in Europe, notably in France. The "Santé mentale en population générale" (SMPG) survey, that took place in France between 1999 and 2003 among more than 36 000 individuals, gives an estimation of the prevalence of psychotraumatic disorders in the general population. Multi-varied analyses were performed on PTSD-related variables and comorbid disorders. The instantaneous prevalence (past month) of PTSD was of 0.7% among the whole SMPG sample, with almost the same proportion of men (45%) and women (55%). There was a high rate of comorbidity among PTSD individuals, notably with mood disorders, anxiety disorders and addictive behaviour. There was an obvious relationship with suicidal behaviour, with 15-fold more suicide attempts during the past month among the PTSD population. This survey analysed the consequences of a psychic traumatism over and above complete PTSD according to DSM-IV criteria, observing for instance the consequences for people exposed both to a trauma and suffering from at least one psychopathological symptom since the trauma. Those who suffered from a psychotraumatic syndrome, according to our enlarged definition, represented 5.3% of the population, half suffered from daily discomfort and a third of them used medication. Then, we compared those psychotraumatic syndromes to complete PTSD from a sociodemographic, functional and type of care point of view. There was little difference in prevalence of PTSD between men and women in the SMPG survey (45% vs 55%), which is clearly distinct from the other

Knowledge Acquisition for the Onboard Planner of an Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

Muscettola, Nicola; Rajan, Kanna

1997-01-01

This paper discusses the knowledge acquisition issues involved in transitioning their novel technology in to space flight software, developing the planer in the context of a large software projet and completing the work under a compressed development schedule.

Le management des projets scientifiques

NASA Astrophysics Data System (ADS)

Perrier, Françoise

2000-12-01

We describe in this paper a new approach for the management of scientific projects. This approach is the result of a long reflexion carried out within the MQDP (Methodology and Quality in the Project Development) group of INSU-CNRS, and continued with Guy Serra. Our reflexion was initiated with the study of the so-called `North-American Paradigm' which was, initially considered as the only relevant management model. Through our active participation in several astrophysical projects we realized that this model could not be applied to our laboratories without major modifications. Therefore, step-by-step, we have constructed our own methodology, using to the fullest human potential resources existing in our research field, their habits and skills. We have also participated in various working groups in industrial and scientific organisms for the benefits of CNRS. The management model presented here is based on a systemic and complex approach. This approach lets us describe the multiple aspects of a scientific project specially taking into account the human dimension. The project system model includes three major interconnected systems, immersed within an influencing and influenced environment: the `System to be Realized' which defines scientific and technical tasks leading to the scientific goals, the `Realizing System' which describes procedures, processes and organization, and the `Actors' System' which implements and boosts all the processes. Each one exists only through a series of successive models, elaborated at predefined dates of the project called `key-points'. These systems evolve with time and under often-unpredictable circumstances and the models have to take it into account. At these key-points, each model is compared to reality and the difference between the predicted and realized tasks is evaluated in order to define the data for the next model. This model can be applied to any kind of projects.

Innovations en vaccinologie: enjeux et perspectives pour l’Afrique

PubMed Central

Diop, Doudou; Sanicas, Melvin

2017-01-01

La vaccination est incontestablement l’une des interventions de santé publique les plus efficaces et les plus rentables qui soient. Les vaccins continuent de révolutionner notre capacité à prévenir les maladies et à améliorer la santé. Avec toutes les avancées technologiques, nous sommes en mesure d’étendre les avantages des vaccins à plus de gens et de fournir une meilleure protection contre les maladies infectieuses mortelles. Toutefois, avec le développement incessant de nouvelles souches microbiennes à travers le monde, la recherche en vaccinologie se doit d’innover continuellement. D’énormes progrès ont été réalisés pour améliorer la couverture vaccinale et introduire de nouveaux vaccins en Afrique. De nouveaux types de vaccins associés à des outils de vectorisation, d’administration et de délivrance spécifiques mais aussi des adjuvants susceptibles de moduler finement la réponse immunitaire sont attendus dans le futur. En Afrique, il est nécessaire de développer une approche régionale afin de répondre efficacement aux nombreux défis. Une meilleure information, la formation des personnels de santé en vaccinologie et des recherches bien ciblées sont les clés des futurs accomplissements dans le domaine. PMID:28690749

Le cannabis et les enfants et adolescents canadiens

PubMed Central

Grant, Christina N; Bélanger, Richard E

2017-01-01

Résumé L’usage du cannabis, la drogue illicite la plus consommée dans le monde, est fréquent chez les adolescents canadiens. La consommation de cannabis à l’adolescence peut provoquer des modifications fonctionnelles et structurelles du cerveau en développement et induire une atteinte cérébrale. Dans ce groupe d’âge, la consommation de marijuana s’associe fortement à la dépendance au cannabis et à d’autres troubles de l’usage d’une substance, à l’adoption et au maintien du tabagisme, à l’augmentation des troubles de santé mentale, y compris la dépression, l’anxiété et la psychose, à une perturbation du développement neurologique et à un déclin cognitif ainsi qu’à une diminution de la performance scolaire et des réalisations au cours de la vie. Le taux de soins médicaux aigus et d’hospitalisations chez les jeunes enfants qui ont consommé involontairement du cannabis est en hausse. Compte tenu du débat en cours sur la réglementation du cannabis au Canada, l’examen attentif des preuves de ses effets sur la santé et la mise en place de mécanismes de protection deviennent des priorités absolues en santé publique.

A New Approach to Electrical Characterization of Exploding Foil Initiators

DTIC Science & Technology

1998-12-01

processed to illustrate the methodology. RESUME Dans une etude precedente de 1a caracterisation electrique des detonateurs a element projete (DEP), on a...applicable a 1a caracterisation electrique des DEP et decrit la methodologie experimentale adequate. Cette methodologie est illustree par la

ALLPATHS: Assembling Large Genomes with Short Illumina Reads

ScienceCinema

Gnerre, Sante

2018-02-06

Sante Gnerre from the Broad Institute speaks on the challenge of developing high quality assemblies of large genomes using short reads at the "Sequencing, Finishing, Analysis in the Future" meeting in Santa Fe, NM.

Le changement comme tradition dans la recherche et la formation a la recherche en biotechnologie et en peripherie Etude de cas en sciences de la sante, sciences naturelles et genie

NASA Astrophysics Data System (ADS)

Bourque, Claude Julie

Le champ de la recherche scientifique et de la formation a la recherche est traverse depuis quelques dizaines d'annees par plusieurs courants et discours associes au changement, mais peu de travaux empiriques permettent de comprendre ce qui change concretement. C'est la contribution originale de cette these au champ de l'education, plus specifiquement a l'etude sociologique de l'enseignement superieur ou sont concentrees les activites liees a la triade thematique du programme doctoral dans lequel elle a ete produite : recherche, formation et pratique. L'enquete-terrain a ete realisee en 2009 et 2010 aupres de 808 repondants affilies a 60 etablissements au Quebec et a produit un vaste materiau de nature mixte (donnees quantitatives et qualitatives). Un portrait de la nebuleuse biotechnologique qui touche les secteurs des sciences de la sante, des sciences naturelles et du genie a ete realise. Ce domaine concerne des dizaines de disciplines et se revele de nature transdisciplinaire, mais les pratiques n'y sont pas davantage marquees par le changement que celles d'autres domaines connexes. Les dynamiques sociales ont fait l'objet d'analyses comparatives dans quatre contextes: le choix des programmes, des objets et des methodes, le financement, la diffusion et la planification de la carriere. Les resultats indiquent que les echanges entre les agents traditionnellement situes au coeur des activites de recherche dominent ces dynamiques dans tous les contextes etudies. L'etude des representations au fondement des pratiques a revele l'existence de trois ecoles de pensee qui coexistent dans le champ scientifique: academique, pragmatique et economiste. Ces ecoles permettent de categoriser les agents en fonction des zones de fractures qui marquent leurs oppositions tout en identifiant ce qu'ils ont en commun. Les representations et les pratiques liees a la formation temoignent d'un habitus plutot homogene, alors que les contradictions semblent plus souvent ancrees dans des

Port Infrastructure: Financing of Navigation Projects at Small and Medium-Sized Ports

DOT National Transportation Integrated Search

2000-03-01

Under the Water Resources Development Act of 1986, all public ports have had to share in the cost of navigation projets with the Corps of Engineers by paying the nonfederal share of the project's cost, which ranges from 20-60 percent depending on the...

Is Changing Teaching Practice the Mission Impossible? A Case Study of Continuing Professional Development for Primary School Teachers in Senegal

ERIC Educational Resources Information Center

Miyazaki, Takeshi

2016-01-01

This paper reports on research into a continuing professional development (CPD) project, "Projet de Renforcement de l'Enseignement des Mathématiques, des Sciences et de la Technologie" (PREMST) [Strengthening Mathematics, Science, and Technologies in Education Project]. The literature review reveals few examples of CPD changing the…

Dispositifs semi-conducteurs pour biodetection photonique et imagerie hyperspectrale

NASA Astrophysics Data System (ADS)

Lepage, Dominic

La creation d'un microsysteme d'analyse biochimique, capable de livrer des diagnostics preliminaires sur la quantification d'elements pathogenes, est un defi multidisciplinaire ayant un impact potentiel important sur la majorite des activites humaines en sante et securite. En effet, un dispositif integre, peu dispendieux et livrant des resultats facilement interpretables, permettrait une vulgarisation des capacites de biodetection a travers differents domaines d'applications societaires et industriels. Le present document se concentre sur l'integration monolithique d'une methode de biocaracterisation dans le but de generer un transducteur miniaturise et efficace, element central d'un microsysteme de detection. Le projet de recherche ici presente vise l'etude de l'applicabilite d'un capteur plasmonique integre par l'entremise de nanostructures semi-conductrices aux proprietes quantiques et luminescentes. L'approche presentee est globale; c'est-a-dire qu'on vise a repondre aux questions fondamentales impliquant la comprehension des phenomenes photoniques, le developpement et la fabrication des dispositifs, les methodes de caracterisations possibles ainsi que l'application d'un transducteur SPR integre a la biodetection. En d'autres termes : dans quelles circonstances et comment un transducteur plasmonique integre doit-il etre realise pour l'application a la detection delocalisee d'elements pathogenes? Dans le but d'engendrer un instrument simple a l'echelle de l'usager, l'integration de la connaissance a l'echelle du design est donc effectuee. Ainsi, des capteurs plasmoniques monolithiques sont concus a l'aide de modeles theoriques ici presentes. Un instrument de mesure hyperspectrale conjuguee permettant de cartographier directement la relation de dispersion des plasmons diffractes a ete construit et teste. Cet instrument est employe a la cartographie d'elements de diffusion. Finalement, une demonstration du fonctionnement du dispositif, appliquee a la

Practical Application of Finite Element Analysis to Aircraft Structural Design

DTIC Science & Technology

1986-08-01

at the design stage AEROELASTICITE ET OPTIMISATION EN AVANT-PROJET (AA)PETIAU, C; (AB) BOUTIN , D. Avions Marcel Dassault-Breguet Aviation, Saint...Interscience, 1981, p. 431-443. 810000 p. 13 refs 8 In: EN (English) p. 2018 The design complexity and size of convectively-cooled engine and airframe

[Raspail, propagandist himself from the "warnings" of the manual of health, between 1845 and 1878].

PubMed

Albou, Philippe

2015-01-01

During the last thirty years of his life, between 1845 and 1878, François-Vincent Raspail (1794-1878) published each year a new edition of his Manuel de santé (Manual of Health), which was intended as a practical guide to prevent and treat, using in particular camphor, major human diseases. Each edition was accompanied by a preamble, as an annual forum where the "revered teacher" applied to give information on his family, his trial, his stays in prison, his resentment, his exile, his publications, schedules consultations, etc. As a libertarian protester against the powers wether medical, political or judicial, Raspail was a tireless defender of the poor and weak, and this attitude earned him his reputation and his popularity. This positive image of "secular saint" was built from an effective propaganda, where the Manuel de santé and its preambles played a central rol.

A Fixed-Precision Sequential Sampling Plan for the Potato Tuberworm Moth, Phthorimaea operculella Zeller (Lepidoptera: Gelechidae), on Potato Cultivars.

PubMed

Shahbi, M; Rajabpour, A

2017-08-01

Phthorimaea operculella Zeller is an important pest of potato in Iran. Spatial distribution and fixed-precision sequential sampling for population estimation of the pest on two potato cultivars, Arinda ® and Sante ® , were studied in two separate potato fields during two growing seasons (2013-2014 and 2014-2015). Spatial distribution was investigated by Taylor's power law and Iwao's patchiness. Results showed that the spatial distribution of eggs and larvae was random. In contrast to Iwao's patchiness, Taylor's power law provided a highly significant relationship between variance and mean density. Therefore, fixed-precision sequential sampling plan was developed by Green's model at two precision levels of 0.25 and 0.1. The optimum sample size on Arinda ® and Sante ® cultivars at precision level of 0.25 ranged from 151 to 813 and 149 to 802 leaves, respectively. At 0.1 precision level, the sample sizes varied from 5083 to 1054 and 5100 to 1050 leaves for Arinda ® and Sante ® cultivars, respectively. Therefore, the optimum sample sizes for the cultivars, with different resistance levels, were not significantly different. According to the calculated stop lines, the sampling must be continued until cumulative number of eggs + larvae reached to 15-16 or 96-101 individuals at precision levels of 0.25 or 0.1, respectively. The performance of the sampling plan was validated by resampling analysis using resampling for validation of sampling plans software. The sampling plant provided in this study can be used to obtain a rapid estimate of the pest density with minimal effort.

Genetics Home Reference: hereditary hemorrhagic telangiectasia

MedlinePlus

... Central OMIM: JUVENILE POLYPOSIS/HEREDITARY HEMORRHAGIC TELANGIECTASIA SYNDROME McDonald J, Bayrak-Toydemir P, Pyeritz RE. Hereditary hemorrhagic ... 10.1097/GIM.0b013e3182136d32. Review. Citation on PubMed McDonald J, Wooderchak-Donahue W, VanSant Webb C, Whitehead ...

Field Testing of High Degree Revenue Service Track for Buckling Safety Assessment

DOT National Transportation Integrated Search

1995-01-01

This report presents the results of a field study of high degree curves in continuous welded rail (CWR) territory. This program was conducted at two test sites: a 10 degree curve on the Atchison, Topeka, and Santa Fe (ATSF) Railroad near Sante Fe, NM...

Modelisation par elements finis du muscle strie

NASA Astrophysics Data System (ADS)

Leonard, Mathieu

Ce present projet de recherche a permis. de creer un modele par elements finis du muscle strie humain dans le but d'etudier les mecanismes engendrant les lesions musculaires traumatiques. Ce modele constitue une plate-forme numerique capable de discerner l'influence des proprietes mecaniques des fascias et de la cellule musculaire sur le comportement dynamique du muscle lors d'une contraction excentrique, notamment le module de Young et le module de cisaillement de la couche de tissu conjonctif, l'orientation des fibres de collagene de cette membrane et le coefficient de poisson du muscle. La caracterisation experimentale in vitro de ces parametres pour des vitesses de deformation elevees a partir de muscles stries humains actifs est essentielle pour l'etude de lesions musculaires traumatiques. Le modele numerique developpe est capable de modeliser la contraction musculaire comme une transition de phase de la cellule musculaire par un changement de raideur et de volume a l'aide des lois de comportement de materiau predefinies dans le logiciel LS-DYNA (v971, Livermore Software Technology Corporation, Livermore, CA, USA). Le present projet de recherche introduit donc un phenomene physiologique qui pourrait expliquer des blessures musculaires courantes (crampes, courbatures, claquages, etc.), mais aussi des maladies ou desordres touchant le tissu conjonctif comme les collagenoses et la dystrophie musculaire. La predominance de blessures musculaires lors de contractions excentriques est egalement exposee. Le modele developpe dans ce projet de recherche met ainsi a l'avant-scene le concept de transition de phase ouvrant la porte au developpement de nouvelles technologies pour l'activation musculaire chez les personnes atteintes de paraplegie ou de muscles artificiels compacts pour l'elaboration de protheses ou d'exosquelettes. Mots-cles Muscle strie, lesion musculaire, fascia, contraction excentrique, modele par elements finis, transition de phase

Aural Classification and Temporal Robustness

DTIC Science & Technology

2010-11-01

Canada – Atlantique ; novembre 2010. Contexte : Le présent projet vise le développement d’un classificateur robuste qui utilise des...10 4.2.2.2 Discriminant score . . . . . . . . . . . . . . . . . . . 11 4.2.3 Principal component analysis . . . . . . . . . . . . . . . . . . . 13 ...allows class separation. . . . . . . . . . . . 13 Figure 7: Hypothetical clutter and target pdfs and posterior probabilties shown as surfaces

INTERACTIONS BETWEEN NUTRIENTS,PHYTOPLANKTON GROWTH AND MICROZOOPLANKTON GRAZING RATES IN A GULF OF MEXICO ESTUARY

EPA Science Inventory

Juhl, Andrew R. and Michael C. Murrell. Submitted. Phytoplankton Growth and Microzooplankton Grazing in a Gulf of Mexico Estuary. Aquat. Microb. Ecol. 38(1): 147-156, 2005.(ERL,GB 1214).

Dilution grazing experiments were conducted on 9 dates over a 16-month period in Sant...

ÉVALUER UNE INTERVENTION COMPLEXE: ENJEUX CONCEPTUELS, MÉTHODOLOGIQUES, ET OPÉRATIONNELS

PubMed Central

Contandriopoulos, André-Pierre; Rey, Lynda; Brousselle, Astrid; Champagne, François

2016-01-01

L’évaluation doit théoriquement aider les décideurs à relever les défis des systèmes de santé contemporains. Paradoxalement, malgré le développement rapide du domaine, l’utilisation des résultats des évaluations par ces décideurs reste faible. Le degré d’utilisation ne dépendrait-il pas de la capacité de l’évaluateur à rendre compte de la complexité des systèmes de santé? La nature complexe d’une intervention amène souvent les évaluateurs à adopter des approches non conventionnelles tenant compte du jeu des acteurs. L’évaluation d’une intervention complexe soulève des enjeux conceptuels, méthodologiques, et opérationnels que doit surmonter l’évaluateur pour accroître le degré d’utilisation des résultats par les décideurs. PMID:27293310

Eccentric preformative molt in the spotted Towhee

DOE PAGES

Fettig, Stephen M.; Hathcock, Charles Dean

2016-11-04

Examination of wing-feather molt often provides information essential for aging birds in the hand (Mulvihill 1993, pyle 1997b, 2008). Correctly aging birds is important for understanding the causal relationships between age-class survival rates and population changes (DeSante et al. 2005). For example, correctly aging birds facilitates understanding of climate effects on reproduction better than merely moni- toring population numbers because reproduction varies widely with annual weather patterns (DeSante and O’grady 2000). Age-class information can also provide a clear measure of habitat quality without confounding effects such as population sources and sinks (Van horne 1983) or misleading habitat-quality information based onmore » relative abundance or population size (pulliam 1988). Changes in bird populations often lag changes in the survival rate of an age class, while environmental changes often affect one age class immediately or after a short lag (Temple and Wiens 1989)« less

Structural basis for Smoothened receptor modulation and chemoresistance to anti-cancer drugs

PubMed Central

Wang, Chong; Wu, Huixian; Evron, Tama; Vardy, Eyal; Han, Gye Won; Huang, Xi-Ping; Hufeisen, Sandy J.; Mangano, Thomas J.; Urban, Dan J.; Katritch, Vsevolod; Cherezov, Vadim; Caron, Marc G.; Roth, Bryan L.; Stevens, Raymond C.

2014-01-01

The Smoothened receptor (SMO) mediates signal transduction in the hedgehog pathway, which is implicated in normal development and carcinogenesis. SMO antagonists can suppress the growth of some tumors; however, mutations at SMO have been found to abolish their anti-tumor effects, a phenomenon known as chemoresistance. Here we report three crystal structures of human SMO bound to the antagonists SANT1 and Anta XV, and the agonist, SAG1.5, at 2.6–2.8Å resolution. The long and narrow cavity in the transmembrane domain of SMO harbors multiple ligand binding sites, where SANT1 binds at a deeper site as compared with other ligands. Distinct interactions at D4736.55 elucidated the structural basis for the differential effects of chemoresistance mutations on SMO antagonists. The agonist SAG1.5 induces a conformational rearrangement of the binding pocket residues, which could contribute to SMO activation. Collectively, these studies reveal the structural basis for the modulation of SMO by small molecules. PMID:25008467

Current process and future path for health economic assessment of pharmaceuticals in France

PubMed Central

Toumi, Mondher; Rémuzat, Cécile; El Hammi, Emna; Millier, Aurélie; Aballéa, Samuel; Chouaid, Christos; Falissard, Bruno

2015-01-01

The Social Security Funding Law for 2012 introduced the Economic and Public Health Assessment Committee (Commission Evaluation Economique et de Santé Publique, or CEESP) in the Social Security Code as a specialised committee affiliated with the Haute Autorité de Santé in charge of providing recommendations and health economic opinions. This article provides an in-depth description of the CEESP's structure and working methods, and analyses the impact of health economic assessment on market access of drugs in France. It also points out the areas of uncertainty and the conflicting rules following the introduction of the health economic assessment in France. The authors also provide their personal opinion on the likely future of health economic assessment of drugs in France, including the possible merge of the CEESP and the Transparency Committee, the implementation of a French threshold, and the extension of health economic assessment to a larger number of products. PMID:27123173

Suivi après le traitement du cancer du sein

PubMed Central

Sisler, Jeffrey; Chaput, Geneviève; Sussman, Jonathan; Ozokwelu, Emmanuel

2016-01-01

Résumé Objectif Offrir aux médecins de famille un résumé des recommandations fondées sur les données probantes pour guider les soins aux survivantes traitées pour le cancer du sein. Qualité des données Une recherche documentaire a été effectuée dans MEDLINE entre 2000 et 2016 à l’aide des mots-clés anglais suivants : breast cancer, survivorship, follow-up care, aftercare, guidelines et survivorship care plans, en se concentrant sur la revue des lignes directrices publiées récemment par les organismes nationaux de cancérologie. Les données étaient de niveaux I à III. Message principal Les soins aux survivantes comportent 4 facettes : surveillance et dépistage, prise en charge des effets à long terme, promotion de la santé et coordination des soins. La surveillance des récidives ne se traduit que par une mammographie annuelle, et le dépistage d’autres cancers doit suivre les lignes directrices basées sur la population. La prise en charge des effets à long terme du cancer et de son traitement aborde des problèmes courants tels la douleur, la fatigue, le lymphœdème, la détresse et les effets indésirables des médicaments, de même que les préoccupations à long terme comme la santé du cœur et des os. La promotion de la santé met en relief les bienfaits de l’activité chez les survivantes du cancer, avec l’accent mis sur l’activité physique. Les soins aux survivantes sont de meilleure qualité lorsque divers services et professionnels de la santé participent aux soins, et le médecin de famille joue un rôle important dans la coordination des soins. Conclusion Les médecins de famille sont de plus en plus souvent les principaux fournisseurs de soins de suivi après le traitement du cancer du sein. Le cancer du sein doit être considéré comme une affection médicale chronique, même chez les femmes en rémission, et les patientes profitent de la même approche que celle utilisée pour les autres affections chroniques en

Nuclear Forensic Field Exercise #1

DTIC Science & Technology

2006-11-01

Ottawa; novembre 2006. Introduction ou contexte Un exercice radiologique pratique a été organisé à l’appui du projet 04-0030TD de l’IRTC. Les...11 List of symbols/abbreviations/acronyms/initialisms ..................................................................... 13 viii DRDC...R&D Canada - Ottawa. 12 DRDC Ottawa TM 2006-214 This page intentionally left blank. DRDC Ottawa TM 2006-214 13 List of symbols/abbreviations

Capability Engineering Process (CEP) Foundations - Version 2

DTIC Science & Technology

2006-03-02

R& D /Ops Research, Infrastructure & Organization, Qoncepts, Doctrine & Collective Training, IT Infrastructure , Equipment, Supplies and Services...les investissements strategiques requis pour repondre it une lacune en matiere de capacite. Ce processus est elabore dans la cadre du projet de...ainsi que six (6) buts secondaires servent it positionner Ie PIC comme un processus interne aux activites de planification axee sur les capacites

Evaluation of Mist-net Sampling as an Index to Productivity in Kirtland's Warblers

Treesearch

Johnathan Bart; Cameron Kepler; Paul Sykes; Carol Bocetti

1999-01-01

Many applied and theoretical investigations require information on how productivity varies in time and space (Temple and Wiens 1989, DeSante 1995). Examples include studies of habitat quality, population trends, life-history tactics, and metapopulation dynamics. From a demographic perspective, reproductivity is the number of young, counted at a given time of year,...

Teacher to Teacher: What Texts Effectively Raise Issues Related to 9/11 for Secondary Students?

ERIC Educational Resources Information Center

English Journal, 2006

2006-01-01

This article deals with texts that effectively raise issues related to 9/11 for secondary students, as discussed by several teachers. Kevin J. Collins from St. Thomas Aquinas High School says, "Elephant," Gus Van Sant's exploration of a Columbine-like tragedy, underscores the current generation's attempt to define the meaning of events in…

Factors affecting the movement and persistence of nitrate and pesticides in the surficial and upper Floridan aquifers in two agricultural areas in the southeastern United States

USGS Publications Warehouse

Katz, B.G.; Berndt, M.P.; Crandall, C.A.

2014-01-01

Differences in the degree of confinement, redox conditions, and dissolved organic carbon (DOC) are the main factors that control the persistence of nitrate and pesticides in the Upper Floridan aquifer (UFA) and overlying surficial aquifer beneath two agricultural areas in the southeastern US. Groundwater samples were collected multiple times from 66 wells during 1993–2007 in a study area in southwestern Georgia (ACFB) and from 48 wells in 1997–98 and 2007–08 in a study area in South Carolina (SANT) as part of the US Geological Survey National Water-Quality Assessment Program. In the ACFB study area, where karst features are prevalent, elevated nitrate-N concentrations in the oxic unconfined UFA (median 2.5 mg/L) were significantly (p = 0.03) higher than those in the overlying oxic surficial aquifer (median 1.5 mg/L). Concentrations of atrazine and deethylatrazine (DEA; the most frequently detected pesticide and degradate) were higher in more recent groundwater samples from the ACFB study area than in samples collected prior to 2000. Conversely, in the SANT study area, nitrate-N concentrations in the UFA were mostly <0.06 mg/L, resulting from anoxic conditions and elevated DOC concentrations that favored denitrification. Although most parts of the partially confined UFA in the SANT study area were anoxic or had mixed redox conditions, water from 28 % of the sampled wells was oxic and had low DOC concentrations. Based on the groundwater age information, nitrate concentrations reflect historic fertilizer N usage in both the study areas, but with a lag time of about 15–20 years. Simulated responses to future management scenarios of fertilizer N inputs indicated that elevated nitrate-N concentrations would likely persist in oxic parts of the surficial aquifer and UFA for decades even with substantial decreases in fertilizer N inputs over the next 40 years.

[Health education in the French Regional Health Agencies in 2012: observations and analysis].

PubMed

Baudier, François; Destaing, Lara; Michaud, Claude

2013-01-01

This paper examines the role of health education in the French Agences régionales de santé (ARS, Regional Health Agencies) in 2012. A survey was conducted among public health managers working in the ARS. Most of the participants reported that health education plays an important role in their agency, notably through their regional health plan and the activities of the organizations responsible for promoting democracy in health care. This is also true of the links with the Institut national de prévention et d'education pour la santé (INPES, the National Institute for Health Prevention and Education) and the network of Instances régionales d'éducation et de promotion de la santé (IREPS, the Regional Authorities for Health Education and Promotion). However, the answers to the open-ended questions and the results of the interviews suggest that these results must be interpreted with caution. The study focuses on a number of factors that must be taken into account when considering the results of the quantitative analysis. These factors include: the subjective (or interpretive) dimension of the term "health education" emphasized by many of the participants (a term involving an emphasis on either health promotion or preventive medicine); the limited emphasis on health education in the ARS (beyond therapeutic patient education) compared to other issues such as health monitoring and security, health care and medico-social problems; the limited resources allocated to health education and the bleak budget outlook; the relationships with the main operators; and the need to develop, promote and apply knowledge of good practice. Finally, the study shows that the role of health education is dependent on individuals' willingness to promote it and, in particular, on the commitment of ARS managers.

Application of the British Food Standards Agency nutrient profiling system in a French food composition database.

PubMed

Julia, Chantal; Kesse-Guyot, Emmanuelle; Touvier, Mathilde; Méjean, Caroline; Fezeu, Léopold; Hercberg, Serge

2014-11-28

Nutrient profiling systems are powerful tools for public health initiatives, as they aim at categorising foods according to their nutritional quality. The British Food Standards Agency (FSA) nutrient profiling system (FSA score) has been validated in a British food database, but the application of the model in other contexts has not yet been evaluated. The objective of the present study was to assess the application of the British FSA score in a French food composition database. Foods from the French NutriNet-Santé study food composition table were categorised according to their FSA score using the Office of Communication (OfCom) cut-off value ('healthier' ≤ 4 for foods and ≤ 1 for beverages; 'less healthy' >4 for foods and >1 for beverages) and distribution cut-offs (quintiles for foods, quartiles for beverages). Foods were also categorised according to the food groups used for the French Programme National Nutrition Santé (PNNS) recommendations. Foods were weighted according to their relative consumption in a sample drawn from the NutriNet-Santé study (n 4225), representative of the French population. Classification of foods according to the OfCom cut-offs was consistent with food groups described in the PNNS: 97·8 % of fruit and vegetables, 90·4 % of cereals and potatoes and only 3·8 % of sugary snacks were considered as 'healthier'. Moreover, variability in the FSA score allowed for a discrimination between subcategories in the same food group, confirming the possibility of using the FSA score as a multiple category system, for example as a basis for front-of-pack nutrition labelling. Application of the FSA score in the French context would adequately complement current public health recommendations.

A Flexible Sensor Technology for the Distributed Measurement of Interaction Pressure

PubMed Central

Donati, Marco; Vitiello, Nicola; De Rossi, Stefano Marco Maria; Lenzi, Tommaso; Crea, Simona; Persichetti, Alessandro; Giovacchini, Francesco; Koopman, Bram; Podobnik, Janez; Munih, Marko; Carrozza, Maria Chiara

2013-01-01

We present a sensor technology for the measure of the physical human-robot interaction pressure developed in the last years at Scuola Superiore Sant'Anna. The system is composed of flexible matrices of opto-electronic sensors covered by a soft silicone cover. This sensory system is completely modular and scalable, allowing one to cover areas of any sizes and shapes, and to measure different pressure ranges. In this work we present the main application areas for this technology. A first generation of the system was used to monitor human-robot interaction in upper- (NEUROExos; Scuola Superiore Sant'Anna) and lower-limb (LOPES; University of Twente) exoskeletons for rehabilitation. A second generation, with increased resolution and wireless connection, was used to develop a pressure-sensitive foot insole and an improved human-robot interaction measurement systems. The experimental characterization of the latter system along with its validation on three healthy subjects is presented here for the first time. A perspective on future uses and development of the technology is finally drafted. PMID:23322104

Optical metrology tools for the Virgo projet

NASA Astrophysics Data System (ADS)

Loriette, V.

For more than thirty years the search for gravitationnal waves, predicted by Einstein's relativistic theory of gravitation, has been an intense research field in experimental as well as theoretical physics. Today, with the constant advance of technology in optics, lasers, data analysis and processing, ... a promising way of directly detecting gravitationnal waves with earth-based instruments is optical interferometry. Before the end of this century many experiments will be carried on in Australia, Europe, Japan and the United States to detect the passage of a gravitationnal wave through giant Michelson-type interferometers. The effects predicted are so small, (a gravitationnal wave changes the length of three kilometer long arms by one thousandth of a fermi) that the need for “perfect” optical components is a key to the success of these experiments. Still a few years ago it would have been impossible to make optical components that would satisfy the required specifications for such interferometric detectors. For nearly ten years constant R&D efforts in optical coating manufacturing, optical material fabrication and optical metrology, allow us today to make such components. This text is intended to describe the field of optical metrology as it is needed for the testing of optical parts having performances far beyond than everything previously made. The first chapter is an introduction to gravitationnal waves, their sources and their effects on detectors. Starting by newtonian mechanics we jump rapidly to the general theory of relativity and describe particular solutions of Einstein's equations in the case of weak gravitationnal fields, which are periodic perturbations of the space-time metric in the form of plane waves, the so-called gravitationnal waves. We present various candidate sources, terrestrial and extra-terrestrial and give a short description of the two families of detectors: resonnant bars and optical interferometers. The second part of this chapter is a description of the various optical components that have to be manufactured and tested for Virgo. The next sections are dedicated to the description of various metrology instruments. In chapter 2 we focus on absorption of light in multilayer coatings. The sensitivity of interferometric detectors is degraded by this loss process, not only because it decreases the laser beam power, but also and chiefly because thermo-elastic deformations and changes of the indexes of refraction modify the beam profile. Optical coatings have now reached an absorption level lower than at m. We present a method based on the mirage effect, i.e. the deflexion of light by an index of refraction gradient induced by non homogeneous heating. This “mirage bench” has a sensitivity better than 10^{-8}. We start by a discussion of the approximations that are useful to simplify the problem, we then derive the equation that give the signal amplitude versus the absorption factor. Afterwards we describe the instrument and give a few results with home made Virgo mirrors as well as commercial samples. In the following chapter we discuss the problem of measuring reflexion factors. We focus on two particular problems, the first one is common, it is to measure high (higher than 0.9999) reflexion factors by the use of Fabry-Perot cavities. We present various possible schemes and we detail a particular one which seems to be the easiest to implement. We use a pulsed laser source and measure the average reflexion factor of the two Fabry-Perot mirrors by studying the pulse shape modification after transmission by the cavity. We estimate the sensitivity of this intrument to 10^{-6}. The second problem is a less common one and is to evaluate the relative homogeneity of reflexion factors on large components. Because inhomogeneities of this parameter will degrade the sensitivity of Virgo by coupling various modes of the laser beam with the fundamental one, homogeneity higher than 1{-}10^{-4} is required. We propose a simple scheme and describe a bench built following this scheme. This bench, being a first try, is far from being optimized and the measurement method could be used with other experimental realizations. By using various geometries measurements can be performed on high reflectivity mirrors as well as on beamsplitters with a comparable sensitivity of 10^{-4}. At last we discuss the problem of surface figure testing. Virgo needs are for optical surfaces with defects smaller than ten nanometers peak to valley on twelve centimeter diameter surfaces. These surfaces can not be tested by classical ways, Fizeau interferometers are sensitive enough but do not have a sufficient precision because of the obligatory presence of a reference surface to compare the samples with. We present a method based on local slope measurement that permits to reach the required precision, to the detriment of measurement time. Les ondes gravitationnelles, déformations locales de l'espace-temps prédites par les théories relativistes de la gravitation, font l'objet depuis plus de trente ans de recherches, tant expérimentales que théoriques, très intenses. Aujourd'hui grâce aux développements technologiques en optique, analyse et traitement des données, fabrication de lasers, ... une méthode prometteuse de détection directe des ondes gravitationnelles est l'interférométrie optique. Avant la fin de ce siècle plusieurs expériences vont être menées en Australie, aux états-Unis, en Europe, et au Japon pour détecter le passage d'une onde gravitationnelle à travers des interféromètres de Michelson géants. Les effets attendus sont si faibles (une onde gravitationnelle modifie la longueur d'un bras de trois kilomètres d'à peu près un millième de fermi) que des composants optiques "parfaits” sont une des clefs du succès de ces expériences. Il y a encore quelques années il aurait été impossible de fabriquer des composants optiques satisfaisant les spécifications de tels détecteurs interférométriques. Depuis près de dix ans des efforts constants en R&D dans les domaines de la réalisation des revêtements multicouches, de la fabrication des matériaux pour l'optique, et de la métrologie optique, permettent aujourd'hui d'obtenir de tels composants. Ce texte présente le domaine de la métrologie optique necessaire aux tests de composants dont les performances se situent au delà de tout ce qui a été réalisé auparavant. Le premier chapitre est une introduction aux ondes de gravitation, leurs sources et leurs effets sur des détecteurs. Partant de la mécanique newtonienne on passe rapidement à la relativité générale pour décrire les solutions particulières des équations d'Einstein dans le cas de champs gravitationnels faibles, qui sont des perturbations périodiques de la métrique de l'espace temps : les ondes gravitationnelles. Après une présentation des différentes sources de rayonnement et des deux familles de détecteurs : barres résonnantes et interféromètres optiques, la seconde partie de ce chapitre est consacrée à la description des différents éléments optiques constitutifs de l'antenne Virgo. Dans les chapitres suivants sont présentés les divers outils de métrologie optique. Le deuxième chapitre traite de l'absorption de la lumière dans les revêtements multicouches. La méthode dite "méthode mirage” est basée sur la déviation de la lumière par un gradient d'indice de réfraction créé par une élévation locale de température. La mesure par effet mirage du facteur d'absorption d'absorption a une sensibilité meilleure que 10^{-8}. Le chapitre suivant décrit tout d'abord les moyens utilisé pour mesurer des facteurs de réflexion élevés (typiquement supérieurs à 0,9999) grâce à l'utilisation de cavités Fabry-Perot avec une sensibilité de l'ordre de 10^{-6}. Un second problème moins fréquemment rencontré est celui de l'évaluation de l'homogénéité du facteur de réflexion sur de grandes pièces. Une méthode simple permet cependant d'obtenir une sensibilité raisonnable de 10^{-4}. Enfin le dernier chapitre est consacré au problème classique de mesure de l'état géométrique d'une surface optique. Les besoins de Virgo interdisent l'utilisation d'instruments classiques tels que les interféromètres de Fizeau, mais une méthode locale basée sur la mesure de gradients permet d'obtenir une précision de mesure de λ/100 crête à crête sur des surfaces de douze centimètres de diamètre.

[A Swiss medical-social institution and the Snoezelen concept].

PubMed

Dubois-Terrail, Caroline; Kemken, Lucie Marigo; Makamwe, Nicole

2016-01-01

In collaboration with six student nurses from the Geneva Haute École de Santé, the Les Franchises medical-social institution in Geneva has launched an innovative project: the integration of the Snoezelen concept into its care programme, which will benefit residents with moderate or advanced dementia. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Dissimilar Deficiency of Glucose-6-Phosphate Dehydrogenase (G-6-PD) among the AFARS and the Somalis of Djibouti

DTIC Science & Technology

1991-01-01

DEFICIENCY OF GLUCOSE - 6 - PHOSPHATE DEHYDROGENASE (G- 6 ...the prevalence of deficient activity of the enzyme glucose - 6 - phosphate dehydrogenase (G- 6 -PD) among - Ces difficiences enzymatiques sant plus particu...Screening for glucose - 6 - 3 - CaosBy W.H. - Hematologic diseases. In : I lunter’s Tropical phosphate dehydrogenase (G- 6 -PD) deficiency by a simple

Telemedicine: what framework, what levels of proof, implementation rules.

PubMed

Zannad, Faiez; Maugendre, Philippe; Audry, Antoine; Avril, Carole; Blaise, Lucile; Blin, Olivier; Burnel, Philippe; Falise-Mirat, Béatrice; Girault, Danièle; Giri, Isabelle; Goehrs, Jean-Marie; Lassale, Catherine; Le Meur, Roland; Leurent, Pierre; Ratignier-Carbonneil, Christelle; Rossignol, Patrick; Satonnet, Evelyne; Simon, Pierre; Treluyer, Laurent

2014-01-01

The concept of telemedicine was formalised in France in the 2009 "Hospital, patients, health territories" (loi hôpital, patients, santé, territoire) law and the 2010 decree through which it was applied. Many experiments have been carried out and the regulatory institutions (Ministry, Regional Health Agency [Agence régionale de santé, ARS], French National Health Authority [Haute autorité de santé, HAS], etc.) have issued various guidance statements and recommendations on its organisation and on the expectations of its evaluation. With this background, the round table wanted to produce recommendations on different areas of medical telemonitoring (the role of telemonitoring, the regulatory system, the principles for assessment, methods of use and conditions for sustained and seamless deployment). Whilst many studies carried out on new medical telemonitoring approaches have led to the postulate that it offers benefit, both clinically and in terms of patient quality of life, more information is needed to demonstrate its impact on the organisation of healthcare and the associated medico-economic benefit (criteria, methods, resources). Similarly, contractual frameworks for deployment of telemonitoring do exist, although they are complicated and involve many different stakeholders (Director General fo the Care Offering [Direction générale de l'offre de soins, DGOS], ARS, HAS, Agency for Shared Health Information Systems [Agence des systèmes d'information partagés de santé, ASIP], French National Data Protection Commission [Commission nationale informatique et libertés, CNIL], French National Medical Council [Conseil national de l'Ordre des médecins, CNOM], etc.) that would benefit from a shared approach and seamless exchange between the partners involved. The current challenge is also to define the conditions required to validate a stable economic model in order to promote organisational change. One topical issue is placing the emphasis on its evaluation and

Value of a national administrative database to guide public decisions: From the système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) to the système national des données de santé (SNDS) in France.

PubMed

Tuppin, P; Rudant, J; Constantinou, P; Gastaldi-Ménager, C; Rachas, A; de Roquefeuil, L; Maura, G; Caillol, H; Tajahmady, A; Coste, J; Gissot, C; Weill, A; Fagot-Campagna, A

2017-10-01

In 1999, French legislators asked health insurance funds to develop a système national d'information interrégimes de l'Assurance Maladie (SNIIRAM) [national health insurance information system] in order to more precisely determine and evaluate health care utilization and health care expenditure of beneficiaries. These data, based on almost 66 million inhabitants in 2015, have already been the subject of numerous international publications on various topics: prevalence and incidence of diseases, patient care pathways, health status and health care utilization of specific populations, real-life use of drugs, assessment of adverse effects of drugs or other health care procedures, monitoring of national health insurance expenditure, etc. SNIIRAM comprises individual information on the sociodemographic and medical characteristics of beneficiaries and all hospital care and office medicine reimbursements, coded according to various systems. Access to data is controlled by permissions dependent on the type of data requested or used, their temporality and the researcher's status. In general, data can be analyzed by accredited agencies over a period covering the last three years plus the current year, and specific requests can be submitted to extract data over longer periods. A 1/97th random sample of SNIIRAM, the échantillon généraliste des bénéficiaires (EGB), representative of the national population of health insurance beneficiaries, was composed in 2005 to allow 20-year follow-up with facilitated access for medical research. The EGB is an open cohort, which includes new beneficiaries and newborn infants. SNIIRAM has continued to grow and extend to become, in 2016, the cornerstone of the future système national des données de santé (SNDS) [national health data system], which will gradually integrate new information (causes of death, social and medical data and complementary health insurance). In parallel, the modalities of data access and protection systems

History of Indian Arts Education in Santa Fe: The Institute of American Indian Arts with Historical Background 1890 to 1962.

ERIC Educational Resources Information Center

Garmhausen, Winona

This book traces the history of the Institute of American Indian Arts in Santa Fe, New Mexico. Sections cover four time periods in the evolution of the Institute: the United States Indian Industrial School at Sante Fe, 1890-1932; the Santa Fe Indian School, 1930-62; and the Institute of American Indian Arts, 1962-70 and 1970-78. The United States…

Repenser ensemble le concept d'autonomie alimentaire.

PubMed

Bélisle, Micheline; Labarthe, Jenni; Moreau, Cynthia; Landry, Elise; Adam, Gracia; Bourque Bouliane, Mijanou; Dupéré, Sophie

2017-03-01

C'est au cœur du projet de recherche-action participative « Vers une autonomie alimentaire pour tou-te-s : agir et vivre ensemble le changement » (VAATAVEC) que s'est élaborée une définition nouvelle et évolutive de l'autonomie alimentaire. De ce projet regroupant des personnes en situation de pauvreté, chercheurs et intervenants, a émergé une conceptualisation résultant à la fois d'une méthode de réflexion collective et d'un processus d'analyse collective, inspiré de la théorisation ancrée et de l'analyse conceptualisante de Paillé et Mucchielli (2003). Le recours à l'expertise des personnes en situation de pauvreté, expertes du vécu de l'insécurité alimentaire, a contribué à ancrer cette définition dans les causes structurelles de l'insécurité alimentaire dans une perspective de développement d'un pouvoir d'agir collectif, de toutes les personnes concernées. Il en résulte une définition de l'autonomie alimentaire d'où ressort une contribution surtout méthodologique et théorique.

Malformations congénitales à Lubumbashi (République Démocratique du Congo): à propos de 72 cas observés et plaidoyer en faveur du développement d'un Registre National des Malformations Congénitales et d'un Centre National de Référence de Génétique Humaine

PubMed Central

Lubala, Toni Kasole; Shongo, Mick Yapongombo; Munkana, Arthur Ndundula; Mutombo, Augustin Mulangu; Mbuyi, Sébastien Musanzayi; wa Momat, Félix Kitenge

2012-01-01

En République Démocratique du Congo, les malformations congénitales constituent un véritable problème de santé publique. En effet, elles relancent le débat sur les effets de l'intensification de l'activité minière sur la santé de la reproduction. De 2009 à 2010, nous avons calculé une prévalence de 5.84 pour 1000 naissances. Les malformations du système nerveux central étaient les plus fréquentes (2.029 pour 1000) suivies des malformations des membres (1.055 pour 1000), et des fentes oro-faciales (0.811 pour 1000). Ces données sont certainement largement sous-estimées et les causes y relatives en République Démocratique du Congo ne sont ni surveillées, ni prévenues dans le cadre d'une politique gouvernementale. La mise en place d'un registre national et d'un centre national de génétique humaine de référence pourrait constituer un cadre rigoureux, organisé et structuré de surveillance et de prévention des malformations congénitales. PMID:23396951

The Decision Module Working Paper

DTIC Science & Technology

1973-12-01

and goal change has received very little attention In the litera- ture on the analysis of choice situations. It has generally been the case that the...Decision Making: Approach and Prototype" (197:0, done In context of the Mesarovlc - Pestel World Model Projet’ The Issues dealing with «-he cho ce...Nelson, Winder, and Schuette (1973) on evolutionary economic growth models. The discussion of the two components of the decision module that follows

Technical Evaluation Report on Knowledge Based System Applications for Guidance and Control (Application des Systemes a Base de Connaissances au Guidage-Pilotage),

DTIC Science & Technology

1991-07-01

base de connaissances. Le doniaine de l’intelligence artificieflcs’affirinc en tant que science dont les 6l6mcnts technologiques 6volucnt tr~s...substantiellc de l’cfficacit6 opdrationnellc. Bien que los applications temps riel soient encore relativement rares, un certain nombre de projets de...Sanz-Aranguez SP ProfessorJohn T.Shcpherd UK Dr Elihu Zimet us HOST PAINEL COORDINATOR Mdr Carlos A. Garriga. Lopez SENER Ingenieria y Sistemas SA

Computing Systems Configuration for Highly Integrated Guidance and Control Systems

DTIC Science & Technology

1988-06-01

conmmunication ear lea imlustrielaiservenant dais an projet. Cela eat renda , possible entre auies par l’adoption dene mibodologie do travai coammune, par...computed graph results to data processors for post processing, or commnicating with system I/O modules. The ESU PI- Bus interface logic includes extra ...the extra constraint checking helps to find more problems at compile time), and it is especially well- suited for large software systems written by a

[The film library of Sandoz].

PubMed

Lefebvre, Thierry

2014-10-01

During nearly forty years, the Cinémathèque Sandoz helped the initial formation of students and the training of doctors and pharmacists. Half a century after the produc tion of one of his most memorable films, Le Horla (Jean-Daniel Pollet), the author provides a brief history of those cultural sponsorship activites. It presents the main leaders of the cinémathèque et some of its iconic projets.

Program and Management Support for the Office of Military Performance Assessment Technology

DTIC Science & Technology

1992-04-03

AD-A267 285 CONTRACT NO: DAMD17-90-C-0061 TITLE: PROGRAM AND MANAGEMENT SUPPORT FOR THE OFFICE OF MILITARY PERFORMANCE ASSESSMENT TECHNOLOGY...1204. Arlington, VA 22202-4302. and to the Office of Management and Budget. Paperwork Reduction Projet (0704-0188). Washington, DC 20503 1. AGENCY USE...NUMBERS Program and Management Support for the Office of Contract No. Military Performance Assessment Technology DAMDI7-90-C-0061 6. AUTHOR(S) Marvin

Social orientations and adolescent health behaviours in Hungary.

PubMed

Piko, Bettina F; Skultéti, Dóra; Luszczynska, Aleksandra; Gibbons, Frederick X

2010-02-01

Adolescent health behaviours are influenced by a variety of social factors, including social orientations, such as social comparison or competitiveness. The main goal of the present study was to investigate the role that these social orientations might play in health behaviours (both health-impairing and health-promoting). Data were collected from high school students (N = 548; ages 14-20 years; 39.9% males) in two counties of the Southern Plain Region of Hungary. The self-administered questionnaires contained items on sociodemographics, such as age, sex, parental schooling, and socioeconomic status (SES) self-assessment; school achievement, health behaviours, competitiveness and social comparison. Multiple regression analyses suggest that those who scored higher on competitiveness engaged in more substance use, a pattern that was not present for health-promoting behaviours. Social comparison, however, was associated with lower levels of substance use. In addition, in relation to health-impairing behaviours, both competitiveness and social comparison interacted with sex; both social orientation variables proved to be more important for boys. Social comparison also contributed to health-promoting behaviours among boys. Findings support the idea that the role of social orientations, such as competitiveness and social comparison, can be quite different depending on sex and the nature of the health behaviour. While competitiveness may act as a risk factor for substance use among boys, social comparison may act as a protection. It appears that social orientations play less of a role in girls' health-related behaviours. More focus is needed on gender differences in influences on adolescents' health-related behaviours. Les comportements de santé des adolescents sont influencés par une variété de facteurs sociaux, incluant les orientations sociales telles que la comparaison sociale ou la compétitivité. Le but principal de la présente étude était d'examiner le r

In-Flight Investigation of Large Airplane Flying Qualities for Approach and Landing

DTIC Science & Technology

1981-09-01

required to Major dficiareratII control Is V40~aemaabr aordtcene Contrl *.it be lost during sante poortion ot 1 Mao denreficeirencies ntnseo.eu,~io...hydraulic pump on each approach. 185 TAIL I AUG. Xpc.R. =l q I n/a I Tq I TR I-ZSP I - ^P PILOT A Long a Med 92.5 B 4.2 -- .87 18 A RATING 7 Land 4 Up

Autoradiographic Distribution and Applied Pharmacological Characteristics of Dextromethorphan and Related Antitissue/Anticonvulsant Drugs and Novel Analogs.

DTIC Science & Technology

1992-08-01

OF DEXTROMETHORPHAN AND RELATED ANTITISSUE/ANTICONVULSANT DRUGS AND NOVEL ANALOGS PRINCIPAL INVESTIGATOR: Norman G. Bowery, Ph.D., DSc CONTRACTING...Characteristics of Dextromethorphan and DAMD17-90-C-0124 Related Anti ti ssue/ Anticonvul sant Drugs and Novel 6. AUTHOR(S) Analogs 61102A...13. ABSTRACT (Maximum 200 words) Binding of dextromethorphan and its analogues to the dextromethorphan binding site and to the PCP and glycine binding

The Organization of Working Time: Developing an Understanding and Action Plan to Promote Workers' Health in a Seasonal Work Context: L'organisation temporelle du travail: la comprendre pour développer des actions favorisant la santé des travailleuses en contexte de travail saisonnier.

PubMed

Major, Marie-Eve; Vézina, Nicole

2017-11-01

Despite the health problems associated with irregular schedules and long working hours, few studies have focused on the temporal dimension of work in seasonal working contexts. Through the monitoring of sixteen seasonal workers in the crab-processing industry over a two-year period, this study aimed to better understand their working reality and to provide a detailed picture of the temporal dimension of seasonal work as experienced by these workers. Observations of the work activity, interviews, and analysis of official documents were carried out. The findings reveal that the organization of working time and working conditions are very restrictive. These constraints are linked not only to the work environment and management but also to various public policies and ministerial directives. Methodological elements essential for the study of the organization of working time have been identified and could contribute to a better understanding of temporal constraints experienced by seasonal workers. Résumé Malgré les problèmes de santé associés aux horaires non standards et aux longues heures de travail, peu d'études se sont attardées à dégager un portrait de la dimension temporelle du travail en contexte de travail saisonnier. Par le suivi de 16 travailleuses saisonnières de l'industrie de la transformation du crabe pendant deux années, cette étude visait à mieux comprendre leur réalité de travail et à dresser un portrait détaillé de la dimension temporelle du travail saisonnier tel que vécu par ces travailleuses. Des observations du travail, des entretiens et l'analyse de documents ont été réalisés. Les résultats révèlent une organisation temporelle et des conditions de travail fort contraignantes pour ces travailleuses liées, entre autres, à l'environnement et à la gestion du travail, mais également à diverses politiques publiques et consignes ministérielles. Des éléments méthodologiques essentiels pour l'étude des temps de travail

Lessons Learned From Methodological Validation Research in E-Epidemiology.

PubMed

Kesse-Guyot, Emmanuelle; Assmann, Karen; Andreeva, Valentina; Castetbon, Katia; Méjean, Caroline; Touvier, Mathilde; Salanave, Benoît; Deschamps, Valérie; Péneau, Sandrine; Fezeu, Léopold; Julia, Chantal; Allès, Benjamin; Galan, Pilar; Hercberg, Serge

2016-10-18

Traditional epidemiological research methods exhibit limitations leading to high logistics, human, and financial burden. The continued development of innovative digital tools has the potential to overcome many of the existing methodological issues. Nonetheless, Web-based studies remain relatively uncommon, partly due to persistent concerns about validity and generalizability. The objective of this viewpoint is to summarize findings from methodological studies carried out in the NutriNet-Santé study, a French Web-based cohort study. On the basis of the previous findings from the NutriNet-Santé e-cohort (>150,000 participants are currently included), we synthesized e-epidemiological knowledge on sample representativeness, advantageous recruitment strategies, and data quality. Overall, the reported findings support the usefulness of Web-based studies in overcoming common methodological deficiencies in epidemiological research, in particular with regard to data quality (eg, the concordance for body mass index [BMI] classification was 93%), reduced social desirability bias, and access to a wide range of participant profiles, including the hard-to-reach subgroups such as young (12.30% [15,118/122,912], <25 years) and old people (6.60% [8112/122,912], ≥65 years), unemployed or homemaker (12.60% [15,487/122,912]), and low educated (38.50% [47,312/122,912]) people. However, some selection bias remained (78.00% (95,871/122,912) of the participants were women, and 61.50% (75,590/122,912) had postsecondary education), which is an inherent aspect of cohort study inclusion; other specific types of bias may also have occurred. Given the rapidly growing access to the Internet across social strata, the recruitment of participants with diverse socioeconomic profiles and health risk exposures was highly feasible. Continued efforts concerning the identification of specific biases in e-cohorts and the collection of comprehensive and valid data are still needed. This summary of

Soins primaires aux adultes ayant des déficiences intellectuelles et développementales

PubMed Central

Sullivan, William F.; Diepstra, Heidi; Heng, John; Ally, Shara; Bradley, Elspeth; Casson, Ian; Hennen, Brian; Kelly, Maureen; Korossy, Marika; McNeil, Karen; Abells, Dara; Amaria, Khush; Boyd, Kerry; Gemmill, Meg; Grier, Elizabeth; Kennie-Kaulbach, Natalie; Ketchell, Mackenzie; Ladouceur, Jessica; Lepp, Amanda; Lunsky, Yona; McMillan, Shirley; Niel, Ullanda; Sacks, Samantha; Shea, Sarah; Stringer, Katherine; Sue, Kyle; Witherbee, Sandra

2018-01-01

Résumé Objectif Mettre à jour les Lignes directrices consensuelles canadiennes 2011 en matière de soins primaires aux adultes ayant une déficience développementale. Méthodes Des médecins de famille et d’autres professionnels de la santé expérimentés dans les soins aux personnes ayant des DID ont examiné et synthétisé les récentes connaissances empiriques, d’écosystèmes, expertes et expérientielles. Un système a été conçu pour catégoriser la qualité des recommandations. Recommandations Les adultes ayant des DID sont un groupe hétérogène de patients qui présentent des affections médicales et des facteurs qui influent sur leur santé, qui diffèrent de ceux qui touchent les autres membres de la communauté de par leur nature, leurs manifestations, leur gravité ou leur complexité. Ces personnes nécessitent une approche de soins et des interventions adaptées à leurs besoins. Les présentes lignes directrices offrent des conseils en matière de normes de soins. Nous avons incorporé des références à des outils cliniques et à d’autres ressources pratiques. Les approches de soins décrites ici s’appliquent aussi à d’autres groupes de patients ayant un déficit cognitif ou de la communication, ou d’autres déficits des fonctions adaptatives. Conclusion À titre de fournisseurs de soins de première ligne, les médecins de famille jouent un rôle vital de promotion de la santé et de bien-être auprès des adultes ayant des DID. Ces lignes directrices peuvent les aider à prendre des décisions avec les patients et les aidants naturels. PMID:29650617

Lessons Learned From Methodological Validation Research in E-Epidemiology

PubMed Central

Assmann, Karen; Andreeva, Valentina; Castetbon, Katia; Méjean, Caroline; Touvier, Mathilde; Salanave, Benoît; Deschamps, Valérie; Péneau, Sandrine; Fezeu, Léopold; Julia, Chantal; Allès, Benjamin; Galan, Pilar; Hercberg, Serge

2016-01-01

Background Traditional epidemiological research methods exhibit limitations leading to high logistics, human, and financial burden. The continued development of innovative digital tools has the potential to overcome many of the existing methodological issues. Nonetheless, Web-based studies remain relatively uncommon, partly due to persistent concerns about validity and generalizability. Objective The objective of this viewpoint is to summarize findings from methodological studies carried out in the NutriNet-Santé study, a French Web-based cohort study. Methods On the basis of the previous findings from the NutriNet-Santé e-cohort (>150,000 participants are currently included), we synthesized e-epidemiological knowledge on sample representativeness, advantageous recruitment strategies, and data quality. Results Overall, the reported findings support the usefulness of Web-based studies in overcoming common methodological deficiencies in epidemiological research, in particular with regard to data quality (eg, the concordance for body mass index [BMI] classification was 93%), reduced social desirability bias, and access to a wide range of participant profiles, including the hard-to-reach subgroups such as young (12.30% [15,118/122,912], <25 years) and old people (6.60% [8112/122,912], ≥65 years), unemployed or homemaker (12.60% [15,487/122,912]), and low educated (38.50% [47,312/122,912]) people. However, some selection bias remained (78.00% (95,871/122,912) of the participants were women, and 61.50% (75,590/122,912) had postsecondary education), which is an inherent aspect of cohort study inclusion; other specific types of bias may also have occurred. Conclusions Given the rapidly growing access to the Internet across social strata, the recruitment of participants with diverse socioeconomic profiles and health risk exposures was highly feasible. Continued efforts concerning the identification of specific biases in e-cohorts and the collection of comprehensive and

Protecting Pregnant Workers while Fighting Sexism: Work-Pregnancy Balance and Pregnant Nurses' Resistance in Québec Hospitals: Protéger les travailleuses enceintes en luttant contre le sexisme: équilibre travail-grossesse et résistance d'infirmières enceintes dans des hôpitaux québécois.

PubMed

Gravel, Anne Renée; Riel, Jessica; Messing, Karen

2017-11-01

Women's workplaces should guarantee healthy pregnancies while supporting pregnant women as workers. In Québec (Canada), a pregnant worker exposed to a "danger" for herself or her fetus may ask her employer to be reassigned to other work appropriate to her skills. This approach differs from other regulatory contexts in North America in that protection of fetal and maternal health is embedded in the health and safety legislation. The advantage is that the pregnant worker is guaranteed access to her full salary, but some may question whether specific provisions for pregnant women single out such women and produce risks for their careers or, conversely, pregnancy should receive even more special consideration. These questions are discussed using the results of a qualitative analysis of interviews with pregnant nurses, their supervisors, and their union representatives in ten hospitals in Québec. We think that the management of pregnancy under this legislation generally protects health, but that, in the absence of true employer commitment to the health of all workers, undue burdens may be placed upon other members of the work team. Résumé Les lieux de travail des femmes devraient garantir des grossesses saines tout en soutenant les femmes enceintes en tant que travailleurs. Au Québec (Canada), une travailleuse enceinte exposée à un danger pour elle-même ou son fœtus peut demander à son employeur d'être réaffectée à d'autres tãches sans danger et adaptéches à ses compétences. Cette approche diffère des autres contextes réglementaires en Amérique du Nord en ce sens que la protection de la santé foetale et maternelle est intégrée dans la législation sur la santé et la sécurité. Certains peuvent se demander si des dispositions spécifiques pour les femmes enceintes singularisent ces travailleuses et contribuent à la précarisation de leur emploi. Ou, à l'inverse, si la grossesse devrait recevoir une considération encore plus spéciale. Ces

Collective Political Violence in Easton’s Political Systems Model (La Violence Politique Collective dans le Modele de Systeme Politique d’Easton)

DTIC Science & Technology

2011-09-01

opérationnelle) [ novembre 2010], note publiée pendant la première phase du projet, soit l’élaboration conceptuelle du programme de recherche. DRDC Toronto...Kirkpatrick, D. & Sanger, D. (2011). A Tunisian-Egyptian link that shook Arab history. The New York Times, 13 February 2011. Martin, J. (1986). The...body of abstract and indexing annotation must be entered when the overall document is classified) 13 . ABSTRACT (A brief and factual summary of the

Hydatidose péricardique

PubMed Central

Fenane, Hicham; Maidi, El mehdi; Bouchikh, Mohamed; Lamboni, Damsane; Achir, Abdellah; Ouchen, Fahd; Oyali, Mbola; Caidi, Mohamed; Aziz, Said Al; Benosman, Abdellatif

2015-01-01

L'hydatidose est un problème de santé publique dans les pays d'endémie dont le Maghreb. L'atteinte péricardique reste rare, le diagnostic est parfois tardif à cause de la non spécificité des symptômes, et repose essentiellement sur les données de l'imagerie. Nous rapportons deux observations d'hydatidose péricardique sans atteinte cardiaque. PMID:26185566

A Microcontroller-Based Device for Monitoring Blood Pressure in the Field

DTIC Science & Technology

1993-12-01

Service de sant6 des Forces armies canadiennes. On a mis au point un appareil de mesure des signes vitaux, qui peut mesurer la fr~quence cardiaque et...methods for taking systolic and diastolic pressure readings include the auscultation method, the oscillometric method, and the ultrasonic method...pressures are determined from its output, are the best ways of distinguishing between the three main methods previously listed. The auscultation method

Evaluation d’un enseignement par les étudiants appliquée au module « aide à la rédaction de thèse»: destiné aux internes des hôpitaux des Armées au Centre d’épidémiologie et de Santé Publique des Armées, Marseille

PubMed Central

Kasouati, Jalal; Velut, Guillaume; Deparis, Xavier; Touloune, Farida

2016-01-01

Introduction En éducation, l'évaluation concerne les institutions de formation, les programmes, les enseignants ou les étudiants. Elle peut être prédictive, sommative ou formative. L'Evaluation d'un Enseignement par les Etudiants (EEE) est l'un des outils de ce dernier type. Objectif Évaluer l'enseignement de la première partie de la formation « aide à la rédaction de thèse ». Méthodes C'est une étude transversale classée dans le cadre « EEE » qui a porté sur le module « aide à la rédaction de thèse » dispensée au CESPA au profit de 27 participants préparant leur projet de fin d'étude. Résultats Le taux de réponse des participants présents était de 100%. D'un sexe ratio F/M de 2 et de une moyenne d'âge de 25,5 ans +/- 2,7 ans, les questionnés étaient majoritairement des internes de médecine générale. Plus de 85% affirmait n'avoir bénéficié d'aucune formation au préalable dans les domaines traités. Les participants avaient des attentes qui rejoignaient sommairement les objectifs de la formation. A part le rythme jugé non adapté par plus de la moitié, 80% des participants ont été satisfaits des autres aspects évalués et 95,8% parmi eux prévoyaient d'assister à la deuxième partie de la formation Pour tout les participants, la formation a permis d'amélioré de façon significative leur connaissance et aurais certainement un impact positif sur leurs travaux de recherche. Conclusion Notre travail était un moyen d'installer une certaine complicité entre les étudiants et les enseignants pour atteindre un objectif commun: « AMELIORER LA FORMATION ». PMID:27800091

[A Triage Scale for Mental Health, an Emerging Practice, a Value-Add for Measuring Demand for Mental Health Services].

PubMed

Boucher, Lucie

Objectives The article aims to present two studies supporting the development of l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, a measuring instrument used to determine - based on the level of customer demand, seriousness, and urgent need for intervention - the priority of a mental health service across all age groups.Methods Both versions have been subject to a measurement interjudge agreement that is compared against the judgment of professionals and other comparison tools.Results The results produced by the interjudge agreement reflect significant correlations with the priorities established by l'Échelle brève de triage RIFCAS en santé mentale 0-99 ans, the judgment of professional experts and the usual instruments used.Conclusion The final version of the triage scale provides an objective measure for the priority that should be given to all mental health service requests - these encompass all recognized and essential clinical information. Clinicians can rely on a reliable and proven instrument to prioritize service requests before placing them on the waiting list. The use of this instrument facilitates the development of a common procedure between professionals and ensures a fair and safe treatment of users.

Role of natural gas in electric generation

DOE Office of Scientific and Technical Information (OSTI.GOV)

VanScant, J.W.; Mespelli, K.L.

1995-08-01

The natural-gas industry must overcome significant operating, market, regulatory, and institutional barriers to meet projected demand growth between 1994 and 2005, according to Jeffrey W> VanSant, vice president the New England Power Company, and Kristine L. Mespelli, a fuel analyst with New England Power. An 85-percent increase in gas use for electric generation is expected to account for most of the overall growth in gas demand during the decade, as environmental policies increasingly favor the use of gas instead of other fossil fuels. Recent changes in the natural gas industry have posed challenges to power producers, however. For instance, restructuringmore » of pipeline services in 1992 caused more tightly controlled flow rates which are incompatible with the variable flow needs of electric generators. Another barrier to increased natural-gas use is its relatively undeveloped market, compared to coal and oil markets. In fact, say VanSant and Mespelli, the gas market in many consuming regions is characterized both by a lack of price transparency and limited access to buyers and sellers. Electric utilities can help make gas a viable fuel by maximizing dual-fuel capability, pooling gas purchases, building new business relationships, and improving electronic information networks to make transactions easier and faster.« less

The Meta-Organization: A Research and Conceptual Landscape

DTIC Science & Technology

2011-06-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...une approche globale en nous intéressant plus particulièrement aux problèmes pernicieux, à la convergence et à l’association, et à la gestion des ...rédigé dans le cadre du projet de modélisation de la collaboration et de la prise de décisions méta-organisationnelles financé par le

Canadian Paramedic Services Standards Report: A Strategic Planning Report

DTIC Science & Technology

2014-06-01

Gestion des programmes 7. Nouvelle technologie 8. Gestion des situations d’urgence La section 4 du rapport sur la stratégie de ...normalisation (CSA) et du Programme canadien pour la sûreté et la sécurité (PCSS). Ce projet a réuni des experts clés de la communauté canadienne du ...existantes pour les services paramédicaux actuels au Canada aux besoins présents et futurs de la communauté

A Cultural Resources Survey of the River Trace Permit Area Marion, Crittenden County, Arkansas

DTIC Science & Technology

1990-09-01

located near the City of Marion, Crittenden County, Arkansas. The tract is within the direct impact area of a proposed lake that will be part of the River...channel. The area is presently situated in a swale between low ridges, and was part of Marion Lake until the early twentieth century. Properties...PRPOSED LAKE ................... B M N225 ~\\\\ \\\\r~~i N * ’~ 7~;777 ........o 7____ *, -T , .1 contour interval fee h~t 0 Mile PROJET ARE Map 0

Major Events Coordinated Security Solutions Technical Report Closeout (MECSS): The Application of Science and Technology to Reduce Risk for V2010 and G8/G20 Summits

DTIC Science & Technology

2010-12-01

CBRNE), aux infrastructures essentielles, à la surveillance, à la sécurité physique, à la cybernétique et à la socio- psychologie . Le présent rapport...la socio- psychologie . Dans le cadre du projet SCSGE, on a produit plus de 195 rapports scientifiques, fruit des efforts, du dévouement et du...aux infrastructures essentielles, à la surveillance, à la sécurité physique, à la cybernétique et à la socio- psychologie . Le présent rapport

[Role of research institutions in management of scientific fraud: The example of Inserm Scientific Integrity delegation].

PubMed

Bungener, Martine; Hadchouel, Michelle

2012-09-01

Fraud is only a part of misconduct in research. Very few French research Institutions have a scientific integrity office, and their prevention. The Institut national de la santé et de la recherche médicale (Inserm) has created a "Scientific Integrity delegation". Scientific Integrity is an international concern. Scientific Integrity is closely linked to organisation, management and evaluation of all research activities. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Bibliography of Battle Fatigue Literature

DTIC Science & Technology

1986-01-16

Psychopathologic and therapeutic aspects of nervous trauma in war). Revue Internationale des Services de Sante, 55, 295-307. Bartemeier, L. H., Kubie , L. S...Army Institute of Research. Kubie , L. S. (1943, December). Manual of emergency treatment for acute war neuroses. War Medicine, 4, 582-598. Kupper, H...stress reaction: A concept in evolution. Military Medicine, 150, 186-190. Margolin, S. G., Kubie , L. S., Kanzer, M., & Stone, L. (1943, April). Acute

Light Scattering from Rough Surfaces. Appendix. Angular Correlation of Speckle Patterns. Draft

DTIC Science & Technology

1994-06-01

For his demonstrations of the various experimental techniques, I owe thanks to Andrew Sant. Also, on behalf of all students writing (and written) up ...less controllable, radar set up . 1.1.1 Theoretical Models This section will present some of the theoretical models which exist for determining the...centre of a turntable set up to spin at :300 revolutions per minute. While the turntable is stationary, photoresist is applied to the centre of the

Occupational Health and Safety in a Vocational Training Program: How Gender Impacts Teachers' Strategies and Power Relationships: Santé et sécurité des stagiaires dans un programme de formation professionnelle: Impact du genre sur les stratégies et rapports de pouvoir.

PubMed

Laberge, Marie; Tondoux, Aurélie; Camiré Tremblay, Fanny; MacEachen, Ellen

2017-11-01

In Quebec (Canada), the Work-Oriented Training Path, a work-study program, prepares students who are having difficulty at school for the job market. Occupational health and safety is an important part of their training. This article aims to analyze the impact of gender on the interpersonal dynamics among teachers, trainees, and key actors from the businesses involved. This article also looks at the influence of gender on teachers' strategies and capacity to act regarding occupational health and safety. Using a work activity analysis lens, a multiple case-study analysis of teachers' work activity was carried out. The findings show that gendered social relationships create a specific supervisory context that influences occupational health and safety training. Solutions aimed at reducing the negative impact of gender-associated prejudice on work injury prevention include training for teachers, attention to work organization at the schools, and the creation of cohesive teachers' work teams. Résumé Au Québec, le Parcours de formation axée sur l'emploi (WOTP), un programme en alternance, offre une préparation au marché du travail aux élèves en difficultés scolaires. La santé et la sécurité du travail (SST) est un enjeu important de la formation. L'article vise à analyser l'impact du genre dans la dynamique relationnelle entre les enseignant.es, leurs élèves et les interlocuteurs clés des entreprises impliquées, et son influence sur les stratégies et la capacité d'agir des enseignant.es en matière de SST. Une analyse de cas multiples basée sur l'analyse ergonomique de l'activité des enseignants a été menée. Les résultats montrent que les relations sociales de genre déterminent un contexte spécifique de supervision qui influence la formation à la SST. La formation des enseignant.es, l'organisation scolaire et la création de collectifs enseignants cohésifs sont des pistes de solution pour réduire l'effet négatif des préjugés liés au genre

Modelling tools for managing Induced RiverBank Filtration MAR schemes

NASA Astrophysics Data System (ADS)

De Filippis, Giovanna; Barbagli, Alessio; Marchina, Chiara; Borsi, Iacopo; Mazzanti, Giorgio; Nardi, Marco; Vienken, Thomas; Bonari, Enrico; Rossetto, Rudy

2017-04-01

Induced RiverBank Filtration (IRBF) is a widely used technique in Managed Aquifer Recharge (MAR) schemes, when aquifers are hydraulically connected with surface water bodies, with proven positive effects on quality and quantity of groundwater. IRBF allows abstraction of a large volume of water, avoiding large decrease in groundwater heads. Moreover, thanks to the filtration process through the soil, the concentration of chemical species in surface water can be reduced, thus becoming an excellent resource for the production of drinking water. Within the FP7 MARSOL project (demonstrating Managed Aquifer Recharge as a SOLution to water scarcity and drought; http://www.marsol.eu/), the Sant'Alessio IRBF (Lucca, Italy) was used to demonstrate the feasibility and technical and economic benefits of managing IRBF schemes (Rossetto et al., 2015a). The Sant'Alessio IRBF along the Serchio river allows to abstract an overall amount of about 0.5 m3/s providing drinking water for 300000 people of the coastal Tuscany (mainly to the town of Lucca, Pisa and Livorno). The supplied water is made available by enhancing river bank infiltration into a high yield (10-2 m2/s transmissivity) sandy-gravelly aquifer by rising the river head and using ten vertical wells along the river embankment. A Decision Support System, consisting in connected measurements from an advanced monitoring network and modelling tools was set up to manage the IRBF. The modelling system is based on spatially distributed and physically based coupled ground-/surface-water flow and solute transport models integrated in the FREEWAT platform (developed within the H2020 FREEWAT project - FREE and Open Source Software Tools for WATer Resource Management; Rossetto et al., 2015b), an open source and public domain GIS-integrated modelling environment for the simulation of the hydrological cycle. The platform aims at improving water resource management by simplifying the application of EU water-related Directives and at

Risk Assessment References: Documented Literature Search

DTIC Science & Technology

2012-10-01

the Minister of National Defence, 2012 © Sa Majesté la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale...vise à démontrer la valeur de l’approche scientifique pour améliorer les capacités de gestion des situations d’urgence en se concentrant sur...l’évaluation des risques et les infrastructures essentielles. Au cours de la première phase du projet, RDDC a effectué une analyse documentaire

Spaceborne Ocean Intelligence Network: SOIN - Fiscal Year 10/11 Year-End Summary

DTIC Science & Technology

2011-10-01

la Reine (en droit du Canada), telle que représentée par le ministre de ...d’ouverture (RSO) de RADARSAT-2. La phase II en cours, d’une durée de trois ans, portera sur l’opérationnalisation et la mise en œuvre des capacités du RSRO...gouvernementales en observation de la Terre (IGOT). Le présent rapport donne un résumé des activités et des réalisations du projet durant l’exercice

Integrating Occupational Characteristics into Human Performance Models: IPME Versus ISMAT Approach

DTIC Science & Technology

2009-08-01

modélisation générique de la performance humaine appelé Integrated Performance Modelling Environment (IPME). Ce projet a permis d’explorer l’utilisation de la...groupes professionnels dans des modèles de performance humaine : l’approche IPME et l’approche ISMAT Par Christy Lorenzen; RDDC RC 2009-059; R & D...application de simulation d’événements discrets disponible sur le marché et servant à développer des modèles qui simulent la performance humaine et de

Les barrières à une bonne prise en charge des diabétiques dans les structures de première ligne de la province de Khouribga (MAROC)

PubMed Central

Hassoune, Samira; Badri, Soufiane; Nani, Samira; Belhadi, Leila; Maaroufi, Abderrahmane

2012-01-01

Introduction Le diabète constitue un important enjeu de santé publique au Maroc et représente un défi auquel les médecins généralistes sont confrontés dans leur pratique quotidienne. Le but de ce travail était de décrire les barrières entravant une bonne prise en charge des patients diabétiques dans les structures de 1ère ligne de la province de khouribga. Méthodes Il s'agit d'une étude transversale menée de décembre 2010 à mars 2011, chez les 54 médecins généralistes (MG) exerçants dans les centres de santé de la province. La collecte des données a été réalisée à l'aide d'un questionnaire prétesté et auto administré et la saisie et l'analyse effectuées sur le logiciel SPSS 16. Résultats Huit pourcent des MG disposaient de registre informatisé pour le suivi des diabétiques. Les principales barrières à une prise en charge correcte des patients étaient le statut socio-économique faible des patients (94%), leur niveau scolaire bas (86%), le manque de moyens de traitement et de suivi (80%), le nombre insuffisant de diabétologues (80%), le manque de coordination avec les structures de 2ème ligne (74%) et l'insuffisance des séminaires de formation continue (58%). Conclusion Les médecins généralistes sont confrontés à de nombreux obstacles concernant la prise en charge des patients diabétiques. L’équipement des centres de santé en moyens diagnostiques et thérapeutiques suffisants, l'amélioration de l'accessibilité des diabétiques aux soins et la formation continue des médecins pourraient être des solutions pour améliorer cette prise en charge surtout devant la pénurie de spécialistes dans notre pays. PMID:23330033

Les inconvénients de perdre du poids

PubMed Central

Bosomworth, N. John

2012-01-01

Résumé Objectif Explorer les raisons pour lesquelles la perte de poids à long terme échoue la plupart du temps et évaluer les conséquences de diverses trajectoires pondérales, y compris la stabilité, la perte et le gain. Source des données Les études qui évaluent les paramètres pondéraux dans la population sont en majorité observationnelles. Des données probantes de niveau I ont été publiées pour évaluer l’influence des interventions relatives au poids sur la mortalité et la qualité de vie. Message principal Seulement un petit pourcentage des personnes qui désirent perdre du poids réussissent à le faire de manière durable. La mortalité est la plus faible chez les personnes se situant dans la catégorie de poids élevé-normal et surpoids. La trajectoire pondérale la plus sécuritaire est la stabilité du poids avec une optimisation de la condition physique et métabolique. Il est démontré que la mortalité est plus faible chez les personnes ayant des comorbidités reliées à l’obésité si elles perdent du poids. Il est aussi établi que la qualité de vie sur le plan de la santé est meilleure chez les personnes obèses qui perdent du poids. Par contre, la perte de poids chez une personne obèse autrement en santé est associée à une mortalité accrue. Conclusion La perte de poids est recommandable seulement chez les personnes qui ont des comorbidités reliées à l’obésité. Les personnes obèses en santé qui veulent perdre du poids devraient être informées qu’il peut y avoir des risques à le faire. Une stratégie qui se traduit par un indice de masse corporelle stable avec une condition physique et métabolique optimisée, peu importe le poids, est l’option d’intervention la plus sécuritaire en ce qui concerne le poids.

Problématique de l'utilisation des Moustiquaires Imprégnées d'insecticide à Longue Durée (MILD) chez les enfants de moins de 5 ans en République Démocratique du Congo

PubMed Central

Philippe, Cilundika Mulenga; Odile, Nyota Nsenga; Numbi, Oscar Luboya

2016-01-01

Introduction Le paludisme est une maladie parasitaire à transmission vectorielle qui constitue un problème majeur de santé publique dans les pays tropicaux, particulièrement les pays de l'Afrique Subsaharienne. La présente étude avait pour objectif d'identifier le niveau d'utilisation de la MILD chez les enfants de moins de 5 ans dans la zone de santé de Mumbunda. Méthodes L’étude, de type transversal, a été mené du 25 au 27 octobre 2013 et a porté sur un échantillon de 410 ménages tirés au hasard et ayant au moins un enfant de moins de 5 ans. Résultats Parmi les ménages qui avaient déclaré possédaient la MILD 13,1% (n=54) des répondant avaient déclaré les utilisé chez les enfants de moins de 5ans et 80,2% pour tout le monde. Dans 22,0% des cas, les répondants ont évoqué le manque d'argent comme motif de la non possession de la MILD. Les répondants savaient déclarer à 79,8% avoir utilisé la MILD pour se protéger contre la malaria et à 66,3% pour se protéger contre les piqures des moustiques. La MILD a été étalée à l'ombre pendant 24h avant d’être utilisée pour la première fois par 77,9% des ménages. Les répondants avaient déclaré à 15,3% (n=63) avoir reçu les conseils par les médias pour l'usage de la moustiquaire. Et le personnel médical était la source la plus importante pour expliquer le mode d'emploi de la MILD pour 51,2% des ménages. Conclusion La réussite pour faire reculer le paludisme doit nécessairement passer par la prévention, le suivi et l’évaluation de l'utilisation des moustiquaires imprégnées au niveau de la zone de santé de Mumbunda. PMID:27222690

Facteurs prédictifs de l’échec de traitement antituberculeux en Guinée Conakry

PubMed Central

Nimagan, Souleymane; Bopaka, Regis Gothard; Diallo, Mamadou Mouctar; Diallo, Boubacar Djelo; Diallo, Mamadou Bailo; Sow, Oumou Younoussa

2015-01-01

La tuberculose est un véritable problème de santé publique. C'est une maladie guérissable et cette guérison passe par une bonne prise en charge thérapeutique. Il arrive parfois on assiste à l’échec thérapeutique, d'où l'intérêt de notre étude portant sur les facteurs prédictifs de ses échecs. Dans l'espace d'une année sur 1300 cas de tuberculose toute forme confondue, 700 cas de tuberculose pulmonaire à microscopie positive ont été répertorié dont 100 cas transférés. La tranche d’âge de 15-25 ans a été la plus touchée avec un sexe-ratio de 2 en faveur des hommes et 41,66% de nos malades ont été les ouvriers suivis de 20,83% des commerçants. La majorité de nos patients provenait de Conakry soit 99, 5%. Sur 600 patients suivis les nouveaux cas représentaient 83,33% et l’échec thérapeutique représentait 12 cas soit 2%. L'interruption du traitement représente le principal facteur de l’échec. Les facteurs qui ont influencé la régularité des malades au traitement ont été multiples. Des facteurs liés à l'organisation du système de santé, la rupture des médicaments antituberculeux, l’éducation sanitaire insuffisante, les contraintes de la supervision du traitement, l'implication insuffisante et la vente des médicaments par le personnel de santé. Des facteurs liés aux patients eux-mêmes, la crainte de perte d'emploi, les contraintes financières. Les renforcements de l'organisation du système sanitaire et l’éducation thérapeutiques pourront réduire le taux d’échec du traitement antituberculeux. L'amélioration de la qualité de la prise en charge des malades en situation d’échec devrait passer par une culture systématique des expectorations avec antibiogramme. PMID:26889327

Development and validation of an individual dietary index based on the British Food Standard Agency nutrient profiling system in a French context.

PubMed

Julia, Chantal; Touvier, Mathilde; Méjean, Caroline; Ducrot, Pauline; Péneau, Sandrine; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2014-12-01

Nutrient profiling systems could be useful public health tools as a basis for front-of-package nutrition labeling, advertising regulations, or food taxes. However, their ability beyond characterization of foods to adequately characterize individual diets necessitates further investigation. The objectives of this study were 1) to calculate a score at the individual level based on the British Food Standard Agency (FSA) food-level nutrient profiling system of each food consumed, and 2) to evaluate the validity of the resulting diet-quality score against food group consumption, nutrient intake, and sociodemographic and lifestyle variables. A representative sample of the French population was selected from the NutriNet-Santé Study (n = 4225). Dietary data were collected through repeated 24-h dietary records. Sociodemographic and lifestyle data were self-reported. All foods consumed were characterized by their FSA nutrient profile, and the energy intake from each food consumed was used to compute FSA-derived aggregated scores at the individual level. A score of adherence to French nutritional recommendations [Programme National Nutrition Santé guideline score (PNNS-GS)] was computed as a comparison diet-quality score. Associations between food consumption, nutritional indicators, lifestyle and sociodemographic variables, and quartiles of aggregated scores were investigated using ANOVAs and linear regression models. Participants with more favorable scores consumed higher amounts of fruits [difference Δ = 156 g/d between quartile 1 (less favorable) and quartile 4 (most favorable), P < 0.001], vegetables (Δ = 85 g/d, P < 0.001), and fish, and lower amounts of snack foods (Δ = -72 g/d, P < 0.001 for sugary snacks); they also had higher vitamin and mineral intakes and lower intakes of saturated fat. Participants with more favorable scores also had a higher adherence to nutritional recommendations measured with the PNNS-GS (Δ = 2.13 points, P < 0.001). Women, older

Etude des connaissances, attitudes et pratiques en matière de réintégration sociale des femmes victimes de fistule obstétricale: région de l'Extrême-nord, Cameroun

PubMed Central

Martin, Sanou Sobze; Adogaye, Sali Ben Béchir; Rodrigue, Mabvouna Biguioh; Maurice, Douryang; Vivaldi, Teikeu Tessa Vladimir; Amede, Saah Fopa Michael; Marie, Ovaga Eyenga Landry; Meriam, Ausseil Sandra; Colizzi, Vittorio; Gianluca, Russo

2015-01-01

Introduction La fistule obstétricale est un orifice entre le vagin et la vessie ou le rectum, voire les deux. Ses impacts sont des conséquences anatomo-fonctionnelles et sociales. On estime à plus de 19 000 le nombre de femmes qui souffrent de fistule obstétricale au Cameroun. Méthodes Il s'agissait d'une étude transversale descriptive conduite dans trois districts de santé de la région de l'Extrême-nord. Vingt-huit femmes victimes de fistules obstétricales, quarante-deux membres de leur entourage et vingt-quatre agents de santé ont été interviewés entre Novembre et Décembre 2013. Trois types de questionnaires ont été utilisés. Les données ont été analysées dans Epi Info version 7.1.4.0. Les moyennes et les fréquences ont été calculées avec un intervalle de confiance à 95%. Résultats 46,4% des femmes victimes de fistule obstétricales interviewées avaient subi une intervention chirurgicale réparatrice parmi lesquelles, 61,5% bénéficiaient de la réintégration. Le fonds de commerce (62,5%) était l'aide la plus reçue. Vingt-deux membres de l'entourage savaient pourquoi on fait la réintégration. Selon eux, les considérations socioculturelles (68,2%), sont la principale barrière de la réintégration. D'après les agents de santé, le suivi psychosocial (58,3%) est la principale activité de la réintégration dans les centres de prise en charge de la fistule. Conclusion La prise en charge des fistules obstétricales au Cameroun souffre de manque de réintégration sociale. Ceci expliquerait en partie la persistance de cette pathologie. Un accent devrait être mis sur l'appui matériel, financier et sur le suivi psychosocial des femmes victimes de fistule obstétricale. PMID:26113915

Systeme microfluidique d'analyse sanguine en temps reel pour l'imagerie moleculaire chez le petit animal

NASA Astrophysics Data System (ADS)

Convert, Laurence

De nouveaux radiotraceurs sont continuellement développés pour améliorer l'efficacité diagnostique en imagerie moléculaire, principalement en tomographie d'émission par positrons (TEP) et en tomographie d'émission monophotonique (TEM) dans les domaines de l'oncologie, de la cardiologie et de la neurologie. Avant de pouvoir être utilisés chez les humains, ces radiotraceurs doivent être caractérisés chez les petits animaux, principalement les rats et les souris. Pour cela, de nombreux échantillons sanguins doivent être prélevés et analysés (mesure de radioactivité, séparation de plasma, séparation d'espèces chimiques), ce qui représente un défi majeur chez les rongeurs à cause de leur très faible volume sanguin (˜1,4 ml pour une souris). Des solutions fournissant une analyse partielle sont présentées dans la littérature, mais aucune ne permet d'effectuer toutes les opérations dans un même système. Les présents travaux de recherche s'insèrent dans le contexte global d'un projet visant à développer un système microfluidique d'analyse sanguine complète en temps réel pour la caractérisation des nouveaux radiotraceurs TEP et TEM. Un cahier des charges a tout d'abord été établi et a permis de fixer des critères quantitatifs et qualitatifs à respecter pour chacune des fonctions de la puce. La fonction de détection microfluidique a ensuite été développée. Un état de l'art des travaux ayant déjà combiné la microfluidique et la détection de radioactivité a permis de souligner qu'aucune solution existante ne répondait aux critères du projet. Parmi les différentes technologies disponibles, des microcanaux en résine KMPR fabriqués sur des détecteurs semiconducteurs de type p-i-n ont été identifiés comme une solution technologique pour le projet. Des détecteurs p-i-n ont ensuite été fabriqués en utilisant un procédé standard. Les performances encourageantes obtenues ont mené à initier un projet de ma

Literacy and Health Project. Phase One. Making the World Healthier and Safer for People Who Can't Read = Projet alphabetisation et sante: Premiere etape. Rendre le milieu plus sain et sans danger pour les personnes qui ne savent pas lire.

ERIC Educational Resources Information Center

Ontario Public Health Association, Toronto.

The Literacy and Health Project was set up to determine how reading and health problems were connected. A research phase documented the relationship between literacy and health. Information was collected from community organizations, literature review, three case studies in Ontario, and key informant interviews. The consultation process involved…

Aircraft Disinsection: A Guide for Military and Civilian Air Carriers (Desinsectisation des aeronefs: Un guide a l’intention des responsables des transports aeriens civils et militaires)

DTIC Science & Technology

1996-04-01

regulations. - Ceratitis capitata (Mediterranean fruit fly). Quarantine regulations generally reduce - Rhagoletis pomonella (Apple maggot). the chances of a...d’insectes nuisibles dans un pays, en 6vitant des risques pour la sant6 des 6quipages, pour la s~curit6 de 1’a~ronef et pour l’industrie. Ce rapport examine 1...diffrrents officiels responsables de la r~glementation des insectes nuisibles introduits, de l’inscription des pesticides et de leur utilisation en

MX Missile MOA Between Four Corners Regional Commission and the United States Air Force.

DTIC Science & Technology

1981-08-20

Mountains east of Beaver. The impact of hunting pres- sure and potential poaching has also ncz been addressed. 0 Despite the fact that phea- sant... impacted by both increased hunting pressure and poach - ing. Pheasant populations in the Delta area will be impacted by the loss of habitat due to...go. Water 0’ is very limiting. 4-780 1 Upland game birds will be impacted by both increased hunting pressure and poach - ing. Pheasant populations in

L'optique pour la sécurité sanitaire des aliments

NASA Astrophysics Data System (ADS)

Piat, Félix

2017-12-01

Il semble aujourd'hui évident que chaque produit alimentaire commercialisé ne représente aucun danger pour la santé. Cet acquis repose pourtant sur un système complexe de règles et de contrôles appliqués quotidiennement dans les coulisses de l'industrie agro-alimentaire. Les technologies optiques y jouent un rôle prépondérant, permettant de séparer le bon grain de l'ivraie.

Intraosseous Erythropoietin for Acute Tissue Protection in Battlefield Casualties Suffering Hypovolemic Shock

DTIC Science & Technology

2013-11-01

Resuscitation. Universidad Católica de la Santísima Concepción, Facultad de Ciencias de la Salud . May 7-8. Concepción, Chile. 1997 Advances in CPR...Med 2003;31:2811-2812. 20. Gazmuri RJ. Editorial: Optimizando la calidad en medicina intensiva [Optimizing the quality of intensive care medicine...increase in left ventricular stroke work index and cardiac index – likely an effect on preload – that helped increase the aor- tic pressure and reduce the

Low Prevalence of HIV Infection in Djibouti - Has the AIDS Epidemic Come to a Stop at the Horn of Africa?

DTIC Science & Technology

1989-01-01

Abbatte’ Ministre de la Sante ernmost part of the Horn of Africa. Its inhabitants publique : Dr Albert; WHO, Djibouti: Dr Wassef; H6pital belong to...Research Unit No. 3, FPO, New York, NY entreprise : Dr Said; Cabinet Medical: Dr Rodier" and Mr 09527-1600, USA. Adel; Dispensaire de Randa: Dr Qufz&k...41 at the Service Medical Inter- entreprise , at the Nation- hospital patients with a disease compatible with al Army Health Centre, at the Service

Seismic behavior of an Italian Renaissance Sanctuary: Damage assessment by numerical modelling

NASA Astrophysics Data System (ADS)

Clementi, Francesco; Nespeca, Andrea; Lenci, Stefano

2016-12-01

The paper deals with modelling and analysis of architectural heritage through the discussion of an illustrative case study: the Medieval Sanctuary of Sant'Agostino (Offida, Italy). Using the finite element technique, a 3D numerical model of the sanctuary is built, and then used to identify the main sources of the damages. The work shows that advanced numerical analyses could offer significant information for the understanding of the causes of existing damage and, more generally, on the seismic vulnerability.

Self-reported Health and Well-being Outcomes of ASERE Students

DTIC Science & Technology

2005-07-01

mesure normalisée) des scores légèrement plus faibles dans l’évaluation de la santé physique à la fin du cours comparativement à ceux indiqués avant...faibles après le cours comparativement à ceux obtenus lors de l’évaluation antérieure au cours...Zachariassen, 2000, p. 334). Indeed, the need for control is so great in humans that stress can trigger a variety of behaviors specifically designed to

Dental treatment under general anesthesia in a group of patients with cerebral palsy and a group of healthy pediatric patients

PubMed Central

Escanilla-Casal, Alejandro; Aznar-Gómez, Mirella; Viaño, José M.; Rivera-Baró, Alejandro

2014-01-01

This is a comparative study between two groups, one of healthy children and the other of children with cerebral palsy, which underwent dental treatment under general anesthesia at Hospital Sant Joan de Déu Barcelona. The purpose of the study was to compare and determine oral pathology, frequency, severity and postoperative complications in pediatric patients with and without an underlying disease which undergo a dental treatment under general anesthesia. Key words:General anesthesia, cerebral palsy, pediatric patients. PMID:24608223

Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the VSP-A (Vécu et Santé Perçue de l'Adolescent), a health-related quality of life (HRQoL) instrument for adolescents, in a healthy Brazilian population

PubMed Central

2011-01-01

Background Health-related quality of life (HRQoL) assessment, encompassing the adolescents' perceptions of their mental, physical, and social health and well-being is increasingly considered an important outcome to be used to identify population health needs and to provide targeted medical care. Although validated instruments are essential for accurately assessing HRQoL outcomes, there are few cross-culturally adapted tools for use in Brazil, and none designed exclusively for use among adolescents. The Vécu et Santé Perçue de l'Adolescent (VSP-A) is a generic, multidimensional self-reported instrument originally developed and validated in France that evaluates HRQoL of ill and healthy adolescents. Purpose To cross-culturally adapt and validate the Brazilian-Portuguese version of the VSP-A, a generic HRQoL measure for adolescents originally developed in France. Methods The VSP-A was translated following a well-validated forward-backward process leading to the Brazilian version. The psychometric evaluation was conducted in a sample of 446 adolescents (14-18 years) attending 2 public high schools of São Gonçalo City. The adolescents self-reported the Brazilian VSP-A, the validated Psychosomatic Symptom Checklist and socio-demographic information. A retest evaluation was carried out on a sub-sample (n = 195) at a two-week interval. The internal construct validity was assessed through confirmatory factor analysis (CFA), multi-trait scaling analyses, Rasch analysis evaluating unidimensionality of each scale and Cronbach's alpha coefficients. The reproducibility was evaluated by intra-class correlation coefficients (ICC). Zumbo's ordinal logistic regression analysis was used to detect differential item functioning (DIF) between the Brazilian and the French items. External construct validity was investigated testing expected differences between groups using one-way analysis of variance (ANOVA), Mann-Whitney tests and the univariate general regression linear model

Projets et développemepts en cryoélectrotechnique

NASA Astrophysics Data System (ADS)

Tixador, P.; Laumond, Y.

1991-02-01

The use of superconductivity in electrical engineering is reviewed. It deals with low T_c superconductors as only applications under development are considered. The article describes first the " classical " uses under constant or slow varying magnetic field: coils for Superconducting Magnetic Energy Storage, they are expected as a power system stabilizer and not only as a energy storage system. The present status of superconducting field a.c. generators is reviewed and the different programs over the world are described: in Germany (KWU/Siemens), in UDSSR, and in Japan where the program Super GM is led by the Engineering Research Association for Superconductive Generation Equipment and Materials. After a description of ultra-fine multifilamentary wires for 50-60 Hz use their applications are reviewed: electrical machines, above all fully superconducting a.c. generators, transformers and limiters based on the superconducting-normal transition above the critical current. Les diverses applications de la supraconductivité en électrotechnique ou courants forts sont passées en revue. Comme il s'agit de développements en cours, seule la supraconductivité à basse température est considérée. Les applications " classiques " des supraconducteurs sont abordées en premier. Ce sont les bobines de stockage (S.M.E.S.), qui peuvent fonctionner également en régulateur, les alternateurs à inducteur supraconducteur (SC) avec les programmes japonais (super GM), allemand (KWU Siemens) et soviétique, sans oublier la lévitation magnétique... Ensuite, après un bref rappel sur les multifilamentaires ultrafins utilisables aux fréquences industrielles apparus en 1983, l'article considère les applications de ces nouveaux conducteurs SC : machines électriques avec les alternateurs entièrement supraconducteurs surtout, transformateurs et enfin limiteurs qui utilisent le phénomène original de la transition supra/normal pour limiter les surintensités.

The Directorate-General for Health and Consumers 1999-2014: An assessment of its functional capacities.

PubMed

Clemens, Timo; Sørensen, Kristine; Rosenkötter, Nicole; Michelsen, Kai; Brand, Helmut

2017-06-01

Capacity assessment has become a popular measure in the health sector to assess the ability of various stakeholders to pursue agreed activities. The European Commission (EC) is increasingly dealing with a variety of health issues to coordinate and complement national health policies. This study analyses the functional capacity of the Directorate-General for Health and Consumers (DG SANCO) between 1999 and 2004. It applies the UNDP Capacity Assessment Framework and uses a literature review, a document review of EU policy documents and expert interviews to assess the capacity of DG SANCO to fulfill its mandate for public health and health systems. Our results suggest that DG SANCO has established capacities to engage with stakeholders; to assess various health issues, to define issue-specific health policies and to collect information for evaluative purposes. In contrast, capacities tend to be less established for defining a clear strategy for the overall sector, for setting priorities and for budgeting, managing and implementing policies. We conclude that improvements to the effectiveness of DG SANTE's (the successor of DG SANCO) policies can be made within the existing mandate. A priority setting exercise may be conducted to limit the number of pursued actions to those with the greatest European added value within DG SANTE's responsibilities. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Research Using In Vivo Simulation of Meta-Organizational Shared Decision Making (SDM). Task 2: Development of an Experimental Plan for In Vivo Exercise and Simulation

DTIC Science & Technology

2011-12-01

la Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2011 DRDC CSS CR 2011-31 ii...participants. Résumé …..... Introduction : Ce rapport présente la Tâche 2 du projet « Recherche par la simulation in-vivo sur la prise de décision partagée...environnement sur la prise de décision partagée in-vivo des opérations de gestion des urgences et pour colliger des données

Study on Cyber Security and Threat Evaluation in SCADA Systems

DTIC Science & Technology

2012-03-01

la sécurité de l’infrastructure essentielle du Canada. DRDC CSS CR 2012-06 vii • Les cadres de gestion des cybermenaces et des ...Reine (en droit du Canada), telle que représentée par le ministre de la Défense nationale, 2012 DRDC CSS CR 2012-06 i Abstract …….. This...ii DRDC CSS CR 2012-06 Résumé …..... Le présent rapport fait la synthèse des résultats du projet PTSP 02-0347eSec

Propagation Limitations of Navigation and Positioning Systems

DTIC Science & Technology

1977-02-01

a aophiatiqutf, tel que . le proJet NAUSTAR andrlcain aatie- faltait aane doute la plupart dee beaoina. Si on prend en compta le facteur coöt, on ...rement "lu modal« gausaien, at c’ast da cette fasjon que le precision eat courammant ddflnie, (Ob- sarvona dka h prtfa«nt qu« 1’ on ne seralt paa...pour memoire un cartain nombre da raraeterletiquas aacondeitsa ’cnt •■■:■.-■■:* qual- ques unea t - le •ystteo eat-il paaaif ( l *installation da bord

Application of reverse engineering in the medical industry.

NASA Astrophysics Data System (ADS)

Kaleev, A. A.; Kashapov, L. N.; Kashapov, N. F.; Kashapov, R. N.

2017-09-01

The purpose of this research is to develop on the basis of existing analogs new design of ophthalmologic microsurgical tweezers by using reverse engineering techniques. Virtual model was obtained by using a three-dimensional scanning system Solutionix Rexcan 450 MP. Geomagic Studio program was used to remove defects and inaccuracies of the obtained parametric model. A prototype of the finished model was made on the installation of laser stereolithography Projet 6000. Total time of the creation was 16 hours from the reverse engineering procedure to 3D-printing of the prototype.

L'optique spatiale au CES

NASA Astrophysics Data System (ADS)

Courtois, M.; Otrio, G.

2018-04-01

Jai le plaisir d'inaugurer cette troisieme conference ICS0'97 consacree a l'optique patialc Les techniques evoluent tres vite; l'optique et l'optoelectronique n'echappent pas a c:ene regle. Depuis Garmisch. en 1994, bien des evenements concemant ces domaines se som produits le rappellerai !es faits les plus saillants dans la premiere panie de mon expose Je donncrai ensuite un apercu des activites en cours au Cnes et je tenninerai en parlant du futur quelles sont les technologies emergentes et quels projets peuvent en decouler ?

Caracterisation experimentale de la transmission acoustique de structures aeronautiques

NASA Astrophysics Data System (ADS)

Pointel, Vincent

Le confort des passagers à l'intérieur des avions pendant le vol est un axe en voie d'amélioration constante. L'augmentation de la proportion des matériaux composites dans la fabrication des structures aéronautiques amène de nouvelles problématiques à résoudre. Le faible amortissement de ces structures, en contre partie de leur poids/raideur faible, est non favorable sur le plan acoustique, ce qui oblige les concepteurs à devoir trouver des moyens d'amélioration. De plus, les mécanismes de transmission du son au travers d'un système double paroi de type aéronautique ne sont pas complètement compris, c'est la raison qui motive cette étude. L'objectif principal de ce projet est de constituer une base de données pour le partenaire industriel de ce projet : Bombardier Aéronautique. En effet, les données expérimentales de performance d'isolation acoustique, de systèmes complets représentatifs d'un fuselage d'avion sont très rares dans la littérature scientifique. C'est pourquoi une méthodologie expérimentale est utilisée dans ce projet. Deux conceptions différentes de fuselage sont comparées. La première possède une peau (partie extérieure du fuselage) métallique raidie, alors que la deuxième est constituée d'un panneau sandwich composite. Dans les deux cas, un panneau de finition de fabrication sandwich est utilisé. Un traitement acoustique en laine de verre est placé à l'intérieur de chacun des fuselages. Des isolateurs vibratoires sont utilisés pour connecter les deux panneaux du fuselage. La simulation en laboratoire de la couche limite turbulente, qui est la source d'excitation prépondérante pendant la phase de vol, n'est pas encore possible hormis en soufflerie. C'est pourquoi deux cas d'excitation sont considérés pour essayer d'approcher cette sollicitation : une excitation mécanique (pot vibrant) et une acoustique (champ diffus). La validation et l'analyse des résultats sont effectuées par le biais des logiciels

Limited Energy Study, EEAP - DACA01-94-D-0037, for Fort Monmouth. Book 1.

DTIC Science & Technology

1997-03-01

Engineers, and Mr. Kevin Dooney and Mr. William Van Sant, Ft. Monmouth represented the government. Entech Engineering, Inc. 2-1 The purpose of the meeting...eas Plant Chilled Waer § Ssdegrees F 05 04 148 AHU- -5 AHU-MC4ilrane 0.0 (MR-35_South 3 0/400 Area) .30/0400 ottices/corodors Plant Chilled Water...441-7403 REPRESENTING: Norfolk District PHONE CODE: 036 SUBJECT: Scope of Study NOTES: Discussed Kevin Dooney’s request that Entech not focus totally

People’s Republic of China Scientific Abstracts No. 179

DTIC Science & Technology

1977-11-08

No 2, April 1977 7 CHIH-WU HSUEH-PAO [ACTA BOTANICA SINICA] No 2, June 1977 22 I-CH’UAN HSUEH-PAO [ACTA GENETICA SINICA] No 1...photorespirators. 8650 C50J 4009 29 ACTA GENETICA SINICA AUTHOR: WU An-chiu [0702 1344 0036] ORG: Technique Staff of San-t’ai Commune Fu County...Liaoning Province TITLE: ’TProceed in Struggle, Bring up Superior Seeds for the Revolution" SOURCE: Peking I-CH’UAN HSUEH-PAO [ACTA GENETICA

[Protection of the thyroid in children and fetuses in case of nuclear accident].

PubMed

Vernis, M; Hindie, E; Galle, P

1997-05-01

The administration of stable iodine in order to keep the thyroid gland away from radioactive iodine isotope contamination has long been regarded with caution by the health authorities, mainly because of the potential toxicity of iodine in newborns, young children and adults with thyroid pathology. Therefore, the risk of oral stable iodine given for a limited period of time must be compared to the risk of cancer due to radioactive exposure. The analysis of complications following the nuclear accidents of Marshall Islands in 1954 and Tchernobyl in 1986 has shown that newborn infants and young children, have the highest risk, the main complications being cancer (papillary carcinoma) and hypothyroidism. In the most exposed areas of Bielorussia, the incidence of child thyroid cancer has been approximately multiplied by 100. On the other hand, studies of children from Utah who were contaminated after nuclear tests in the Nevada desert have shown that following mild iodine radioactive exposure, the risk is not significant. Among complications attributed to stable iodine, only those related to an oral intake over a limited period of time should be considered. On the basis of nuclear medicine experience and scientific literature, the risk can be considered as negligible in adults but not in children. However, the Polish experience in children has reported a low risk and only benign complications, mainly transient hypothyroidism. Thus from current knowledge, it appears that the potent risks linked to stable iodine administration should not contraindicate the collective preventive stable iodine administration in case of nuclear accident.

Interactive Visualization of Network Dynamics (Visualisation interactive de la dynamique des reseaux)

DTIC Science & Technology

2014-06-01

la prise de décision du commandement militaire, aux opérations de santé et de sûreté publique...comporter la dénomination « STO », « RTO » ou « AGARD » selon le cas, suivi du numéro de série. Des informations analogues, telles que le titre est la date...Bibliothécaire des ressources du savoir Secretariat General of Defence 061353 Bucharest R et D pour la défense Canada National Armaments

Conference Proceedings of The Application of New Technologies to Improve the Delivery of Aerospace and Defence Information Held at Ottawa, Canada on 14-15 September 1983.

DTIC Science & Technology

1984-01-01

S : L : K -W+ ~ ~ : PP: R: ~FAC NAT:BL LANG:Bs IC: 1: T A 4 CQMIT< E INTERNATIONAL DE M<EDECINE ET DE PHARMACIE...PSYCHOLOGIQUES DE STRESS DANS LE VOL SPATIAL CONCEPTS ACTUELS S ,X ADAPTATON UMAINE AU VOL SPATIAL 5 1 8 EVUE INTERNATIONALE DES SERVICES DE _SANT< E ...Teea . l ,ale ol-ti 1te o sta ) aid pagty letIn* Ito lv te ttit 1.- e b26 l s oul, - t I o ottetlil tttd ye -eile .o o -

Oil Shale in the Piceance Basin: An Analysis of Land Use Issues,

DTIC Science & Technology

1983-07-01

basins -the Piceance, Uinta , Green River, and Washakie. The locations of these basins are shown on the map of the Green River Formation in Fig. 3...commercial interest. Deposits of low grade shale in the other basins are thin and scattered. Only the rich (30 gpt) deposits in the Uinta Basin are of...r n~p I S 806 OIL SHALE, IN lilE PICCANCE BASIN : AN ANALYSIS of LAND USE ISSUESIUI RAND CORP SANtA MONICA CA lJN IASIFID 0 RUBENSON El AL. JUL 83

Virtual Reality: State of Military Research and Applications in Member Countries (La realite virutelle: L’etat actuel des travaux de recherche et des applications militaires dans les pays membres de l’Alliance)

DTIC Science & Technology

2003-02-01

conducteur pour des sources liées au véhicule (bruits liés au moteur et à la transmission, bruits d’équipements, bruits des passagers , …), pour des...maquette de film , de pièce de théâtre ou de publicité. Initié par le département Réalité Virtuelle de CS, et financé par la Communauté Européenne, le projet... films vidéo, l’utilisateur interagit avec la simulation. L’objectif était de permettre d’étudier les apports de la Réalité Virtuelle dans les

The application of additive technologies in creation a medical simulator-trainer of the human head operating field

NASA Astrophysics Data System (ADS)

Kashapov, L. N.; Kashapov, N. F.; Kashapov, R. N.; Pashaev, B. Y.

2016-06-01

The aim of the work was to determine the possible application of additive manufacturing technology during the manufacturing process as close as possible to reality of medical simulator-trainers. In work were used some additive manufacturing technologies: selective laser sintering (SLS), fused deposition modeling (FDM), binder Jetting. As a result, a prototype of simulator-trainer of the human head operating field, which based on the CT real patient, was manufactured and conducted its tests. It was found that structure, which is obtained with the use of 3D-printers ProJet 160, most appropriate and closest to the real properties of the bone.

DRDC Toronto Technical Stream Integrated Capabilities and Vision

DTIC Science & Technology

2011-09-01

du RT, et les présenter à la séance d’information 2010 destinée à tout le personnel, puis à la réunion du Comité de gestion . Reposant sur une...profession technique, c) adoption d’une culture de collaboration et de réseautage, d ) élargissement de l’influence de la profession technique. Grâce à...d’information 2010 destinée à tout le personnel, puis à la réunion du Comité de gestion . Résultats : Une équipe de projet, composée de huit membres du

International Congress on Transposable Elements (ICTE) 2012 in Saint Malo and the sea of TE stories.

PubMed

Ainouche, Abdelkader; Bétermier, Mireille; Chandler, Mick; Cordaux, Richard; Cristofari, Gaël; Deragon, Jean-Marc; Lesage, Pascale; Panaud, Olivier; Quesneville, Hadi; Vaury, Chantal; Vieira, Cristina; Vitte, Clémentine

2012-10-30

An international conference on Transposable Elements (TEs) was held 21-24 April 2012 in Saint Malo, France. Organized by the French Transposition Community (GDR Elements Génétiques Mobiles et Génomes, CNRS) and the French Society of Genetics (SFG), the conference's goal was to bring together researchers from around the world who study transposition in diverse organisms using multiple experimental approaches. The meeting drew more than 217 attendees and most contributed through poster presentations (117), invited talks and short talks selected from poster abstracts (48 in total). The talks were organized into four scientific sessions, focused on: impact of TEs on genomes, control of transposition, evolution of TEs and mechanisms of transposition. Here, we present highlights from the talks given during the platform sessions. The conference was sponsored by Alliance pour les sciences de la vie et de la santé (Aviesan), Centre national de la recherche scientifique (CNRS), Institut national de la santé et de la recherche médicale (INSERM), Institut de recherche pour le développement (IRD), Institut national de la recherche agronomique (INRA), Université de Perpignan, Université de Rennes 1, Région Bretagne and Mobile DNA. CHAIR OF THE ORGANIZATION COMMITTEE: Jean-Marc Deragon ORGANIZERS: Abdelkader Ainouche, Mireille Bétermier, Mick Chandler, Richard Cordaux, Gaël Cristofari, Jean-Marc Deragon, Pascale Lesage, Didier Mazel, Olivier Panaud, Hadi Quesneville, Chantal Vaury, Cristina Vieira and Clémentine Vitte.

Interdire aux enfants et aux adolescents de moins de 18 ans l’accès aux établissements commerciaux de bronzage

PubMed Central

Taddeo, Danielle; Stanwick, Richard

2012-01-01

RÉSUMÉ Le nombre de mélanomes cutanés malins a plus que triplé depuis 35 ans. Puisque les dommages sont cumulatifs, l’exposition aux rayonnements ultraviolets tôt dans la vie accroît le risque, qui augmente davantage avec l’utilisation de sources artificielles de rayonnements ultraviolets. Il peut falloir des années pour évaluer les répercussions et l’étendue complètes des dommages causés par le bronzage artificiel à longueur d’année, compte tenu de la longue période de latence de la plupart des cancers de la peau. Les adolescents fréquentent souvent les salons de bronzage, les filles s’y rendant davantage et de manière soutenue. L’industrie du bronzage conteste la classification de cancérigène physique de groupe 1 qu’attribuent au bronzage artificiel l’Organisation mondiale de la santé et le Centre international de recherche sur le cancer. Les salons de bronzage cherchent à établir et à maintenir une clientèle chez les adolescents. Par conséquent, la Société canadienne de pédiatrie s’ajoute à d’autres organismes de santé réputés pour appuyer l’interdiction des établissements commerciaux de bronzage aux enfants et adolescents de moins de 18 ans.

Predictors of symptom severity in patients with chronic prostatitis and interstitial cystitis.

PubMed

Clemens, J Quentin; Brown, Sheila O; Kozloff, Lara; Calhoun, Elizabeth A

2006-03-01

Numerous studies have been performed to identify potential risk factors for CP/CPPS and IC. However, few studies have been done to identify predictors of disease severity. A total of 174 men with CP/CPPS and 111 women with IC completed questionnaires to quantify symptom severity and identify demographic, medical and psychosocial characteristics. Symptom severity was assessed with the National Institutes of Health CPSI in men, and the O'Leary-Sant ICSI and problem index in women. Univariate and multivariate analyses were performed to identify characteristics predictive of worse symptoms. The mean National Institutes of Health CPSI score in men was 15.32, and the mean O'Leary-Sant ICSI and problem index in women was 19.17. The most commonly reported comorbidities were allergies, sinusitis, erectile dysfunction and irritable bowel syndrome in men, and allergies, urinary incontinence, sinusitis and irritable bowel syndrome in women. In the 2 sexes self-reported urinary frequency and urgency, worse depression scores and lower education level were independent predictors of worse symptom severity. In men additional independent predictors were self-reported pelvic pain, fibromyalgia and previous heart attack, and in women an additional independent predictor was postmenopausal status. There are several common medical conditions associated with urological pelvic pain syndromes in men and women. Few of them were predictive of symptoms severity in this analysis. Self-reported pelvic pain symptoms, education and depression severity were the factors most strongly predictive of symptom severity in patients with CP/CPPS and IC.

Crystal Structure of the Chromodomain Helicase DNA-binding Protein 1 (Chd1) DNA-binding Domain in Complex with DNA*

PubMed Central

Sharma, Amit; Jenkins, Katherine R.; Héroux, Annie; Bowman, Gregory D.

2011-01-01

Chromatin remodelers are ATP-dependent machines that dynamically alter the chromatin packaging of eukaryotic genomes by assembling, sliding, and displacing nucleosomes. The Chd1 chromatin remodeler possesses a C-terminal DNA-binding domain that is required for efficient nucleosome sliding and believed to be essential for sensing the length of DNA flanking the nucleosome core. The structure of the Chd1 DNA-binding domain was recently shown to consist of a SANT and SLIDE domain, analogous to the DNA-binding domain of the ISWI family, yet the details of how Chd1 recognized DNA were not known. Here we present the crystal structure of the Saccharomyces cerevisiae Chd1 DNA-binding domain in complex with a DNA duplex. The bound DNA duplex is straight, consistent with the preference exhibited by the Chd1 DNA-binding domain for extranucleosomal DNA. Comparison of this structure with the recently solved ISW1a DNA-binding domain bound to DNA reveals that DNA lays across each protein at a distinct angle, yet contacts similar surfaces on the SANT and SLIDE domains. In contrast to the minor groove binding seen for Isw1 and predicted for Chd1, the SLIDE domain of the Chd1 DNA-binding domain contacts the DNA major groove. The majority of direct contacts with the phosphate backbone occur only on one DNA strand, suggesting that Chd1 may not strongly discriminate between major and minor grooves. PMID:22033927

Accelerated solvent extraction by using an 'in-line' clean-up approach for multiresidue analysis of pesticides in organic honey.

PubMed

Chiesa, Luca Maria; Labella, Giuseppe Federico; Panseri, Sara; Britti, Domenico; Galbiati, Fabrizio; Villa, Roberto; Arioli, Francesco

2017-05-01

The worldwide loss of honeybee colonies may be due to their exposure to several contaminants (i.e., pesticides); such contamination may also have impacts on consumers' health. Therefore, it is essential to develop quick and new methods to detect several pesticide residues in honey samples. In this study, the effectiveness of accelerated solvent extraction (ASE) was compared with QuEChERS methods for the analysis of 53 pesticides in organic honey by gas chromatography-triple quadrupole mass spectrometry. Two simple and rapid ASE methods with 'in-line' clean-up were optimised and then compared with QuEChERS. Hexane-ethyl acetate (Hex:EtAc) and Florisil were chosen as extraction solvent and retainer for the first ASE method respectively; acetonitrile and a primary-secondary amine phase (ACN-PSA) were selected for the second ASE method. The methods were validated according to the European Union SANTE/11945/2015 guidelines. The validation parameters showed that QuEChERS and ASE with PSA as retainer had better repeatability than ASE with Hex:EtAc and Florisil. In particular, QuEChERS and ASE (ACN-PSA) showed good recovery, according to the SANTE criteria, for the majority of investigated pesticides. Conversely, when ASE with Hex:EtAc and Florisil was used as the retainer, several compounds showed recoveries lower than the acceptable value of 70%. The ASE in-line method was finally applied to evaluate pesticide concentration in organic honey samples.

Lignes directrices simplifiées sur les lipides

PubMed Central

Allan, G. Michael; Lindblad, Adrienne J.; Comeau, Ann; Coppola, John; Hudson, Brianne; Mannarino, Marco; McMinis, Cindy; Padwal, Raj; Schelstraete, Christine; Zarnke, Kelly; Garrison, Scott; Cotton, Candra; Korownyk, Christina; McCormack, James; Nickel, Sharon; Kolber, Michael R.

2015-01-01

Résumé Objectif Produire un guide de pratique clinique comportant une approche simplifiée à la prévention primaire des maladies cardiovasculaires (MCV), en insistant sur l’estimation du risque de MCV et la prise en charge des profils lipidiques à l’intention des cliniciens de soins primaires et leurs équipes; nous avons recherché la contribution de professionnels des soins primaires qui n’avaient que peu ou pas de conflits d’intérêts et nous nous sommes concentrés sur les données probantes de la plus haute qualité accessibles. Méthodes Neuf professionnels de la santé (4 médecins de famille, 2 internistes, 1 infirmière praticienne, 1 infirmière autorisée et 1 pharmacienne) et 1 membre non votant (pharmacienne gestionnaire de projet) formaient le comité principal appelé le Lipid Pathway Committee (le comité). La sélection des membres s’est fondée sur la profession, le milieu de pratique et son emplacement. Les membres ont divulgué tous leurs conflits d’intérêts potentiels ou réels. Le processus d’élaboration des lignes directrices était itératif et s’appuyait sur des affichages en ligne, une révision détaillée des données probantes, des réunions par téléphone et en ligne. Le comité a cerné 12 questions prioritaires à répondre. Le groupe de révision des données probantes a répondu à ces questions. À la suite d’un examen des réponses, les principales recommandations ont été formulées par consensus du comité. Nous avons produit une ébauche des lignes directrices qui a ensuite été peaufinée, distribuée à un groupe de cliniciens (médecins de famille, autres spécialistes, pharmaciens, infirmières et infirmières praticiennes) et à des patients pour obtenir de la rétroaction, la réviser en conséquence et le comité l’a ensuite finalisée. Recommandations Des recommandations sont présentées concernant le dépistage et les analyses, les évaluations du risque, le suivi, de même que le r

International overview of hospital procurement.

PubMed

Ferrier, Maud; Lariviere, David; Laurent, Claire; Roque, Eric

2011-01-01

This article was written by four French hospital director students at the Ecole des Hautes Etudes en Santé Publique (EHESP-School of Public Health) from a study conducted jointly with students at the Grenoble School of Management to present an international overview of hospital procurement methods in ten countries. An analysis of these methods showed that there was a general trend towards group purchasing, with some common aims in terms of costs and performance and some differences in legislation (competition), size of the public sector and centralization or decentralization.

Development of a Dynamic Biomechanical Model for Load Carriage: Phase 4, Parts A and B: Development of a Dynamic Biomechanical Model Version 2 of Human Load Carriage

DTIC Science & Technology

2005-08-01

de charge et de comprendre les effets des caractéristiques de conception de systèmes de transport de charge sur la santé et la mobilité humaines...supérieur et le torse inférieur et la force totale de contact. Les travaux sont en cours en vue de l’intégration d’une couche de peau , ce qui...permettrait d’examiner en détail l’interaction au niveau de l’interface équipement- peau . Le but consiste à évaluer les risques de

Peut-on Eduquer des Enfants Sans un Projet de Societe?

ERIC Educational Resources Information Center

Caouette, Charles E.

1988-01-01

Discusses the responsibility of educators of young children to make a commitment to the future of pre-school education. Discusses the relationship of education to present day society and to future societies. States that it is OMEP-CANADA's mandate to work with systems to find ways to prevent violence, abuse, alienation, and suicide. Text is in…

Supplémentation préconceptionnelle en acide folique / multivitamines pour la prévention primaire et secondaire des anomalies du tube neural et d'autres anomalies congénitales sensibles à l'acide folique.

PubMed

Wilson, R Douglas

2016-12-01

Offrir des renseignements à jour sur l'utilisation pré et postconceptionnelle d'acide folique par voie orale, avec ou sans supplément de multivitamines / micronutriments, aux fins de la prévention des anomalies du tube neural et d'autres anomalies congénitales. Ces renseignements aideront les médecins, les sages-femmes, les infirmières et les autres professionnels de la santé à contribuer aux efforts de sensibilisation des femmes quant à l'utilisation et aux posologies adéquates de la supplémentation en acide folique / multivitamines, avant et pendant la grossesse. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed, Medline, CINAHL et la Cochrane Library en janvier 2011 au moyen d'un vocabulaire contrôlé et de mots clés appropriés (p. ex. « folic acid », « prenatal multivitamins », « folate sensitive birth defects », « congenital anomaly risk reduction », « pre-conception counselling »). Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre 1985 et juin 2014. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en juin 2014. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques, dans des registres d'essais cliniques, et auprès de sociétés de spécialité médicale nationales et internationales. COûTS, RISQUES ET AVANTAGES: Les coûts financiers sont ceux de la supplémentation quotidienne en vitamines et de la consommation d'un régime alimentaire santé enrichi en folate. Les risques sont ceux qui sont liés à une association signalée entre la suppl

The stem canker (blackleg) fungus, Leptosphaeria maculans, enters the genomic era.

PubMed

Rouxel, T; Balesdent, M H

2005-05-01

SUMMARY Leptosphaeria maculans is the most ubiquitous pathogen of Brassica crops, and mainly oilseed brassicas (oilseed rape, canola), causing the devastating 'stem canker' or 'blackleg'. This review summarizes our current knowledge on the pathogen, from taxonomic issues to specific life traits. It mainly illustrates the importance of formal genetics approaches on the pathogen side to dissect the interaction with the host plants. In addition, this review presents the main current research topics on L. maculans and focuses on the L. maculans genome initiative recently begun, including its main research issues. Leptosphaeria maculans (Desm.) Ces. & de Not. (anamorph Phoma lingam Tode ex Fr.). Kingdom Fungi, Phylum Ascomycota, Class Dothideomycetes (Loculoascomycetes), Order Pleosporales, Genus Leptosphaeria, Species maculans. cultivated Brassicas such as Brassica napus (oilseed rape, canola), B. rapa, B. juncea, B. oleracea, etc., along with numerous wild crucifers species. Arabidopsis thaliana was recently reported to be a potential host for L. maculans. Primary disease symptoms are greyish-green collapse of cotyledon or leaf tissue, without a visible margin, bearing tiny black spots (pycnidia). The fungus then develops an endophytic symptomless growth for many months. Secondary symptoms, at the end of the growing season, are dry necroses of the crown tissues with occasional blackening (stem canker or blackleg) causing lodging of the plants. Pseudothecia differentiate on leftover residues. Seedling damping-off and premature ripening are also reported under certain environmental conditions. Leptosphaeria maculans sequencing project at Genoscope: http://www.genoscope.cns.fr/externe/English/Projets/Projet_DM/organisme_DM.html; the SECURE site: http://www.secure.rothamsted.ac.uk/ the 'Blackleg' group at the University of Melbourne: http://www.botany.unimelb.edu.au/blackleg/overview.htm.

The significance of Cern

ScienceCinema

None

2017-12-09

Le Prof. V.Weisskopf, DG du Cern de 1961 à 1965, est né à Vienne, a fait ses études à Göttingen et a une carrière académique particulièrement riche. Il a travaillé à Berlin, Copenhague et Berlin et est parti aux Etats Unis pour participer au projet Manhattan et était Prof. au MTT jusqu'à 1960. Revenu en Europe, il a été DG du Cern et lui a donné l'impulsion que l'on sait.

[Promotion of community-based care in Africa: example of community general practice in Benin].

PubMed

Caplain, Roland; Yacoubou, Ismaïl; Adedemy, Didier; Sani, Alidou; Takam, Sandrine; Desplats, Dominique

2014-01-01

Considerable effort has been made to provide rural African populations with basic health care, but the quality of this care remains unsatisfactory due to the absence of first-line GPs. This is a paradoxical situation in view of the large number of physicians trained in medical schools in French-speaking Africa and Madagascar. of the lack of GPs working in rural areas is a real concern, as many young doctors remain unemployed in cities. For more than 20 years, the NGO Santé Sud has proposed a Community General Medicine concept, which, combined with a support system, has allowed the installation of more than 200 community GPs in Mali and Madagascar. The advantage of this concept is that it provides family medicine and primary health care in the same practice. Since 2009, Santé Sud supports an installation project in rural areas of northern Benin, where community GPs work independently, as a complementary partner of the public sector. Since 2013, the installation process comprises a university degree created with the University of Parakou Faculty of Medicine. Based on this experience in Benin, the authors show that the presence of a first-line general practitioner is an original strategy that provides a major contribution to health promotion : reducing health inequalities between rural and urban populations, allowing women to receive medically assisted childbirth close to home, developing family planning activities, education and health care for chronic diseases, strengthening health coverage by participating in vaccination campaigns, etc. Due to their functions and proximity, community GPs represent an added value for health promotion.

[The main health problems according to patients' opinion].

PubMed

Icart Isern, M T; Icart Isern, M C; Pulpón Segura, A M; Mena Sánchez, J; García De Las Mestas Castilla, A M; Carrés Esteve, L

2001-09-15

To know the health problems or diseases that patients of 2 basic health areas (BHA) assess as the most important for Spanish population and for themselves; to know if any relation exists between these problems and their existence in the family or social patients' environment. An observational cross-sectional and descriptive study. Four clinics of the BHA Sant Josep (L'Hospitalet de Llobregat) and 2 clinics of the BHA Sant Martí (Barcelonés).Patients. The sample consists of 360 patients aged above 26 years who attended clinics for some health problem. Participants were chosen by a randomised systematic sampling, from May to October 2000. Data were gathered from a questionnaire of ten items. According with the participants, the main problems for Spanish population and for themselves were: cancer, cardiovascular diseases and AIDS. Cancer (58,61%; 95% CI, 53,53-63,69) and AIDS (15,27%; 95% CI, 11,56-18,98) are the problems pointed out as research priorities. The aparato locomotor (22,10%; 95% CI, 17,82-26,38), hypertension (14,74%; 95% CI, 11,08-18,40) and diabetes (13,14%, 95% CI, 9,66-16,62) are the main problems suffered by the surveyed. Cancer is the disease that more participants' relatives suffered. Cancer and cardiovascular diseases are the pathologies that cause more concern among the surveyed and these are the diseases which mostly affect their relatives and relationships. Nevertheless their worry for the AIDS don't show their immediate reality. Frequently, patients don't recognize the health problem that motivated their visit as a real disease.

Short and long-term quality of life after reconstruction of bladder exstrophy in infancy: preliminary results of the QUALEX (QUAlity of Life of bladder EXstrophy) study.

PubMed

Jochault-Ritz, Sandy; Mercier, Mariette; Aubert, Didier

2010-08-01

The aim of the study was to assess quality of life (QOL) of patients born with bladder exstrophy (BE) and reconstructed during early childhood in 7 French university hospitals (QUALEX study: QUAlity of Life of bladder EXstrophy). Patients from 6 to 42 years old answered self-administered Short-Form 36 (SF-36), VSP-A (Vécu et Santé Perçue de l'Adolescent), VSP-AE (Vécu et Santé Perçue de l'Enfant), AUQUIE (AUto-QUestionnaire Imagé de l'Enfant), and general questionnaires about functional and socioeconomic data. Dimension scores were compared between adults and adolescents using SF-36 and adolescents and children using VSP-AE. Scores were also compared to the general French population. Among the 134 eligible patients, 36 adults, 18 adolescents, and 17 children answered the questionnaire. There was no difference between responders and nonresponders in reconstruction criteria. Continence was achieved in 77% of adults, 65% of adolescents, and 12% of children. Adolescent QOL was globally superior to adults and children. Adult QOL was globally lower than the general population except on the physical dimension. Children's QOL was also globally lower than the general population except for relations with family and school work. Adolescents' scores on SF-36 were superior to the general population but lower on half of the dimensions with VSP-AE. Patients presenting with reconstructed BE have impaired QOL, and functional results seem to be the most likely predictive factor of health-related QOL score. Copyright 2010 Elsevier Inc. All rights reserved.

Traumatic Brain Injury in a Military Operational Setting (Le traumatisme cranien dans un cadre militaire operationnel)

DTIC Science & Technology

2015-01-01

la gestion du TCCL lié à un déploiement. Les objectifs de ce rapport étaient de : 1) Décrire la pratique clinique... de la projection de débris et à l’accélération/décélération ou rotation. L’impact sur la santé publique du TCCL lié à un déploiement sur tout...montré que le cours clinique du TCCL provoqué par une déflagration présente de forts parallèles avec ce qu’on constate dans la littérature sur le

HALESIS projet: Hight Altitude Luminous Events Studied by Infrared Spectro-imagery

NASA Astrophysics Data System (ADS)

Croizé, Laurence; Payan, Sébastien; Bureau, Jérome; Duruisseau, Fabrice; Huret, Nathalie

2014-05-01

During the last two decades, the discovery of transient luminous events (TLEs) in the high atmosphere [1], as well as the observation of gamma ray flashes of terrestrial origin (Terrestrial Gamma Flashes or TGF) [2] demonstrated the existence of another interaction processes between the different atmospheric layers (troposphere, stratosphere, mesosphere and ionosphere). Indeed, the frequency of occurrence of these phenomena over thunderstorm cells, and the energies involved provide evidence for an impulsive energy transfer between the troposphere and the highest atmospheric layers, which was not considered before. HALESIS (High Altitude Luminous Events Studied by Infrared Spectro-imagery) is an innovative project based on hyperspectral imagery. The purpose of this experience is to measure the atmospheric perturbation in the minutes following the occurrence of Transient Luminous Events (TLEs) from a stratospheric balloon in the altitude range of 20 to 40 km. The first part of the study has been dedicated to establish the project feasibility. To do that, we have simulated spectral perturbation induced by an isolated blue jet. Theoretical predictions [3] have been used to simulate the radiative perturbation due to O3, NO, NO2, NO+ concentration induced by the blue jet. Simulations have been performed using the line by line radiative transfer model LBLRM [4] taking into account of the Non Local Thermodynamic Equilibrium hypotheses. Then, the expected signatures have been compared to the available instrumentation. During this talk, HALESIS project and the results of the feasibility study will be presented. Then, the estimated spectral signatures will be confronted with the technical capabilities of different kind of hyperspectral imagers. We will conclude on the project feasibility, but also on the challenges that lie ahead for an imager perfectly suited for experiences like HALESIS. 1. Franz R, Nemzek R, Winckler J. Television image of a large upward electrical discharge above a thunderstorm system. Science 1990,249:48-51. 2. Fishman GJ, Bhat P, Mallozzi R, Horack J, Koshut T, Kouveliotou C, et al. Discovery of intense gamma-ray flashes of atmospheric origin: National Aeronautics and Space Administration; 1994. 3. Duruisseau Fabrice, Huret N. Private communication In. 4. Clough SA, Iacono MJ, Moncet JL. Line-by-line calculations of atmospheric fluxes and cooling rates: Application to water vapor. Journal of Geophysical Research: Atmospheres (1984-2012) 1992,97:15761-15785.

Evaluation de l'intergiciel de communication DDS pour son utilisation dans le domaine avionique

NASA Astrophysics Data System (ADS)

Levesque-Landry, Kevin

Les aeronefs modernes doivent combler de plus en plus de fonctionnalites afin de satisfaire les besoins de la clientele. De ce fait, les besoins en communications des systemes avioniques sont grandissants. De plus, la portabilite et la reutilisabilite des applications sont des defis d'actualite dans le domaine avionique. De ce fait, ce projet de recherche vise a faire une evaluation de la technologie d'intergiciel de service de distribution de donnees (DDS) pour son utilisation dans le domaine avionique. Cette technologie permettrait de reduire la complexite des communications et faciliter la portabilite et reutilisabilite des applications grâce a son interface standardisee. Dans ce projet de recherche, la norme DDS est tout d'abord etudiee pour cibler les fonctionnalites qui sont utiles au domaine avionique. Les differentes polices de qualite de services sont ainsi etudiees et denotent la flexibilite de la technologie DDS. Un intergiciel DDS est egalement evalue dans un environnement de laboratoire afin de mesurer l'impact de l'utilisation de cette technologie sur les performances de latence ainsi que sur l'utilisation de la bande passante. Les resultats montrent une faible augmentation de la latence moyenne lorsque l'intergiciel DDS est utilise. L'intergiciel DDS est egalement utilise dans une etude de cas avec un AFCS (automatic flight control system) afin de quantifier les effets de son utilisation sur une application avionique. Les resultats montrent que l'utilisation de l'intergiciel DDS n'empeche pas l'AFCS d'atteindre la stabilite, mais qu'elle ralentit l'atteinte de cette derniere. Finalement, une etude de cas est effectuee afin de valider que la technologie DDS peut etre utilisee pour construire des systemes redondants. Les resultats montrent que l'intergiciel DDS permet de faire de la redondance de reserve sans avoir un impact visible sur les performances du systeme redondant.

Association among individual deprivation, glycemic control, and diabetes complications: the EPICES score.

PubMed

Bihan, Hélène; Laurent, Silvana; Sass, Catherine; Nguyen, Gérard; Huot, Caroline; Moulin, Jean Jacques; Guegen, René; Le Toumelin, Philippe; Le Clésiau, Hervé; La Rosa, Emilio; Reach, Gérard; Cohen, Régis

2005-11-01

Previous studies have related poor glycemic control and/or some diabetes complications to low socioeconomic status. Some aspects of socioeconomic status have not been assessed in these studies. In the present study, we used an individual index of deprivation, the Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé (Evaluation of Precarity and Inequalities in Health Examination Centers [EPICES]) score, to determine the relationship among glycemic control, diabetes complications, and individual conditions of deprivation. We conducted a cross-sectional prevalence study in 135 consecutive diabetic patients (age 59.41 +/- 13.2 years [mean +/- SD]) admitted in the hospitalization unit of a French endocrine department. Individual deprivation was assessed by the EPICES score, calculated from 11 socioeconomic questions. Glycemic control, lipid levels, blood pressure, retinopathy, neuropathy, and nephropathy were assessed. HbA(1c) level was significantly correlated with the EPICES score (r = 0.366, P < 0.001). The more deprived patients were more likely than the less deprived patients to have poor glycemic control (beta = 1.984 [SE 0.477], P < 0.001), neuropathy (odds ratio 2.39 [95% CI 1.05-5.43], P = 0.037), retinopathy (3.66 [1.39-9.64], P = 0.009), and being less often admitted for 1-day hospitalization (0.32 [0.14-0.74], P = 0.008). No significant relationship was observed with either nephropathy or cardiovascular risk factors. Deprivation status is associated with poor metabolic control and more frequent microvascular complications, i.e., retinopathy and neuropathy. The medical and economic burden of deprived patients is high.

Dietary intake, physical activity and nutritional status in adults: the French nutrition and health survey (ENNS, 2006-2007).

PubMed

Castetbon, Katia; Vernay, Michel; Malon, Aurélie; Salanave, Benoit; Deschamps, Valérie; Roudier, Candice; Oleko, Amivi; Szego, Emmanuelle; Hercberg, Serge

2009-09-01

The French National Programme on Nutrition and Health (Programme national nutrition santé (PNNS)), the aim of which is to reduce nutrition-related chronic diseases, necessitates monitoring of nutritional characteristics. Our objective was to describe dietary intake, physical activity and nutritional status in a national sample of adults, especially according to current French recommendations. The study is based on a cross-sectional population-based survey using a multistage sampling design (Etude nationale nutrition santé (ENNS)). Between February 2006 and March 2007, 3115 18-74-year-old adults were included (participation rate 59.7 %). Energy, macronutrient and food consumption were estimated through three randomly distributed 24 h recalls, and compared to PNNS recommendations; physical activity was described using International Physical Activity Questionnaire guidelines; anthropometry, blood pressure and biochemical measurements were assessed according to national and international references. When compared to current recommendations, intake of carbohydrates (>50 % energy intake without alcohol: 26.4 %), SFA ( < 35 % total lipids: 18.5 %) and total fibre (>25 g/d: 13.7 %) was frequently unsatisfactory. While overall consumption of 'meat, seafood and eggs' was satisfactory, that of fruits and vegetables ( > or = 400 g/d: 43.8 %) and seafood (two or more servings per week: 29.9 %) was frequently too low. The physical activity level was satisfactory at 63.2 %. Overweight was observed in 49.3 % of adults, while 30.9 % were hypertensive and 44.1 % had dyslipidaemia. Vitamin and iron-poor status was found to affect less than 10 % of the population. Based on the ENNS survey, overall nutrition remains a problem in France. Comparison of these data with those of other countries could contribute to a better understanding of variations in nutrition-related diseases.

Association Between Blood Pressure and Adherence to French Dietary Guidelines.

PubMed

Lelong, Helene; Blacher, Jacques; Menai, Mehdi; Galan, Pilar; Fezeu, Leopold; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2016-08-01

Adopting a healthy diet like the Dietary Approach to Stop Hypertension (DASH) or Mediterranean diet (MD) represents a major lifestyle for blood pressure (BP) control in general population. Nutritional policies, such as the French Nutrition and Health Program (Programme National Nutrition Santé or PNNS), have been implemented in several countries with the aims of preventing chronic diseases. The objective of our study was to investigate association between BP and adherence to PNNS guidelines compared with adherence to DASH or MD. We conducted a cross-sectional study in 11,302 untreated participants from the NutriNet-Santé study, a French web-based cohort study. Three validated scores reflecting adherence to PNNS guidelines, DASH diet, and MD were calculated from repeated 24-hour records. Three BP measurements using a standardized protocol were collected. Multivariate linear models were used to assess the associations between the dietary scores and BP. In women, independent of age, socioeconomic status, body mass index, tobacco use, alcohol consumption, and physical activity, adherence to PNNS guidelines was inversely significantly associated with systolic BP (β = -0.63, P < 0.0001). This association was of similar amplitude that between BP and adherence to DASH-style diet (β = -0.66, P < 0.0001) or MD (β = -0.63, P = 0.0002). No significant association was found in men. Adherence to French nutritional recommendations was found negatively associated with BP at the same magnitude as adherence to well-known dietary pattern in the prevention and treatment of hypertension. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort.

PubMed

Buscail, Camille; Sabate, Jean-Marc; Bouchoucha, Michel; Torres, Marion J; Allès, Benjamin; Hercberg, Serge; Benamouzig, Robert; Julia, Chantal

2017-01-01

There is growing interest in using diet counselling in the management of patients with irritable bowel syndrome (IBS). Among new emerging diets, vegetarian diets (VD) seem to be experiencing an important popularity, partly because of their alleged health benefits. A recent study performed among a rural Indian population showed that predominant VD could be associated with IBS. This cross-sectional study aimed at assessing the association between the VD and IBS, among a large French cohort, the NutriNet-santé study. Subjects participating in the NutriNet-Santé cohort study completed a questionnaire based on Rome III criteria (N = 41,682). Anthropometrics, socio-demographical and lifestyle data, including VD, were collected prior to the completion of Rome III questionnaire via self-administered questionnaires. Association between VD and IBS and its subtypes was investigated through multivariate logistic regression. The included subjects were mainly women (78.0%) and the mean age was 49.8±14.3 years. Among these individuals, 2,264 (5.4%) presented an IBS, and 805 (1.9%) reported a VD. Overall, VD was not associated with IBS or subtypes. A stable VD (i.e. self-declared at least three times) was associated with IBS (aOR 2.60 95%CI [1.37-4.91]), IBS mixed (aOR 2.97 95%CI [1.20-7.36]) and IBS diarrhoea (aOR 2.77 95%CI [1.01-7.59]). This study suggests that a long term VD could be associated with IBS. Nevertheless, further studies are needed to confirm these results, and investigate the multiple aspects of the vegetarian diet, possibly related to the IBS.

Ontology- and graph-based similarity assessment in biological networks.

PubMed

Wang, Haiying; Zheng, Huiru; Azuaje, Francisco

2010-10-15

A standard systems-based approach to biomarker and drug target discovery consists of placing putative biomarkers in the context of a network of biological interactions, followed by different 'guilt-by-association' analyses. The latter is typically done based on network structural features. Here, an alternative analysis approach in which the networks are analyzed on a 'semantic similarity' space is reported. Such information is extracted from ontology-based functional annotations. We present SimTrek, a Cytoscape plugin for ontology-based similarity assessment in biological networks. http://rosalind.infj.ulst.ac.uk/SimTrek.html francisco.azuaje@crp-sante.lu Supplementary data are available at Bioinformatics online.

Psychological predictors of retention in a low-threshold methadone maintenance treatment for opioid addicts: a 1-year follow-up study.

PubMed

Perreault, Michel; Julien, Dominic; White, Noe Djawn; Rabouin, Daniel; Lauzon, Pierre; Milton, Diana

2015-01-01

This study investigated the role of psychological variables and judicial problems in treatment retention for a low-threshold methadone program in Montreal, Canada. Logistic regression analyses were computed to examine associations between psychological variables (psychological distress, self-esteem, stages of change), criminal justice involvement, and treatment retention for 106 highly-disorganized opioid users. Higher methadone dosage was associated with increased odds of treatment retention, whereas criminal charges and lower self-esteem decreased these odds. Psychological variables could be identified early in treatment and targeted to increase potential treatment retention. Financial support for this study was provided by the Fonds de Recherche en Santé du Québec.

Nitramine Propellant Erosivity - III.

DTIC Science & Technology

1980-12-01

Commanld c r AFTN. I. Busut t i I US A rmy M i ,, i I (ommiiad W ., Awst in ATTN: R ( IUN1I -YI. R . Mont 1,ol11v rv Red st ollAc enaIAl~~ .iIington .1 .Sant...A-D-A96 878 ARMY ARMAMENT RESEARCHRAN4D EVELOPMENTUCOMMAND ABERO--ETC F/G 19/1 NITRAM INE PROPELLANT EROSII TY_ II.( ) DEC 80 R GEENE, B GROLLMAN, A...NIILER A RYE UNCLASSIFIED ARBRL - R -02278 SBIE D-E430 574 N11hEEE~EEn~hh~~E EohEEEohhEE... LEVEL TECHNICAL REPORT ARBRL-TR-02278 NITRAMINE PROPELLANT

Lymphogranuloma venereum in an Italian MSM: concurrent pharyngeal and rectal infection.

PubMed

Foschi, Claudio; Filippini, Andrea; D'Antuono, Antonietta; Compri, Monica; Macca, Francesca; Banzola, Nicoletta; Marangoni, Antonella

2014-07-01

An Italian HIV-positive man having sex with men (MSM) attended the STIs Outpatients Clinic of Sant'Orsola Hospital in Bologna complaining of anal pain and constipation. According to patient's sexual history and repertoires, NAAT testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) was performed. Pharyngeal and anal swabs resulted positive for CT DNA detection and the following molecular genotyping identified a L2 serovar, coming to the final diagnosis of pharyngeal and rectal lymphogranuloma venereum (LGV) infection. After an antibiotic therapy with doxycycline 100 mg twice a day for 3 weeks, the patient completely recovered and the test of cure was negative for LGV infection.

Recovering Plastics in a Hospital Can Have Environmental, Social and Economic Benefits.

PubMed

Ribesse, Jérôme; Robitaille, Nathalie

2016-01-01

Plastics are omnipresent in today's healthcare facilities. In Quebec, recyclable plastics (the ones with a 1 to 7 number on it, excluding number 6 or styrofoam) represent 7% of all the waste generated by healthcare institutions - 2,907 tonnes each year (Proulx et al. 2009). The vast majority of these plastics are sent to landfill instead of being recycled due to the lack of suitable recycling systems. In collaboration with three Montreal-based hospitals, Synergie Santé Environnement (SSE) conducted an 18-month pilot project to implement a sustainable plastic recycling system with threefold objectives: reduce landfill costs, obtain royalties for the plastics and assure traceability.

Evaluation of reforestation using remote sensing techniques

NASA Technical Reports Server (NTRS)

Parada, N. D. J. (Principal Investigator); Filho, P. H.; Shimabukuro, Y. E.; Dossantos, J. R.

1982-01-01

The utilization of remotely sensed orbital data for forestry inventory. The study area (approximately 491,100 ha) encompasses the municipalities of Ribeirao Preto, Altinopolis, Cravinhos, Serra Azul, Luis Antonio, Sao Simao, Sant Rita do Passa Quatro and Santa Rosa do Viterbo (Sao Paulo State). Materials used were LANDSAT data from channels 5 and 7 (scale 1:250,000) and CCT's. Visual interpretation of the imagery showed that for 1977 a total of 37,766.00 ha and for 1979 38,003.75 ha were reforested with Pinus and Eucalyptus within the area under study. The results obtained show that LANDSAT data can be used efficiently in forestry inventory studies.

Etude de la flore bactérienne contaminant les téléphones mobiles avant et après la désinfection: comparaison entre les professionnels soignants de l'hôpital militaire d'instruction Mohammed V de Rabat et les témoins

PubMed Central

Uwingabiye, Jean; Moustanfii, Wafaa; Chadli, Meryem; Sekhsokh, Yassine

2015-01-01

Introduction L'objectif de notre travail était évaluer la contamination microbienne des téléphones mobiles utilisés par les personnels soignants des différents services de l'hôpital militaire d'instructions Mohammed V de Rabat et la comparer à celui d'une population témoin et aussi démontrer l'efficacité des solutions hydroalcoolique dans la désinfection de ces téléphones mobiles. Méthodes Il s'agit d'une étude descriptive transversale réalisée sur une période de 9 mois entre septembre 2010 et juin 2011, dans le service de bactériologie de l'hôpital militaire d'Instruction Mohammed V. Résultats L’étude bactériologique a été faite sur 240 téléphones mobiles dont 50% provenaient de personnels de sante. Le taux de contamination bactérienne de tous les téléphones mobiles était de 100%. Les cultures des bactéries isolées au niveau des téléphones mobiles du personnel médical étaient plus polymorphes que celles de la population témoin (p=0,028). Parmi 437 bactéries isolées: 223(51%) provenaient de téléphones de personnels de santé et 214(49%) de téléphones de la population témoin avec une différence qui n’était pas statistiquement significative(p>0,05) sauf pour les isolats de Staphylocoque à coagulase négative et Staphylococcus aureus. Les bactéries isolées étaient représentées par: Staphylocoque à coagulase (57,7%), Staphylococcus aureus (18,1%), Corynebacterium sp (18,8%), Bacillus sp (2,3%) et autres (2,2%). La différence entre la prévalence des bactéries isolées selon les services et les fonctions des personnels de santé n’était pas statistiquement significative (p>0,05). La désinfection des téléphones portables par la solution hydroalcoolique a réduit à 99,5% le nombre des colonies. Conclusion Ce travail montre que les téléphones portables pourraient jouer un rôle dans la transmission des infections nosocomiales et communautaires. Dans le cadre de prévention de ces risques, il faut

["Les Impatients": expression through art].

PubMed

Lamontagne, Céline; Palardy, Lorraine

2015-01-01

The organization called "Les Impatients" was founded in 1992. Using a unique model, Les Impatients welcomes those with mental health issues who would like to express themselves through art. Les Impatients offers free creative workshops and encourages exchanges with the community through the sharing of its participants' creations. The name Les Impatients reinforces the idea that the organization does not consider those attending its workshops as patients, but rather creators who are eager to heal, develop their craft and find their place in society. The participants contribute to the collective objective of breaking down the stigma that surrounds mental illness.Les Impatients collaborates with various mental health organizations in Quebec, such as the Institut universitaire en santé mentale de Montréal (IUSMM) affiliated to the Université de Montréal, Douglas Mental Health University Institute (DMHUI), the Centre de santé et services sociaux Drummond (CSSS Drummond) and the Centre de santé et services sociaux Pierre-Boucher (CSSS Pierre-Boucher). Les Impatients offers more than 48 workshops in eight different locations to around 450 participants each week.Dissemination activities, remarkable events, original projects: Les Impatients stands out through its realizations. Examples are exhibitions, collections of love letters, comic books, CD, concerts, and reading nights. The organization's originality resides in the exploration of the links between the work of the participants and that of professional artists. An illustration of this interest is the annual Parle-moi d'amour auction-exhibition, which has been one of Les Impatients' major events since 1999.As part of its mission, Les Impatients conserves the works of art created by the participants during the workshops. Its collection includes more than 15,000 works of art from Les Impatients as well as pieces donated by collectors of unconventional art, commonly known as "art brut" or "outsider art". The

Consensus canadien sur la contraception (3(e) partie de 4) : chapitre 8 - contraception à progestatif seul.

PubMed

Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie

2016-03-01

Fournir des lignes directrices aux fournisseurs de soins quant à l'utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d'une sexualité saine. Orientation des praticiens canadiens en ce qui concerne l'efficacité globale, le mécanisme d'action, les indications, les contre-indications, les avantages n'étant pas liés à la contraception, les effets indésirables, les risques et le protocole de mise en œuvre des modes de contraception abordés; planification familiale dans le contexte de la santé sexuelle et du bien-être général; méthodes de counseling en matière de contraception; et accessibilité et disponibilité des modes de contraception abordés au Canada. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans MEDLINE et The Cochrane Library entre janvier 1994 et janvier 2015 au moyen d'un vocabulaire contrôlé (p. ex. contraception, sexuality, sexual health) et de mots clés (p. ex. contraception, family planning, hormonal contraception, emergency contraception) appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre janvier 1994 et janvier 2015. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en juin 2015. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques, dans des registres d'essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats a été évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé pr

PubMed Central

Farneti, P.; Cantore, S.; Macrì, G.; Chuchueva, N.; Cuffaro, L.; Pasquini, L.; Puxeddu, R.

2017-01-01

SUMMARY Obstructive sialadenitis is the most common non-neoplastic disease of the salivary glands, and sialendoscopy is increasingly used in both diagnosis and treatment, associated in selected cases with endoscopic laser lithotripsy. Sialendoscopy is also used for combined minimally invasive external and endoscopic approaches in patients with larger and proximal stones that would require excessively long laser procedures. The present paper reports on the technical experience from the Ear, Nose and Throat Unit of the Sant'Orsola-Malpighi Hospital of Bologna, and from the Department of Otorhinolaryngology of the University Hospital of Cagliari, Italy, including the retrospective analysis of the endoscopic and endoscopic assisted procedures performed on 48 patients (26 females and 22 males; median age 45.3; range 8-83 years) treated for chronic obstructive sialadenitis at the University Hospital of Cagliari from November 2010 to April 2016. The results from the Sant'Orsola-Malpighi Hospital of Bologna have been previously published. The technical aspects of sialendoscopy are carefully described. The retrospective analysis of the University Hospital of Cagliari shows that the disease was unilateral in 40 patients and bilateral in 8; a total of 56 major salivary glands were treated (22 submandibular glands and 34 parotids). Five patients underwent bilateral sialendoscopy for juvenile recurrent parotitis. 10 patients were treated for non-lithiasic obstructive disease. In 33 patients (68.75%) the obstruction was caused by salivary stones (bilateral parotid lithiasis in 1 case). Only 8 patients needed a sialectomy (5 submandibular glands and 3 parotids). The conservative approach to obstructive sialadenitis is feasible and can be performed either purely endoscopically or in a combined modality, with a high percentage of success. The procedure must be performed with dedicated instrumentation by a skilled surgeon after proper training since minor to major complications can

The Ne3LS Network, Québec's initiative to evaluate the impact and promote a responsible and sustainable development of nanotechnology

NASA Astrophysics Data System (ADS)

Endo, Charles-Anica; Emond, Claude; Battista, Renaldo; Parizeau, Marie-Hélène; Beaudry, Catherine

2011-07-01

The spectacular progress made by nanosciences and nanotechnologies elicits as much hope and fear. Consequently, a great number of research and training initiatives on the ethical, environmental, economic, legal and social issues regarding nanotechnology development (Ne3LS) are emerging worldwide. In Québec, Canada, a Task Force was mandated by NanoQuébec to conceive a Ne3LS research and training strategy to assess those issues. This Task Force brought together experts from universities, governments or industry working in nanosciences and nanotechnologies or in Ne3LS. Their resulting action plan, made public in November 2006, contained several recommendations, including the creation of a knowledge network (Ne3LS Network). In the following years, after consulting with numerous key players concerned with the possible impacts of nanosciences and nanotechnologies in Québec, the Ne3LS Network was launched in January 2010 in partnership with the Fonds québécois de la recherche sur la nature et les technologies, the Fonds québécois de la recherche sur la société et la culture and the Fonds de la recherche en santé du Québec, NanoQuébec, the Institut de recherche Robert-Sauvé en santé et en sécurité du travail as well as the University of Montreal. Its objectives are to 1) Foster the development of Ne3LS research activities (grants and fellowships); 2) Spearhead the Canadian and international Ne3LS network; 3) Take part in the training of researchers and experts; 4) Encourage the creation of interactive tools for the general public; 5) Facilitate collaboration between decision-makers and experts; 6) Involve the scientific community through a host of activities (symposium, conferences, thematic events); 7) Build multidisciplinary research teams to evaluate the impact of nanotechnology.

Long-term outcomes of intravesical dimethyl sulfoxide/heparin/hydrocortisone therapy for interstitial cystitis/bladder pain syndrome.

PubMed

Lim, Yik N; Dwyer, Peter; Murray, Christine; Karmakar, Debjyoti; Rosamilia, Anna; Thomas, Elizabeth

2017-07-01

For decades, intravesical dimethyl sulfoxide (DMSO) cocktail therapy has been used for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS), but little is known about its long-term efficacy. We aimed to assess the long-term efficacy of intravesical DMSO/heparin/hydrocortisone/bupivacaine therapy in patients with IC/BPS. Patients with IC/BPS from our institutions who underwent this therapy with >2 years follow-up were surveyed with O'Leary-Sant interstitial cystitis symptom and problem index questionnaires before and after therapy. Chart reviews and telephone surveys were then conducted to determine their posttherapy course. Of 68 eligible women, 55 (80.0%) with a median follow-up of 60 months (range 24-142) were surveyed. Their mean age at therapy onset was 44.8 years and their mean body mass index was 26.2 kg/m 2 . There were statistically significant improvements in O'Leary-Sant and pain scores of 23-47% at both 6 weeks and the end of the follow-up period. At the end of the follow-up period, 19 of the 55 women (34.5%) were cured (requiring no further treatment) and 12 (21.8%) were significantly improved (requiring only ongoing oral medication). Univariate and multivariate analyses showed that DMSO treatment failure was more likely in patients with pretreatment day-time urinary frequency more than 15 episodes per day (OR 1.41), nocturia more than two episodes per night (OR 2.47), maximum bladder diary voided volume <200 ml (OR 1.39) and bladder capacity under anaesthesia <500 ml (OR 1.6). At a median follow-up of 60 months, intravesical DMSO cocktail therapy appeared moderately effective for the treatment of IC/BPS. Treatment failure was more frequent in patients with pretreatment symptoms of reduced bladder capacity.

Going beyond the vertical: leveraging a national HIV quality improvement programme to address other health priorities in Haiti.

PubMed

Joseph, Jean Paul; Jerome, Gregory; Lambert, Wesler; Almazor, Patrick; Cupidon, Colette Eugene; Hirschhorn, Lisa R

2015-07-01

Although the central role of quality to achieve targeted population health goals is widely recognized, how to spread the capacity to measure and improve quality across programmes has not been widely studied. We describe the successful leveraging of expertise and framework of a national HIV quality improvement programme to spread capacity and improve quality across a network of clinics in HIV and other targeted areas of healthcare delivery in rural Haiti.The work was led by Zamni LaSante, a Haitian nongovernment organization and its sister organization, Partners In Health working in partnership with the Haitian Ministry of Health in the Plateau Central and Lower Artibonite regions in 12 public sector facilities.Data included routinely collected organizational assessments of facility quality improvement capacity, national HIV performance measures and Zamni LaSante programme records.We found that facility quality improvement capacity increased with spread from HIV to other areas of inpatient and outpatient care, including tuberculosis (TB), maternal health and inpatient services in all 12 supported healthcare facilities. A significant increase in the quality of HIV care was also seen in most areas, including CD4 monitoring, TB screening, HIV treatment (all P < 0.01) and nutritional assessment and prevention of mother-to-child transmission (both P < .05), with an increase in average facility performance from 39 to 72% (P < .01).In conclusion, using a diagonal approach to leverage a national vertical programme for wider benefit resulted in accelerated change in professional culture and increased capacity to spread quality improvement activities across facilities and areas of healthcare delivery. This led to improvement within and beyond HIV care and contributed to the goal of quality of care for all.

Association between self-reported vegetarian diet and the irritable bowel syndrome in the French NutriNet cohort

PubMed Central

Sabate, Jean-Marc; Bouchoucha, Michel; Torres, Marion J.; Allès, Benjamin; Hercberg, Serge; Benamouzig, Robert; Julia, Chantal

2017-01-01

Background There is growing interest in using diet counselling in the management of patients with irritable bowel syndrome (IBS). Among new emerging diets, vegetarian diets (VD) seem to be experiencing an important popularity, partly because of their alleged health benefits. A recent study performed among a rural Indian population showed that predominant VD could be associated with IBS. Objective This cross-sectional study aimed at assessing the association between the VD and IBS, among a large French cohort, the NutriNet-santé study. Methods Subjects participating in the NutriNet-Santé cohort study completed a questionnaire based on Rome III criteria (N = 41,682). Anthropometrics, socio-demographical and lifestyle data, including VD, were collected prior to the completion of Rome III questionnaire via self-administered questionnaires. Association between VD and IBS and its subtypes was investigated through multivariate logistic regression. Results The included subjects were mainly women (78.0%) and the mean age was 49.8±14.3 years. Among these individuals, 2,264 (5.4%) presented an IBS, and 805 (1.9%) reported a VD. Overall, VD was not associated with IBS or subtypes. A stable VD (i.e. self-declared at least three times) was associated with IBS (aOR 2.60 95%CI [1.37–4.91]), IBS mixed (aOR 2.97 95%CI [1.20–7.36]) and IBS diarrhoea (aOR 2.77 95%CI [1.01–7.59]). Conclusions This study suggests that a long term VD could be associated with IBS. Nevertheless, further studies are needed to confirm these results, and investigate the multiple aspects of the vegetarian diet, possibly related to the IBS. PMID:28841661

The effect of intravesical instillations with Hyaluronic Acid on sexual dysfunction in women with recurrent urinary tract infections (RUTI).

PubMed

Nightingale, Gemma; Shehab, Qasem; Kandiah, Chandrakumaran; Rush, Lorraine; Rowe-Jones, Clare; Phillips, Christian H

2018-02-01

To determine whether sexual dysfunction in women with recurrent urinary tract infections (RUTI) improved following treatment with intravesical Hyaluronic Acid (HA) instillations. Ethical approval was obtained for a prospective study to be performed. Patients referred for bladder instillations to treat RUTI, and who were sexually active, were recruited to the study. A selection of validated questionnaires (ICIQ-UI, ICIQ-VS, FSDS-R, ICIQ-FLUTS, O'Leary/Sant and PGI-I) were completed at baseline, three, six and 12 months after initiation of treatment with bladder instillations. Treatment consisted of weekly bladder instillations with a preparation containing HA for four weeks then monthly for two further treatments. Results were populated in SPSS for statistical analysis and statistical significance was powered for 22 patients. Thirty women were included in the study. FSDS-R was used to determine sexual dysfunction and showed that 57% patients with RUTI had significant sexual distress. There was a significant improvement in FSDS-R at three, six and 12 months when compared to baseline (Friedman two-way analysis p < 0.001). ICIQ FLUTS F and I scores, O'Leary/Sant, ICIQ VS and PGI-I also showed a statistically significant improvement throughout the period of follow up. A statistically significant, negative correlation was found between FSDS-R and PGI-I at 12 months (r = -0.468, p = 0.009). We have reinforced previous work showing the association between RUTI and sexual dysfunction, and an improvement in bladder symptoms following treatment with HA. To our knowledge, this is the first study to prove an improvement in sexual dysfunction following intravesical treatment with HA which is sustained for up to 12 months. Crown Copyright © 2017. Published by Elsevier B.V. All rights reserved.

Public perception and characteristics related to acceptance of the sugar-sweetened beverage taxation launched in France in 2012.

PubMed

Julia, Chantal; Méjean, Caroline; Vicari, Florence; Péneau, Sandrine; Hercberg, Serge

2015-10-01

In France, an excise tax on sugar-sweetened beverages was introduced on 1 January 2012. Our objective was to assess perception of this tax as well as the sociodemographic characteristics of its supporters and opponents. Cross-sectional study within the Nutrinet-Santé cohort. A sub-sample of 1996 individuals was selected among participants in the Nutrinet-Santé cohort study. Perceptions of the sugar-sweetened beverage tax were assessed via self-administered questionnaires. The sociodemographic and dietary profiles of supporters and opponents of this tax were explored by multinomial logistic regression. Setting Nationally representative French sample, 2012. Adults aged >18 years (largest sample n 1996). Half of the study sample was generally supportive of the tax and 57·7 % perceived it as helpful in improving population health. Participants were more likely to support the tax model if the revenue it generated would be used for health-care system improvement (72·7 %) and if such taxing was associated with a corresponding decrease in the prices of other foodstuffs (71·5 %). Older participants were more likely to support the tax than were their younger counterparts (OR=2·37; 95 % CI 1·60, 3·49 for >65 years v. 26-45 years; P<0·001). Participants with lower educational levels were less likely to support the tax than were those with more formal education (OR=0·31; 95 % CI 0·19, 0·52 for low educational level v. high education level; P<0·001). In our models, sugar-sweetened beverage consumption was not associated with tax perception. The French sugar-sweetened beverage tax appeared to be favourably perceived by the public. Sociodemographic factors modulated such perceptions and should thus be taken into consideration when drafting future public health measures.

Earth Observations taken by the Expedition 35 Crew

NASA Image and Video Library

2013-03-22

ISS035-E-007431 (22 March 2013) --- One of the Expedition 35 crew members aboard the Earth-orbiting International Space Station used a digital camera equipped with a 400 millimeter lens to capture this image of the island of Ibiza (Eivissa in the native Catalan language), located off of the southeastern coast of Spain. Ibiza is part of the Balearic archipelago. Together with the neighboring island of Formentera (not shown), it comprises the Pine Islands of the western archipelago. The largest cities on the island, Ibiza Town, Sant Antoni de Portmany, and Santa Eularia des Riu, appear as white to pink regions near coastal bays in the image. Much of the lowland interior of the island is covered with green to light brown agricultural fields; some are still in active production for such crops as wheat, olives, and grapes but many fields are inactive and experiencing regrowth of native trees such as pine (Pinus halpensis) and savine (Juniperus phoenicea). The northern and southwestern coastlines are hilly (grey-brown regions), with the highest peak (Sa Talaia, 475 meters above sea level) located in the southwestern region. Like many of the Balearic Islands, the major industry of Ibiza is European tourism, and it is particularly well known for the nightlife of Ibiza Town and Sant Antoni de Portmany. Ships near Ibiza Town and a ship wake off the southwestern coastline are visible at image lower left. The island hosts a large variety of birds and lizards; however no large land fauna are present. The Mediterranean Sea to the southeast of the island appears dark in the image due to shadowing by clouds, just visible at the lower right corner of the image.

Professional development programs in health promotion: tools and processes to favor new practices.

PubMed

Torres, Sara; Richard, Lucie; Guichard, Anne; Chiocchio, François; Litvak, Eric; Beaudet, Nicole

2017-06-01

Developing innovative interventions that are in sync with a health promotion paradigm often represents a challenge for professionals working in local public health organizations. Thus, it is critical to have both professional development programs that favor new practices and tools to examine these practices. In this case study, we analyze the health promotion approach used in a pilot intervention addressing children's vulnerability that was developed and carried out by participants enrolled in a public health professional development program. More specifically, we use a modified version of Guichard and Ridde's (Une grille d'analyse des actions pour lutter contre les inégalités sociales de santé. In Potvin, L., Moquet, M.-J. and Jones, C. M. (eds), Réduire les Inégalités Sociales en Santé. INPES, Saint-Denis Cedex, pp. 297-312, 2010) analytical grid to assess deductively the program participants' use of health promotion practices in the analysis and planning, implementation, evaluation, sustainability and empowerment phases of the pilot intervention. We also seek evidence of practices involving (empowerment, participation, equity, holism, an ecological approach, intersectorality and sustainability) in the intervention. The results are mixed: our findings reveal evidence of the application of several dimensions of health promotion (equity, holism, an ecological approach, intersectorality and sustainability), but also a lack of integration of two key dimensions; that is, empowerment and participation, during various phases of the pilot intervention. These results show that the professional development program is associated with the adoption of a pilot intervention integrating multiple but not all dimensions of health promotion. We make recommendations to facilitate a more complete integration. This research also shows that the Guichard and Ridde grid proves to be a thorough instrument to document the practices of participants. © The Author 2015. Published by

Microcomputers, software combine to provide daily product, movement inventory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cable, T.

1985-06-01

This paper describes the efforts of Sante Fe Pipelines Inc. in keeping track of product inventory on the 810 mile, 12-in. Chapparal Pipeline and the 1,913 mile, 8- and 10-in. Gulf Central Pipeline. The decision to use a PC for monitoring the inventory was significant. The application was completed by TRON, Inc. The system is actually two major subsystems. The pipeline system accounts for injections into the pipeline and deliveries of product. This feeds the storage and the terminal inventory system where inventories are maintained at storage locations by shipper and supplier account. The paper further explains the inventory monitoringmore » process in detail. Communications software is described as well.« less

The function of prehistoric lithic tools: a combined study of use-wear analysis and FTIR microspectroscopy.

PubMed

Nunziante Cesaro, Stella; Lemorini, Cristina

2012-02-01

The application of combined use-wear analysis and FTIR micro spectroscopy for the investigation of the flint and obsidian tools from the archaeological sites of Masseria Candelaro (Foggia, Italy) and Sant'Anna di Oria (Brindisi, Italy) aiming to clarify their functional use is described. The tools excavated in the former site showed in a very high percentage spectroscopically detectable residues on their working edges. The identification of micro deposits is based on comparison with a great number of replicas studied in the same experimental conditions. FTIR data confirmed in almost all cases the use-wear analysis suggestions and added details about the material processed and about the working procedures. Copyright © 2011 Elsevier B.V. All rights reserved.

Electrical resistivity tomography for studying liquefaction induced by the May 2012 Emilia-Romagna earthquake (Mw = 6.1, North Italy)

NASA Astrophysics Data System (ADS)

Giocoli, A.; Quadrio, B.; Bellanova, J.; Lapenna, V.; Piscitelli, S.

2013-10-01

This work shows the result of an Electrical Resistivity Tomography survey carried out for imaging and characterizing the shallow subsurface affected by the coseismic effects of the Mw = 6.1 Emilia-Romagna (North Italy) earthquake occurred on 20 May 2012. The most characteristic coseismic effects were ground failure, lateral spreading and liquefaction that occurred extensively along the paleo-Reno river in the urban areas of San Carlo, a hamlet of Sant'Agostino municipality, and of Mirabello (south-western portion of the Ferrara Province). Totally, six Electrical Resistivity Tomography were performed and calibrated with surface geological surveys, exploratory borehole and aerial photo interpretations. This was one of the first applications of the Electrical Resistivity Tomography method in investigating coseismic liquefaction.

[The Gang of Six Demands more Freedom. Juvenile Offenders Interned in Saint-Jean-de-Dieu, Mid-20th Century].

PubMed

Desmeules, Martin; Thifault, Marie-Claude

In recent years, we have worked with many psychiatric records kept by the Archive Services of the Institut universitaire en santé mentale de Montréal (IUSMM). The proposed article is focused on the February 12th 1959 document Assemblée des médecins located within the records of six illegitimate children admitted to the Hôpital Saint-Jean-de-Dieu in the late 1950s. Our study, inspired by the work of historian Roy Porter and his approach from below, contributes to the historical discourse seeking to incorporate patient's voices, in this case, a gang of young offenders identified by a life course shaped by repeated institutional experience.

The Politics of Access to Expensive Drugs: INESSS and the Innovative Pharmaceutical Industry

PubMed Central

Hughes, David

2012-01-01

The innovative pharmaceutical industry employs thousands of people in Quebec and so has the ability to exert strong political pressure; the public statements of Sanofi-Aventis concerning the provincial reimbursement of certain expensive drugs are an example. “Maintaining a dynamic biopharmaceutical industry” is one of four main axes of the drug policy of Quebec's ministry of health. However, this role of government should not take precedence over the efficient and equitable management of health resources. We defend the legitimate and responsible choice of the Institut national d'excellence en santé et en services sociaux du Québec (INESSS) to require an acceptable cost-effectiveness ratio from expensive new drugs. PMID:23634161

Three perspectives on partnering to close the care gap.

PubMed

Tsuyuki, Ross T; Sebestyen, Norma; Davis, Sheila; Rondos, Spyro

2015-11-01

Given their frontline relationship with patients, community pharmacists fill a vital role in our healthcare system. This article offers three perspectives on how a team-based approach, which integrates the community pharmacist, can enhance patient care and reduce system costs. It is the success of these partnership models which have helped drive system-level change. It offers reflections by Dr. Ross T. Tsuyuki, among Canada's leading researchers on the subject, and presents some findings over his 20-year partnership with Merck in Canada. Dr. Tsuyuki's peer-reviewed studies have been largely centred in Alberta, one province in which the scope of practice for pharmacists has been expanded. © 2015 Collège canadien des leaders en santé

Préface

NASA Astrophysics Data System (ADS)

Ouerdane, Youcef; Laporte, Pierre

2005-06-01

L'objectif de la série de colloques UVX est de réunir, au rythme d'une fois tous les deux ans, les scientifiques et industriels travaillant dans le domaine du développement des sources de photon de grande énergie (UV, VUV, et X) et de leurs applications. En particulier cette manifestation est l'occasion de faire se rencontrer une communauté très pluridisciplinaire (physique, chimie, biologie, sciences de l'univers) liée à des domaines en forte évolution technologique (lasers et rayonnement synchrotron notamment). Le colloque UVX 2004 s'est tenu au Palais des Congrès de Saint-Étienne (42000) du 7 au 11 juin 2004. La période écoulée depuis l'édition précédente (Oléron 2002) a été particulièrement active dans tous les domaines concernés : grands projets de sources, méthodes de diagnostic au sens large. Une nouvelle fois on constate que le bref et l'ultra-bref ont une place privilégiée, qu'il s'agisse du travail sur les accélérateurs ou sur les lasers qui, bien sûr, dans la course aux temps courts remportent la palme avec la présence de spécialistes du domaine attoseconde. La communauté représentée a la chance d'être en prise directe avec de très grands projets en phase active de réalisation comme le Laser Megajoule (LMJ), la source SOLEIL, et un projet d'ampleur plus modeste mais remarquable dans son domaine : la source LASERIX d'Orsay/Palaiseau. On pourra citer aussi le projet Arc en Ciel qui, lui, est encore au stade de sa définition. - SOLEIL, source de nouvelle génération de rayonnement synchrotron (plateau de Saclay) est dans une phase active de réalisation : achèvement de l'infrastructure en 2005 et injection du 1o faisceau dans l'anneau de stockage prévu également en 2005. Cette source devrait être la meilleure au monde dans le domaine VUV/X mous, tout en restant très polyvalente (brillance, accordabilité, structure temporelle, polarisation) et complémentaire de l'ESRF. Au final on disposera de 21 lignes de lumi

Discussing epigenetics in Southern California: a report from the International Symposium on Epigenetic Control and Cellular Plasticity, UCI, December 15-16, 2011.

PubMed

Rattner, Barbara P

2012-04-01

With the goal of discussing how epigenetic control and chromatin remodeling contribute to the various processes that lead to cellular plasticity and disease, this symposium marks the collaboration between the Institut National de la Santé et de la Recherche Médicale (INSERM) in France and the University of California, Irvine (UCI). Organized by Paolo Sassone-Corsi (UCI) and held at the Beckman Center of the National Academy of Sciences at the UCI campus December 15-16, 2011, this was the first of a series of international conferences on epigenetics dedicated to the scientific community in Southern California. The meeting also served as the official kick off for the newly formed Center for Epigenetics and Metabolism at the School of Medicine, UCI (http://cem.igb.uci.edu).

[Care for unaccompanied minor migrant adolescents at the Youth Health Consultation: Support, psychotherapy and resilience].

PubMed

Devillé, Cédric; Lambert, Nelle

2018-04-18

The Unité Santé Jeunes of the Geneva University Hospitals offers multidisciplinary care to young people between the ages of 12 years and 25 years, including unaccompanied minor migrant adolescents. The psychiatrist and child psychiatrist of the unit participate actively. These young people are primarily teenagers, but it is clear from our experience that their care has some specificities and require an adaptation of the framework. The aim of this article is to open the reflection on socio-legal-educational support and the care to offer them to help them feeling secure and a different psychotherapeutic space. Fostering personal resources by building resilience and increasing self-esteem, the adolescent will thus be able to positive experiences encouraging him in his future project.

Moral Decisions and Military Mental Health (Decisions morales et sante mentale dans l’armee)

DTIC Science & Technology

2018-01-01

obedience, Journal of Abnormal and Social Psychology , 67, pp. 371-378. [60] Mischel, W. (2004), Toward an integrative model for CBT: Encompassing...veterans, Journal of Abnormal Psychology , 104(1), pp. 184-196. [17] Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Jordan, B.K., Marmar, C.R. and...Temperament, personality, and the mood and anxiety disorders, Journal of Abnormal Psychology , 103, pp. 103-116. [4] Cloninger, C.R., Svrakic, D.M. and

Medically Unexplained Physical Symptoms in Military Health (Symptomes physiques medicalement inexpliques dans la sante militaire)

DTIC Science & Technology

2017-12-01

Development of Persistent Pain and psychological Morbidity after Motor Vehicle Collision: Integrating the Potential Role of Stress Response Systems... abnormalities of quantitative EEG which suggest a THE LONG-TERM COSTS OF TRAUMATIC STRESS: INTERTWINED PHYSICAL AND PSYCHOLOGICAL CONSEQUENCES STO-TR-HFM...S.A., Clauw, D.J., Abelson, J.L. et al., The development of persistent pain and psychological morbidity after motor vehicle collision: integrating

["Tèt asanm pou la sante": ethnographic notes on international cooperation for health in Haiti].

PubMed

Esteves, Uliana

2016-01-01

This article discusses the functioning of a health-oriented development project pursued in an emergency situation and its impacts beyond its stated goals. The tripartite project between Brazil, Haiti, and Cuba was designed to strengthen Haiti's health and epidemiologic surveillance system, introduced in 2010 as part of the aid effort after the earthquake. An essentially ethnographic perspective is taken, with a focus on describing the practices and perspectives of the agents involved in the program. The networks of agents were mapped out, paying particular attention to translators, drivers, and journalists, who were understood as being "cooperation brokers". Finally, the article discusses the project's position in the broader context of international health initiatives in Haiti.

Smoking patterns and predictors of smoking cessation in elderly populations in Lebanon

PubMed Central

Chaaya, M.; Mehio-Sibai, A.; El-Chemaly, S.

2006-01-01

SUMMARY OBJECTIVE To investigate smoking patterns in an elderly, low-income population and to identify predictors of smoking cessation, in addition to analyzing the importance of smoking in relation to other risk factors for hospitalization. DESIGN The data were part of an urban health study conducted among 740 individuals aged ≥60 years in three suburban communities of low socio-economic status in Beirut, one of them a refugee camp. A detailed interview schedule was administered that included comprehensive social and health information. RESULTS The overall prevalence of current smokers was 28.1%. Almost half of the group were ever smokers, of whom 44% had quit smoking when they experienced negative health effects. Having at least one chronic illness and having a functional disability significantly increased the odds of smoking cessation. In addition, being a former smoker increased the likelihood of hospital admission. CONCLUSIONS This study is of particular importance, as it has implications for similar low-income and refugee communities in the region and elsewhere. There is a need for more concerted efforts by public health officials to target elderly individuals as a group for smoking cessation interventions, particularly now that mortality and health benefits have been well documented. RÉSUMÉ OBJECTIF Investiguer les types de tabagisme dans une population âgée à faibles revenus et identifier les facteurs prédictifs de l’arrêt du tabagisme, tout en analysant l’importance du tabagisme par rapport aux autres facteurs de risque d’hospitalisation. SCHÉMA Les données constituent une fraction de l’étude de santé urbaine menée chez 740 personnes âgées de ≥60 ans à Beyrouth dans trois collectivités suburbaines à faible statut socio-économique dont une des trois se situe dans un camp de réfugiés. Un schéma détaillé d’interview a été utilisé comportant des informations complètes sur le plan social et celui de la santé. R�

Inversion of Atmospheric Tracer Measurements, Localization of Sources

NASA Astrophysics Data System (ADS)

Issartel, J.-P.; Cabrit, B.; Hourdin, F.; Idelkadi, A.

When abnormal concentrations of a pollutant are observed in the atmosphere, the question of its origin arises immediately. The radioactivity from Tchernobyl was de- tected in Sweden before the accident was announced. This situation emphasizes the psychological, political and medical stakes of a rapid identification of sources. In tech- nical terms, most industrial sources can be modeled as a fixed point at ground level with undetermined duration. The classical method of identification involves the cal- culation of a backtrajectory departing from the detector with an upstream integration of the wind field. We were first involved in such questions as we evaluated the ef- ficiency of the international monitoring network planned in the frame of the Com- prehensive Test Ban Treaty. We propose a new approach of backtracking based upon the use of retroplumes associated to available measurements. Firstly the retroplume is related to inverse transport processes, describing quantitatively how the air in a sam- ple originates from regions that are all the more extended and diffuse as we go back far in the past. Secondly it clarifies the sensibility of the measurement with respect to all potential sources. It is therefore calculated by adjoint equations including of course diffusive processes. Thirdly, the statistical interpretation, valid as far as sin- gle particles are concerned, should not be used to investigate the position and date of a macroscopic source. In that case, the retroplume rather induces a straightforward constraint between the intensity of the source and its position. When more than one measurements are available, including zero valued measurements, the source satisfies the same number of linear relations tightly related to the retroplumes. This system of linear relations can be handled through the simplex algorithm in order to make the above intensity-position correlation more restrictive. This method enables to manage in a quantitative manner the

Thrombolyse d’un AVC ischémique vertébro-basilaire à N’Djamena, République du Tchad

PubMed Central

Lamblin, Antoine; Bascou, Marc; Drouard, Eve; Alberti, Nicolas; de Greslan, Thierry

2018-01-01

L’accident vasculaire cérébral ischémique est une pathologie rare chez les militaires français, mais les médecins militaires projetés en opérations extérieures peuvent être amenés à en prendre en charge, notamment en Afrique Sub-Saharienne. Dès lors, il s’agit d’une urgence vitale nécessitant de réagir rapidement avec des moyens limités, de façon multidisciplinaire avec les médecins neurologues de France métropolitaine, afin d’assurer au patient une prise en charge optimale. Nous rapportons le cas d’un patient victime d’un accident vasculaire cérébral ischémique sur le territoire vertébro-basilaire, traité par thrombolyse intraveineuse. PMID:29875917

PHARAO flight model: optical on ground performance tests

NASA Astrophysics Data System (ADS)

Lévèque, T.; Faure, B.; Esnault, F. X.; Grosjean, O.; Delaroche, C.; Massonnet, D.; Escande, C.; Gasc, Ph.; Ratsimandresy, A.; Béraud, S.; Buffe, F.; Torresi, P.; Larivière, Ph.; Bernard, V.; Bomer, T.; Thomin, S.; Salomon, C.; Abgrall, M.; Rovera, D.; Moric, I.; Laurent, Ph.

2017-11-01

PHARAO (Projet d'Horloge Atomique par Refroidissement d'Atomes en Orbite), which has been developed by CNES, is the first primary frequency standard specially designed for operation in space. PHARAO is the main instrument of the ESA mission ACES (Atomic Clock Ensemble in Space). ACES payload will be installed on-board the International Space Station (ISS) to perform fundamental physics experiments. All the sub-systems of the Flight Model (FM) have now passed the qualification process and the whole FM of the cold cesium clock, PHARAO, is being assembled and will undergo extensive tests. The expected performances in space are frequency accuracy less than 3.10-16 (with a final goal at 10-16) and frequency stability of 10-13 τ-1/2. In this paper, we focus on the laser source performances and the main results on the cold atom manipulation.

[Multidisciplinary health houses and regional development: a necessarily shared dyanamics.].

PubMed

Autès, Michel; Dufay, Marie-Guite

2009-03-29

Many regional authorities (Conseils Régionaux) have taken up the issue of health houses by underlining their competence in dealing with regional development issues. This initiative is part of a broader process designed to ensure the continuity of healthcare at the different levels of provision as well as equal, universal access according to the specific needs of patients, from prevention to the most specialized forms of medical treatment. Health houses are one of the chief access points in this process, and are situated at the cross-roads of health and healthcare. The territorial health project must provide the fondations of the new health house model. According to the Health Committee of the Association of French Regions (Commission Santé de l'Association des Régions de France), there are three prerequisites: 1. a multidisciplinary offer of access to front-line healthcare services; 2. public healthcare activities: prevention, promotion of health...; 3. a network mode of organization with the local and regional hospital system to ensure optimum healthcare provision for patients. Yet a number of obstacles need to be overcome, particularly the risk of concentrating healthcare provision within a single center, thus depriving the surrounding area, but also the ill-adapted current framework of remuneration for independent medical practitioners. The purpose of regional authorities (i.e. Conseils Régionaux) is not to ensure the expansion of health houses, but rather to enable innovation by accompanying the different actors involved within the sector. Heeding the specific requirements of the local area and its needs, as well as the will of elected representatives and healthcare professionals, their aim is to develop a policy of exemplarity with all the actors involved in the sector and to uphold their legitimacy as agents of regional development. The ?Hospital, patients, health and territories' law (loi "Hôpital, patients, santé et territoires") may yet throw the

[Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].

PubMed

d'Elbée, M; Baumevieille, M; Dumartin, C

2017-06-01

In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information

Connaissances des médecins généralistes de Mohammedia (Maroc) concernant le dépistage du cancer du sein

PubMed Central

Zine, Karima; Nani, Samira; Lahmadi, Imad Ait; Maaroufi, Abderrahmane

2016-01-01

Introduction Le cancer du sein représente un problème de santé publique majeur au Maroc. C'est le premier cancer chez la femme. L'objectif de ce travail était d'évaluer les connaissances des médecins généralistes (MG) en matière de dépistage du cancer du sein dans la préfecture de Mohammedia Maroc. Méthodes Nous avons mené une étude transversale, descriptive, exhaustive incluant les 97 MG exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Mohammedia. Résultats Le taux de participation était de 87%. L'âge moyen des MG était de 49,6 ± 8,1. Quatre-vingt pour cent (n=55) des MG ont donné une incidence incorrecte, 77,6% (n=85) ont reconnu l'existence d'un plan national de prévention et de contrôle du cancer (PNPCC) au Maroc, et 67,1 des MG ont rapporté l'existence d'un registre du cancer au Maroc. Le secteur d'activité était associé significativement avec les connaissances des MG sur le PNPCC et sur l'existence d'un guide de détection précoce du cancer du sein avec respectivement (p=0,003 et p=0,001). Une association significative entre l'ancienneté et l'existence d'un guide de détection précoce du cancer du sein et d'un registre du cancer du sein a été retrouvée avec (respectivement p=0,005 et p=0.002). Conclusion À la lumière de ces résultats il faudra renforcer les connaissances et les pratiques des MG par la promotion de la formation initiale et continue sur le dépistage. PMID:27800098

Participation des médecins généralistes de la province de Benimellal (Maroc) dans le dépistage du cancer du col

PubMed Central

Nani, Samira; Benallal, Mohamed; Hassoune, Samira; Kissi, Dounia; Maaroufi, Abderrahmane

2013-01-01

Introduction Au Maroc, chaque année il y aurait environ 2000 nouveaux cas de cancer du col et les 2/3 des cas sont pris en charge à un stade très avancé. Nous avons mené une étude transversale, exhaustive incluant les 71 médecins généralistes exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Benimellal. Le but était d’évaluer leurs connaissances et leur participation au dépistage du cancer du col. Méthodes Nous avons mené une étude transversale, exhaustive incluant les 71 médecins généralistes exerçant dans les établissements de soins de santé de base du secteur public et privé de la province de Benimellal. Le but était d’évaluer leurs connaissances et leur participation au dépistage du cancer du col. Résultats Le niveau de connaissance était relativement modeste, 22 médecins généraliste avaient répondu à la question sur l'incidence du cancer du col au Maroc, Parmi eux (81,8%) avaient donné une réponse incorrecte. L'Herpes Papilloma virus comme facteur de risque du cancer du col a été identifié par seulement 21% des médecins généralistes. La participation au dépistage était également défaillante, 92,8% n'avaient jamais pratiqué le FCV chez leurs patientes à cause principalement du manque de formation (95,5%). Conclusion Les résultats montrent la nécessité d'améliorer les connaissances théoriques et pratique des médecins généralistes concernant le dépistage du cancer du col. PMID:23785557

Thallium-rich rust scales in drinkable water distribution systems: A case study from northern Tuscany, Italy.

PubMed

Biagioni, Cristian; D'Orazio, Massimo; Lepore, Giovanni O; d'Acapito, Francesco; Vezzoni, Simone

2017-06-01

Following the detection of a severe thallium contamination of the drinkable water from the public distribution system of Valdicastello Carducci-Pietrasanta (northern Tuscany, Italy), and the identification of the source of contamination in the Molini di Sant'Anna spring (average Tl content≈15μgL -1 ), the replacement of the contaminated water with a virtually Tl-free one (Tl<0.10μgL -1 ) caused an increase in Tl concentration in the drinkable water. This suggested that the pipeline interior had become a secondary source of Tl contamination, promoting its mineralogical and geochemical study. Rust scales samples taken from several pipeline segments, as well as leaching products obtained from these samples, were investigated through scanning electron microscopy, X-ray fluorescence chemical analyses, inductively coupled plasma - mass spectrometry, X-ray diffraction, and X-ray absorption spectroscopy. Thallium-rich rust scales (up to 5.3wt% Tl) have been found only in pipeline samples taken downstream the water treatment plant, whereas the sample taken upstream contains much less Tl (~90μgg -1 ). The Tl-rich nature of such scales is related to the occurrence of nano- and micro-spherules of Tl 2 O 3 and less abundant nanocrystalline μm-sized encrustations of TlCl. Leaching experiments on Tl-rich rust scales indicate that a fraction of the available Tl is easily dissolved in tap water; X-ray absorption spectroscopy suggests that monovalent thallium occurs in water equilibrated with the rust scales, probably related to the dissolution of TlCl encrustations. Therefore, Tl dissolved as Tl + only in the water from the Molini di Sant'Anna spring was partially removed through oxidative precipitation of Tl 2 O 3 and precipitation of TlCl. This highlights the critical role played by the addition of chlorine-based oxidants in water treatment plants that could favour the deposition of Tl-rich coatings within the pipelines, giving rise to unexpected secondary sources of

Une version québécoise du Sport Concussion Assessment Tool 2 (SCAT2)—Outil d'évaluation des commotions cérébrales dans le sport 2 : Québec (SCAT2-Qc)

PubMed Central

Boyd, Jami; Boyer-Rémillard, Marie-Eve; Pilon-Piquette, Michael; McKinley, Patricia

2013-01-01

RÉSUMÉ Objectif : traduire le Sport Concussion Assessment Tool 2 (SCAT2) dans la langue française parlée au Québec et en vérifier l'acceptabilité pour la population québécoise francophone. Méthodologie : le processus de traduction de la version originale du SCAT2 a fait appel à une variante de la méthode de traduction et d'adaptation d'outils proposée par l'Organisation mondiale de la santé. Une traduction parallèle a d'abord été réalisée. Ensuite, un comité a révisé cette traduction parallèle dans le but de produire une version préliminaire du SCAT2-Qc. Puis, on a procédé à une rétrotraduction parallèle, que l'on a comparée à la version originale. La version préliminaire a été modifiée. Pour parvenir à la version finale, on a intégré les suggestions et les commentaires formulés par deux sujets sains lors de l'essai de l'outil, et lors de la comparaison du SCAT2-Qc à la version française existante par trois réviseurs du domaine de la santé. On a ensuite testé la version finale du SCAT2-Qc auprès de douze sujets sains pour en vérifier l'acceptabilité. Résultats : les douze sujets sains n'ont eu aucun problème de compréhension en utilisant le SCAT2-Qc. Conclusion : les différentes étapes de traduction ont permis de créer le SCAT2-Qc. Son contenu ayant été validé, il peut à présent être utilisé dans le milieu sportif et scientifique québécois. PMID:24396168

The impact of wildland fires on calcareous Mediterranean pedosystems (Sardinia, Italy) - An integrated multiple approach.

PubMed

Capra, Gian Franco; Tidu, Simona; Lovreglio, Raffaella; Certini, Giacomo; Salis, Michele; Bacciu, Valentina; Ganga, Antonio; Filzmoser, Peter

2018-05-15

Sardinia (Italy), the second largest island of the Mediterranean Sea, is a fire-prone land. Most Sardinian environments over time were shaped by fire, but some of them are too intrinsically fragile to withstand the currently increasing fire frequency. Calcareous pedoenvironments represent a significant part of Mediterranean areas, and require important efforts to prevent long-lasting degradation from fire. The aim of this study was to assess through an integrated multiple approach the impact of a single and highly severe wildland fire on limestone-derived soils. For this purpose, we selected two recently burned sites, Sant'Antioco and Laconi. Soil was sampled from 80 points on a 100×100m grid - 40 in the burned area and 40 in unburned one - and analyzed for particle size fractions, pH, electrical conductivity, organic carbon, total N, total P, and water repellency (WR). Fire behavior (surface rate of spread (ROS), fireline intensity (FLI), flame length (FL)) was simulated by BehavePlus 5.0.5 software. Comparisons between burned and unburned areas were done through ANOVA as well as deterministic and stochastic interpolation techniques; multiple correlations among parameters were evaluated by principal factor analysis (PFA) and differences/similarities between areas by principal component analysis (PCA). In both sites, fires were characterized by high severity and determined significant changes to some soil properties. The PFA confirmed the key ecological role played by fire in both sites, with the variability of a four-modeled components mainly explained by fire parameters, although the induced changes on soils were mainly site-specific. The PCA revealed the presence of two main "driving factors": slope (in Sant'Antioco), which increased the magnitude of ROS and FLI; and soil properties (in Laconi), which mostly affected FL. In both sites, such factors played a direct role in differentiating fire behavior and sites, while they played an indirect role in determining

Evaluation des Connaissances-Attitudes-Pratiques des populations des districts sanitaires de Benoye, Laoukassy, Moundou et N’Djaména Sud sur la rage canine au Tchad

PubMed Central

Mindekem, Rolande; Lechenne, Monique; Alfaroukh, Idriss Oumar; Moto, Daugla Doumagoum; Zinsstag, Jakob; Ouedraogo, Laurent Tinoaga; Salifou, Sahidou

2017-01-01

Introduction La rage canine demeure une préoccupation en Afrique comme au Tchad. La présente étude vise à évaluer les Connaissances-Attitudes-Pratiques des populations pour la prise en charge appropriée des personnes exposées et une lutte efficace. Méthodes C’était une étude transversale descriptive réalisée en juillet et septembre dans quatre districts sanitaires au Tchad en 2015. Les données ont été collectées à l’aide d’un questionnaire auprès des ménages recrutés suivant un sondage aléatoire à 3 degrés. Résultats C’était 2428 personnes enquêtées avec un niveau maximum primaire (54,12%). L’âge moyen était de 36 ± 13,50 ans. Ils étaient cultivateurs (35,17%), commerçants (18,04%), ménagères (12,81%). La rage était définie comme une maladie transmise du chien à l’homme (41,43%), une altération du cerveau (41,27%), une sous-alimentation (10,26%). Le chat était faiblement connu réservoir (13,84%) et vecteur (19,77%) ainsi que la griffure comme moyen de transmission (4,61%) et la vaccination du chat comme mesure préventive (0,49%). Les premiers soins en cas de morsure à domicile étaient les pratiques traditionnelles (47,69%), le lavage des plaies (19,48%) ou aucune action entreprise (20,43%). Les ménages consultaient la santé humaine (78,50%), la santé animale (5,35%) et les guérisseurs traditionnels (27%). Conclusion La communication en rapport avec des premiers soins à la maison en cas de morsure, la connaissance du chat comme réservoir et vecteur, celle de la griffure comme moyen de transmission et la promotion de la consultation des services vétérinaires en cas de morsure sont nécessaires. PMID:28761600

Ampleur et impact des évènements indésirables graves liés aux soins: étude d'incidence dans un hôpital du Centre-Est tunisien

PubMed Central

Bouafia, Nabiha; Bougmiza, Iheb; Bahri, Fathi; Letaief, Mondher; Astagneau, Pascal; Njah, Mansour

2013-01-01

Introduction La prévention des événements indésirables représente une priorité de santé du fait de leur fréquence et de leur gravité potentielle. Ce travail a été mené afin d'avoir un diagnostic de la situation épidémiologique relative aux événements indésirables survenant dans notre hôpital. Méthodes Une étude prospective a été menée auprès de tous les patients qui ont été hospitalisés au CHU Farhat Hached - Sousse (Tunisie) sur une période d'un mois dans quatorze services de l'hôpital. La détection d'évènement indésirable grave (EIG) était basée sur les critères adoptés dans différentes études. Les tests T et Chi 2 ont été utilisés pour identifier les facteurs contribuant à l'apparition d'évènements indésirables. Résultats Au total, 162 EIG ont été identifiés pendant la période. 45% de ces évènements étaient des infections nosocomiales. Ces EIG ont eu comme conséquences un décès chez 9,2% des patients, la mise en jeu du pronostic vital de 26% des patients et la prolongation de la durée de séjour chez 61,7% d'entre eux. L'admission dans des circonstances particulières et l'exposition à des soins invasifs étaient identifiés comme des facteurs de risque potentiels EIG. Conclusion Le renforcement de la stratégie de gestion des risques sanitaires en ciblant préférentiellement le risque infectieux constitue une étape fondamentale dans l'amélioration de la sécurité des patients au sein de notre établissement de santé. PMID:24711868

Aspects épidemiocliniques et évolutifs chez 157 cas de leishmaniose cutanée au Maroc

PubMed Central

Hjira, Naoufal; Frikh, Rachid; Marcil, Tarik; Lamsyah, Hanane; Oumakhir, Siham; Baba, Noureddine; Boui, Mohammed

2014-01-01

Connue au Maroc depuis la fin du XIX siècle, la leishmaniose cutanée (LC) constitue un problème de santé publique dans notre pays. Le but de notre travail est de décrire le profil épidémioclinique et l’évolution post thérapeutique chez les patients ayant une leishmaniose cutanée dans notre contexte. Nous avons effectué une étude rétrospective, basée sur l'exploitation des dossiers de malades ayant présenté une leishmaniose cutanée confirmée entre janvier 2003 et décembre 2012. Nous avons colligés 157 cas de leishmaniose cutanée. L’âge moyen des patients était de 34.5 ans avec des extrêmes de 6 ans à 63 ans. Le sex-ratio était de 2.34 H/F. La durée d’évolution moyenne des lésions était de 3,6 mois avec des extrêmes de 2 semaines à 10 mois. Les lésions étaient uniques dans 29.5% des cas. Les lésions siégeaient sur membres dans 63%. La forme ulcèro- croûteuse touchait plus de 48%. Le Glucantime était utilisé dans 29.3% des cas, l'azote liquide était utilisé chez 111 autres. L’évolution post-thérapeutique était favorable avec disparition quasi-complète des lésions dans un délai variant de 6 à 10 semaines, au prix de cicatrices inesthétiques chez 14 patients. La leishmaniose cutanée continue à poser un vrai problème de santé publique dans notre pays. L’émergence de formes sévères et résistantes à travers le monde doit inciter à multiplier et renforcer les mesures prophylactiques. PMID:25309671

T245. THE ROLE OF PROTECTIVE FACTORS IN THE FIRST-EPISODE PSYCHOSIS: PRELIMINARY RESULTS

PubMed Central

Vila-Badia, Regina; Butjosa, Anna; Del Cacho, Núria; de Aguileta, Itziar Riera-López; Alvárez, Mar; Pardo, Marta; Coromina, Marta; Grases, Núria; Ochoa, Susana; Usall, Judith

2018-01-01

Abstract Background Currently, there is a great interest in stress since many diseases can be affected by stress, including psychotic disorders. Interpretation and capacity of the person to tackle situations of psychosocial stress and their recovery capacities are relevant factors in the prevention of psychotic disorders (López-Soler, 2008; N Pereda, 2009, 2010; Noemí Pereda, Guilera, Forns, & Gómez-Benito, 2009). Some of protector factors that have been studied are the following: Resilience (R), Coping Strategies (CS) and Social Support (SS). Furthermore, few studies have been performed with FEP population. Methods This research was part of a longitudinal observational study called ‘PROFEP Group’ in Catalonia. The patients belong to Mental Health Parc Sanitari Sant Joan de Déu (for adults) and Hospital Sant Joan de Déu (for children and adolescents) health care sector. Participants were FEP patients (N=15); males= 9, females= 6) and HC (N=19; males=6, females=13) between 14 and 42 years. We used the PANSS scale (positive, negative and general) to evaluate psychotic symptoms and DUKE (social support), EMA (coping strategies) and CD-RISC-17 (resilience) scales to evaluate protective factors. Results FEP patients showed worse resilience (p<0.05), less social support (p<0.05) and more avoidance coping strategies (p<0.05) than HC. On the other hand, in FEP patients, some protective factors correlate with the symptomatology. The DUKE scale and the EMA cautious action subscale correlate with the total PANSS, while the EMA social joining subscale correlates with the positive symptoms (p<0.05). Discussion Resilience, Coping Strategies and Social Support seem to have an important role in the appearance and severity of an FEP. It is necessary to carry out more studies with more sample, even so, the results indicate that these factors may be important for the prevention of an FEP and could be worked on in future interventions in FEP patients as well as in HC.

Malaria elimination in Haiti by the year 2020: an achievable goal?

PubMed

Boncy, Paul Jacques; Adrien, Paul; Lemoine, Jean Frantz; Existe, Alexandre; Henry, Patricia Jean; Raccurt, Christian; Brasseur, Philippe; Fenelon, Natael; Dame, John B; Okech, Bernard A; Kaljee, Linda; Baxa, Dwayne; Prieur, Eric; El Badry, Maha A; Tagliamonte, Massimiliano S; Mulligan, Connie J; Carter, Tamar E; Beau de Rochars, V Madsen; Lutz, Chelsea; Parke, Dana M; Zervos, Marcus J

2015-06-05

Haiti and the Dominican Republic, which share the island of Hispaniola, are the last locations in the Caribbean where malaria still persists. Malaria is an important public health concern in Haiti with 17,094 reported cases in 2014. Further, on January 12, 2010, a record earthquake devastated densely populated areas in Haiti including many healthcare and laboratory facilities. Weakened infrastructure provided fertile reservoirs for uncontrolled transmission of infectious pathogens. This situation results in unique challenges for malaria epidemiology and elimination efforts. To help Haiti achieve its malaria elimination goals by year 2020, the Laboratoire National de Santé Publique and Henry Ford Health System, in close collaboration with the Direction d'Épidémiologie, de Laboratoire et de Recherches and the Programme National de Contrôle de la Malaria, hosted a scientific meeting on "Elimination Strategies for Malaria in Haiti" on January 29-30, 2015 at the National Laboratory in Port-au-Prince, Haiti. The meeting brought together laboratory personnel, researchers, clinicians, academics, public health professionals, and other stakeholders to discuss main stakes and perspectives on malaria elimination. Several themes and recommendations emerged during discussions at this meeting. First, more information and research on malaria transmission in Haiti are needed including information from active surveillance of cases and vectors. Second, many healthcare personnel need additional training and critical resources on how to properly identify malaria cases so as to improve accurate and timely case reporting. Third, it is necessary to continue studies genotyping strains of Plasmodium falciparum in different sites with active transmission to evaluate for drug resistance and impacts on health. Fourth, elimination strategies outlined in this report will continue to incorporate use of primaquine in addition to chloroquine and active surveillance of cases. Elimination of

Access to physician services: does supplemental insurance matter? evidence from France.

PubMed

Buchmueller, Thomas C; Couffinhal, Agnès; Grignon, Michel; Perronnin, Marc

2004-07-01

In France, public health insurance is universal but incomplete, with private payments accounting for roughly 25% of all spending. As a result, most people have supplemental private health insurance. We investigate the effects of such insurance on the utilization of physician services using data from the 1998 Enquête sur la santé et la protection sociale, a nationally representative survey of the non-institutionalized French population. Our results indicate that insurance has a strong and significant effect on the utilization of physician services. Individuals with supplemental coverage have substantially more physician visits than those without. While French patients have greater freedom than patients in other countries to choose to see a specialist rather than a general practitioner, we find no evidence that supplemental insurance affects this decision. Copyright 2004 John Wiley & Sons, Ltd.

Computer simulation of the activity of the elderly person living independently in a Health Smart Home.

PubMed

Noury, N; Hadidi, T

2012-12-01

We propose a simulator of human activities collected with presence sensors in our experimental Health Smart Home "Habitat Intelligent pour la Sante (HIS)". We recorded 1492 days of data on several experimental HIS during the French national project "AILISA". On these real data, we built a mathematical model of the behavior of the data series, based on "Hidden Markov Models" (HMM). The model is then played on a computer to produce simulated data series with added flexibility to adjust the parameters in various scenarios. We also tested several methods to measure the similarity between our real and simulated data. Our simulator can produce large data base which can be further used to evaluate the algorithms to raise an alarm in case of loss in autonomy. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Discussing epigenetics in Southern California

PubMed Central

2012-01-01

With the goal of discussing how epigenetic control and chromatin remodeling contribute to the various processes that lead to cellular plasticity and disease, this symposium marks the collaboration between the Institut National de la Santé et de la Recherche Médicale (INSERM) in France and the University of California, Irvine (UCI). Organized by Paolo Sassone-Corsi (UCI) and held at the Beckman Center of the National Academy of Sciences at the UCI campus December 15–16, 2011, this was the first of a series of international conferences on epigenetics dedicated to the scientific community in Southern California. The meeting also served as the official kick off for the newly formed Center for Epigenetics and Metabolism at the School of Medicine, UCI (http://cem.igb.uci.edu). PMID:22414797

Allergy immunotherapy across the life cycle to promote active and healthy ageing: from research to policies: An AIRWAYS Integrated Care Pathways (ICPs) programme item (Action Plan B3 of the European Innovation Partnership on active and healthy ageing) and the Global Alliance against Chronic Respiratory Diseases (GARD), a World Health Organization GARD research demonstration project.

PubMed

Calderon, M A; Demoly, P; Casale, T; Akdis, C A; Bachert, C; Bewick, M; Bilò, B M; Bohle, B; Bonini, S; Bush, A; Caimmi, D P; Canonica, G W; Cardona, V; Chiriac, A M; Cox, L; Custovic, A; De Blay, F; Devillier, P; Didier, A; Di Lorenzo, G; Du Toit, G; Durham, S R; Eng, P; Fiocchi, A; Fox, A T; van Wijk, R Gerth; Gomez, R M; Haathela, T; Halken, S; Hellings, P W; Jacobsen, L; Just, J; Tanno, L K; Kleine-Tebbe, J; Klimek, L; Knol, E F; Kuna, P; Larenas-Linnemann, D E; Linneberg, A; Matricardi, M; Malling, H J; Moesges, R; Mullol, J; Muraro, A; Papadopoulos, N; Passalacqua, G; Pastorello, E; Pfaar, O; Price, D; Del Rio, P Rodriguez; Ruëff, R; Samolinski, B; Scadding, G K; Senti, G; Shamji, M H; Sheikh, A; Sisul, J C; Sole, D; Sturm, G J; Tabar, A; Van Ree, R; Ventura, M T; Vidal, C; Varga, E M; Worm, M; Zuberbier, T; Bousquet, J

2016-01-01

Allergic diseases often occur early in life and persist throughout life. This life-course perspective should be considered in allergen immunotherapy. In particular it is essential to understand whether this al treatment may be used in old age adults. The current paper was developed by a working group of AIRWAYS integrated care pathways for airways diseases, the model of chronic respiratory diseases of the European Innovation Partnership on active and healthy ageing (DG CONNECT and DG Santé). It considered (1) the political background, (2) the rationale for allergen immunotherapy across the life cycle, (3) the unmet needs for the treatment, in particular in preschool children and old age adults, (4) the strategic framework and the practical approach to synergize current initiatives in allergen immunotherapy, its mechanisms and the concept of active and healthy ageing.

The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study.

PubMed

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2013-07-01

This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

Morningness-eveningness and health-related quality of life among adolescents.

PubMed

Delgado Prieto, Pedro; Diaz-Morales, Juan Francisco; Escribano, Barreno Cristina; Collado Mateo, M José; Randler, Christoph

2012-07-01

Accumulating evidence suggests that evening-type adolescents are exposed to a number of determinants that might have a negative impact on their health condition. Given that few studies have investigated the association between chronotype and quality of life measures in large samples of adolescents, the aim of this study was to assess the relationship between morningness-eveningness and health-related quality of life among 1600 adolescents (aged 12-16 years). Adolescents completed the Veçu et Santé Perçue de L'adolescent (VSP-A) and the Morningness-Eveningness Scale for Children (MESC). Girls and older adolescents reported worse health indicators and were more evening oriented. Evening-type adolescents obtained lower scores on vitality, physical and psychological well-being, body image, relations with parents, relations with teachers, school work and global health scale.

An update on minding the gap in cancer.

PubMed

Mesnil, Marc; Aasen, Trond; Boucher, Jonathan; Chépied, Amandine; Cronier, Laurent; Defamie, Norah; Kameritsch, Petra; Laird, Dale W; Lampe, Paul D; Lathia, Justin D; Leithe, Edward; Mehta, Parmender P; Monvoisin, Arnaud; Pogoda, Kristin; Sin, Wun-Chey; Tabernero, Arantxa; Yamasaki, Hiroshi; Yeh, Elizabeth S; Dagli, Maria Lucia Zaidan; Naus, Christian C

2018-01-01

This article is a report of the "International Colloquium on Gap junctions: 50Years of Impact on Cancer" that was held 8-9 September 2016, at the Amphitheater "Pôle Biologie Santé" of the University of Poitiers (Poitiers, France). The colloquium was organized by M Mesnil (Université de Poitiers, Poitiers, France) and C Naus (University of British Columbia, Vancouver, Canada) to celebrate the 50th anniversary of the seminal work published in 1966 by Loewenstein and Kanno [Intercellular communication and the control of tissue growth: lack of communication between cancer cells, Nature, 116 (1966) 1248-1249] which initiated studies on the involvement of gap junctions in carcinogenesis. During the colloquium, 15 participants presented reviews or research updates in the field which are summarized below. Copyright © 2017 Elsevier B.V. All rights reserved.

Le syndrome des enfants battus: aspects cliniques et radiologiques

PubMed Central

Jlalia, Zied; Znaigui, Talel; Smida, Mahmoud

2016-01-01

La maltraitance physique des enfants ou le syndrome des enfants battus est responsable de plus de 75.000 décès par an en France. Ce problème de santé publique reste sous diagnostiqué en Tunisie et dans le monde. Le chemin a été laborieux pour la reconnaissance du syndrome des enfants battus dans certaines sociétés même occidentales. Nous avons voulus exposer ce problème aux praticiens afin qu'il soit mieux diagnostiqué et pris en charge. La maltraitance physique des enfants est appelée à tort syndrome de Silverman qui ne regroupe en fait que les lésions squelettiques chez ces enfants tels que les fractures. Mots clés: Fracture, maltraitance, enfant, neuro-radiologie PMID:27642408

Caracterisation des revetements par projection thermique a haute vitesse obtenus a partir de differentes poudres de wc-10co-4cr pour des applications en aeronautique =

NASA Astrophysics Data System (ADS)

Quintero Malpica, Alfonso

Les revetements par projection thermique HVOF (High Velocity Oxy-Fuel) sont communement utilises dans l'industrie aeronautique, notamment au sein du partenaire industriel du projet (Tecnickrome Aeronautique Inc), comme des remplacants pour les revetements produits par l'electrodeposition du chrome dur due aux problemes environnementaux. Ce projet avait pour but de trouver une poudre alternative a celle qui est actuellement utilisee pour la production des revetements de type WC-10Co-4Cr obtenus avec la technologie de projection thermique a haute vitesse HVOF et en utilisant le systeme de projection HVOF-JET KOTERTM III. Dans un premier temps, cinq poudres incluant celle de reference, ayant des distributions granulometriques differentes, ont ete projetees dans le but d'identifier quelles poudres pouvaient etre utilisees avec le systeme de projection HVOF-JET KOTERTM III en gardant des parametres similaires (debit d'hydrogene, debit d'oxygene, debit de poudre et distance de projection) que pour la poudre de reference. Les revetements obtenus a partir des poudres etudiees ont ete evalues selon les criteres d'acceptation des revetements sollicites par les principaux manufacturiers des trains d'atterrissage. Les tests ont porte sur l'epaisseur, l'adhesion, la microstructure, la microdurete, les contraintes residuelles et la rugosite. A partir des resultats obtenus, seulement deux poudres ont rencontre toutes les proprietes demandees par les specifications aeronautiques. L'influence de la variation de la distance de projection sur la qualite des revetements a ete etudiee. Cinq distances (100, 125, 150, 175 et 200 mm) ont ete choisies pour faire la projection des deux poudres selectionnees. Les revetements obtenus ont montre de proprietes des revetements similaires (epaisseur, adhesion, microstructure, microdurete, contraintes residuelles et rugosite). Il a ete trouve que la distance de projection est un parametre indirect du systeme de projection HVOF-JET KOTERTM III et

Laser sans mode et étoile laser

NASA Astrophysics Data System (ADS)

Pique, J.-P.; Farinotti, S.; Fesquet, V.

2004-11-01

Nous décrivons la chaîne laser étudiée dans le cadre du projet Etoile-Laser-Polychromatique pour l'Optique-Adaptative (ELP-OA). Cette chaîne est constituée d'un oscillateur sans-mode, d'un préamplificateur intra-cavité et d'un amplificateur. L'objectif fixé est : 20 W de puissance moyenne, avec un taux de répétition de 15 kHz et une largeur d'impulsion de 40 ns. Nous montrons que l'aspect sans-mode de cette chaîne permet de s'affranchir du phénomène de saturation de l'atome de sodium. Nous avons mesuré un gain de 5 sur l'intensité de l'étoile monochromatique D{2}. Un facteur 30 est attendu sur l'intensité de la composante UV de l'étoile polychromatique.

État de santé des nouveaux réfugiés à Toronto, en Ontario

PubMed Central

Redditt, Vanessa J.; Janakiram, Praseedha; Graziano, Daniela; Rashid, Meb

2015-01-01

Résumé Objectif Déterminer la prévalence de certaines maladies infectieuses parmi les patients nouvellement réfugiés et la présence ou non d’une variation en fonction de facteurs démographiques clés. Conception Revue rétrospective de dossiers. Contexte Clinique de soins primaires pour patients réfugiés à Toronto, en Ontario. Participants Au total, 1063 patients réfugiés inscrits à la clinique entre décembre 2011 à juin 2014. Principaux paramètres à l’étude Données démographiques (âge, sexe et pays de naissance); prévalence de VIH, d’hépatite B, d’hépatite C, d’infections à strongyloïdes, à schistosomes, à parasite intestinal, de gonorrhée, de chlamydia et de syphilis; et immunité contre la varicelle. Résultats L’âge médian des patients était de 29 ans et 56 % étaient de sexe féminin. Les réfugiés étaient nés dans 87 pays différents. Environ 33 % des patients étaient originaires d’Afrique, 28 % d’Europe, 14 % de la région de la Méditerranée orientale, 14 % d’Asie et 8 % des Amériques (à l’exception de 4 % nés au Canada ou aux États-Unis). Le taux global de VIH était de 2 %. La prévalence d’hépatite B était de 4 %, ce taux étant supérieur parmi les réfugiés originaires d’Asie (12 %, p < 0,001). L’immunité contre l’hépatite B était de 39 %, ce taux étant supérieur parmi les réfugiés originaires d’Asie (64 %, p < 0,001) et les enfants de moins de 5 ans (68 %, p < 0,001). Le taux d’hépatite C se situait à moins de 1 %. Une infection à strongyloïdes a été dépistée chez 3 % des patients testés, ce taux étant supérieur parmi les réfugiés originaires d’Afrique (6 %, p = 0,003). Une infection à schistosomes a été dépistée chez 15 % des patients africains. Des parasites intestinaux ont été observés chez 16 % des patients ayant soumis un échantillon de selles. Environ 8 % des patients n’étaient pas immunisés contre la varicelle, ce taux étant supérieur parmi les patients originaires des Amériques (21 %, p < 0,001). Conclusion Cette étude met en lumière l’importance des tests de dépistage des maladies infectieuses parmi les patients réfugiés dans le but de leur offrir des soins préventifs et curatifs prompts. Nos données exposent également certaines répercussions politiques et cliniques potentielles, telles que des approches de dépistage ciblé et un meilleur accès à la vaccination et aux soins thérapeutiques.

[Assessment of the acceptance of set meals served at the "Sant Joan de Reus" University Hospital].

PubMed

Guillén, N; Torrentó, M; Alvadalejo, R; Salas-Salvadó, J

2004-01-01

Despite the fact that, in most of the series published, cancer is the most frequent base pathology for the indication of home parenteral nutrition (HPN), the use of this technique in terminally-ill patients is still a controversial issue. Our goal has been to review the evolution of cancer patients with HPN treatment from "La Paz" Hospital with a view to studying the indication, evolution and complications. We review a total of 9 terminal oncological patients who had been treated with HPN between January 2000 and December 2002, with a mean age of 60.4 (44-81) years, the most common base cancer was gastric adenocarcinoma (44%). Intestinal obstruction in the context of peritoneal carcinomatosis was the reason for indicating HPN in 89% of cases and the median survival time was 71 (23-131) days. Catheter infection was the most frequent complication with 1.4 episodes/patient. The existence of a Home Support Team meant follow-up of patients was easier, with HPN being estimated as the treatment provided in 67% of cases. 56% of the patients were not sufficiently informed as to their underlying illness. Although HPN is one more therapeutic resource, which may or may not be used in some terminal oncological patients, we must refine the indication as much as possible to take into account a series of "systematic guarantees" including fulfilment of pertinent clinical criteria, informed consent and the adoption of a collective decision with the involvement of all the professionals monitoring the patient. We propose an action algorithm to help in improving the decision-taking process in these patients.

État de santé des nouveaux réfugiés à Toronto, en Ontario

PubMed Central

Redditt, Vanessa J.; Graziano, Daniela; Janakiram, Praseedha; Rashid, Meb

2015-01-01

Résumé Objectif Déterminer la prévalence de certaines maladies chroniques parmi les nouveaux réfugiés et la présence ou non d’une variation en fonction de facteurs démographiques clés. Conception Revue rétrospective de dossiers. Contexte Clinique de soins primaires pour patients réfugiés à Toronto, en Ontario. Participants Au total, 1063 patients réfugiés inscrits à la clinique entre décembre 2011 et juin 2014. Principaux paramètres à l’étude Données démographiques (âge, sexe et pays de naissance); prévalence de résultats anormaux au test Pap, d’anémie, d’élévation de la tension artérielle (TA) et de présence de marqueurs de prédiabète ou de diabète (glycémie aléatoire, glycémie à jeun ou taux d’hémoglobine A1c élevés). Résultats Plus de la moitié de nos patients étaient des femmes (56 %) et l’âge médian était de 29 ans. Les réfugiés étaient nés dans 87 pays différents. Les pays d’origine du plus grand nombre de réfugiés étaient la Hongrie (210 patients), la Corée du Nord (119 patients) et le Nigéria (93 patients). La plupart des patients sont arrivés à titre de demandeurs d’asile (92 %) plutôt qu’à titre de réfugiés pris en charge par le gouvernement (5 %). Dans l’ensemble, 11 % des patientes ayant subi un test Pap ont obtenu des résultats de cytologie cervicale anormaux, ce taux étant le plus élevé parmi les patientes originaires d’Asie (26 %; p = 0,028). La prévalence d’anémie parmi les enfants de moins de 15 ans était de 11 %; et elle était de 14 % parmi les enfants de moins de 5 ans. Environ 25 % des femmes de plus de 15 ans étaient anémiques, ce taux était le plus élevé parmi les patientes originaires d’Afrique (37 %; p < 0,001). L’élévation de la TA a été observée chez 30 % des adultes de plus de 15 ans, ce taux étant supérieur parmi les patients de sexe masculin (38 %; p < 0,001) et originaires d’Europe (42 %; p < 0,001). Les marqueurs biologiques de prédiabète ou de diabète ont été détectés chez 8 % des patients de plus de 15 ans, ce taux étant supérieur parmi les patients originaires d’Europe (15 %; p = 0,026). Conclusion Cette étude a mis en évidence un fardeau notable de maladies chroniques parmi les réfugiés, y compris d’anémie, d’élévation de la TA et de piètre contrôle de la glycémie, de même que de résultats anormaux de cytologie cervicale. Ces résultats mettent en lumière l’importance de permettre aux réfugiés d’accéder à des soins primaires complets, en mettant l’accent sur la prévention et la prise en charge des maladies chroniques en plus de la prise en charge des maladies infectieuses.

La gestion des gestionnaires de projets: Le cas de l'industrie aerospatiale au Quebec

NASA Astrophysics Data System (ADS)

Petit, Marie-Claude

This research focuses on the management of project managers (PMs) working in high technology organizations. In particular, it examines how these professionals are taken charge of from a human resources management (HRM) standpoint in firms within the aerospace industry in Quebec. The literature in the field of project management generally depicts PMs as entrepreneurs and resource managers, managing human resources (e.g. project team members) among other things. It also defines them as single-handedly responsible for managing their own career, stress and motivation. This profile suggests that once selected and assigned to projects, PMs receive little attention in terms of HRM from the organization. It is hardly conceivable, however, that PMs would move about completely on their own within the organization, let alone that they wouldn't represent any special challenge in terms of HRM, as the ones the literature so clearly underlines for project team members. The review of the literature also reveals that the subject of HRM as applied to PMs is poorly documented empirically, especially on the topic of what particular challenges the project context might bring up for the HRM of PMs. There is also little told about the actors involved in supporting and contributing to meet the challenges that arise out of managing PMs. This study sought to discern those challenges and the means put forth to address them. Also, it wanted to identify the actors of the HRM of PMs, their roles, their skills, and their relationships, among themselves and with the PMs, in order to efficiently take charge of them. This study also wanted to demonstrate the logic that ties the means put forth by the identified actors with the objectives PM-employing organizations want to reach. Finally, the study wanted to identify the impact of the HRM of PMs as it is occurring in organizations. The Quebec aerospace sector was chosen as the field of research primarily because the success of projects in organizations of that sector, alongside regular manufacturing operations, seems to contribute to their performance. In fact, most of these organizations currently are industry leaders worldwide. The data that form the basis of this research were obtained through 65 semi-structured interviews with representatives of project management, HRM and upper management in eight organizations in the aerospace industry in Quebec. First, the collected data was treated case by case using the qualitative data analysis software application Atlas.ti. Subsequently, the description and interpretation of the data were developed in a transversal way to achieve a sector-wide portrait of the HRM of PMs. The results reveal that PMs, like other human resources, do present particular HRM challenges and are actually managed as such in the organizations. PMs benefit both from traditional HRM practices (collective HRM) and from the relationship established and maintained with their immediate manager (individualized HRM). A network of actors is also involved in the HRM of PMs. Among these, the immediate manager of PMs stands out as the key HRM actor. In addition to applying HRM policies and practices to PMs, the manager of PMs, in his position of proximity with PMs, is destined to play different roles such as coach, motivator and talent agent. This hybrid HRM of PMs provides a sense of well-being among PMs and allows organizations to retain these creators of value, it secures faithful customers (repeat business) as a consequence of the success of projects managed by those PMs, and contributes to build a pool for their future managerial elite. Keywords: project management, human resource management, project manager, proximity management, high technology, aerospace industry, Quebec.

Training Entrepreneurship at a French Grande Ecole: The Projet Entreprendre at the ESC Rouen

ERIC Educational Resources Information Center

Klapper, Rita

2005-01-01

Purpose: In response to an identified information need about entrepreneurial teaching methods employed in the European higher education system, aims to investigate whether this type of experimentation could make a difference--an activity traditionally considered individualistic within a collectivist society--and, second, to evaluate the project in…

Etude de la transmission sonore a travers un protecteur de type "coquilles" : modelisation numerique et validation experimentale

NASA Astrophysics Data System (ADS)

Boyer, Sylvain

On estime que sur les 3,7 millions des travailleurs au Quebec, plus de 500 000 sont exposes quotidiennement a des niveaux de bruits pouvant causer des lesions de l'appareil auditif. Lorsqu'il n'est pas possible de diminuer le niveau de bruit environnant, en modifiant les sources de bruits, ou en limitant la propagation du son, le port de protecteurs auditifs individualises, telles que les coquilles, demeure l'ultime solution. Bien que vue comme une solution a court terme, elle est communement employee, du fait de son caractere peu dispendieux, de sa facilite d'implantation et de son adaptabilite a la plupart des operations en environnement bruyant. Cependant les protecteurs auditifs peuvent etre a la fois inadaptes aux travailleurs et a leur environnement et inconfortables ce qui limite leur temps de port, reduisant leur protection effective. Afin de palier a ces difficultes, un projet de recherche sur la protection auditive intitule : " Developpement d'outils et de methodes pour ameliorer et mieux evaluer la protection auditive individuelle des travailleur ", a ete mis sur pied en 2010, associant l'Ecole de technologie superieure (ETS) et l'Institut de recherche Robert-Sauve en sante et en securite du travail (IRSST). S'inscrivant dans ce programme de recherche, le present travail de doctorat s'interesse specifiquement a la protection auditive au moyen de protecteurs auditifs " passifs " de type coquille, dont l'usage presente trois problematiques specifiques presentees dans les paragraphes suivants. La premiere problematique specifique concerne l'inconfort cause par exemple par la pression statique induite par la force de serrage de l'arceau, qui peut reduire le temps de port recommande pour limiter l'exposition au bruit. Il convient alors de pouvoir donner a l'utilisateur un protecteur confortable, adapte a son environnement de travail et a son activite. La seconde problematique specifique est l'evaluation de la protection reelle apportee par le protecteur. La

Envenimation scorpionique compliqué d'un accident vasculaire cérébral ischemique

PubMed Central

Bibiche, Youssef; Berdai, Adnan; Labib, Smael; Harandou, Mustapha

2015-01-01

Les piqûres de scorpion sont dans un certain nombre de pays, un accident fréquemment rencontré, et un risque grave. Au Maroc, les données épidémiologiques établies par le centre anti-poison (CAPM) montrent que les piqûres scorpioniques se placent en tête de toutes les intoxications relevées par le centre (60%). Les envenimations scorpioniques posent un grand problème de santé publique. L'apparition de signes neurologiques lors d'une envenimation scorpionique témoigne d'une envenimation grave et correspond au stade III de l’échelle de sévérité. Nous rapportons le cas d'une envenimation scorpionique compliqué d'un Accident vasculaire cérébral ischémique (AVCI) chez un enfant. PMID:26175806

A pilot study for the integration of cytometry reports in digital cytology telemedicine applications.

PubMed

Giansanti, Daniele; Cerroni, Fabio; Amodeo, Rachele; Filoni, Marco; Giovagnoli, Maria Rosaria

2010-01-01

Up to date, tele-pathology in the three different forms of application, "dynamic", "static" and "virtual microscopy" has been mainly based on tele-hystology remote consulting. Today the diffusion of specialized WAN connections is guiding the research of new applications of tele-pathology. A specific analysis has been conducted, focused on digital cytology, in the biomedical laboratory of Sant'Andrea Hospital to investigate the technologies potentially useful to integrate in the LAN/WAN for telemedicine applications. Among the possible tools useful to be integrated in the LAN/WAN for telemedicine applications, the cytometry equipment available in the technical unity of cytometry has been considered important. The study finally provides a proposal for a tele-consulting architecture for the integration of cytometry reports both in the hospital LAN and the WAN for possible cooperative diagnosis and second opinion support.

Different decay patterns observed in a nineteenth-century building (Palma, Spain).

PubMed

Genestar, Catalina; Pons, Carmen; Cerro, José Carlos; Cerdà, Víctor

2014-01-01

The effects of atmospheric pollutants and climatic conditions were studied in a decayed column in the Seminary of Sant Pere. This nineteenth-century building is situated in the historic centre of Palma (Mallorca, Spain), less than 0.5 km from the sea. Samples were collected from the internal and external part of the crusts formed in the four sides of the column. The samples were analysed by means of thermal analysis, X-ray diffractometry, scanning electron microscopy, Fourier transform infrared spectroscopy and ion chromatography. Results show significant differences in the four sides of the column. A high degree of carbonate stone sulfation is observed in all of the samples analysed. A synergistic effect between atmospheric factors and micropollutants on the deterioration of stone is observed. A high uptake of atmospheric particulate matter is found in the external part of the black crusts.

From medico-administrative databases analysis to care trajectories analytics: an example with the French SNDS.

PubMed

Drezen, Erwan; Guyet, Thomas; Happe, André

2018-02-01

Medico-administrative data like SNDS (Système National de Données de Santé) are not collected initially for epidemiological purposes. Moreover, the data model and the tools proposed to SNDS users make their in-depth exploitation difficult. We propose a data model, called the ePEPS model, based on healthcare trajectories to provide a medical view of raw data. A data abstraction process enables the clinician to have an intuitive medical view of raw data and to design a study-specific view. This view is based on a generic model of care trajectory, that is a sequence of time stamped medical events for a given patient. This model is combined with tools to manipulate care trajectories efficiently. © 2017 Société Française de Pharmacologie et de Thérapeutique.

Viridans streptococcal shock syndrome during bone marrow transplantation.

PubMed

Martino, R; Manteiga, R; Sánchez, I; Brunet, S; Sureda, A; Badell, I; Argilés, B; Subirá, M; Bordes, R; Domingo-Albós, A

1995-01-01

Of 320 patients receiving a marrow transplant at the Hospital de Sant Pau between 1986 and 1992, 12% developed viridans streptococcal bacteremia during severe neutropenia. Five of these patients (13%) developed a rapidly progressive fatal shock syndrome characterized by bilateral pulmonary infiltrates, acute respiratory failure (ARDS) and septic shock early in the transplantation course (6 or 7 days posttransplantation). All patients were transplanted for acute leukemia in remission, and 2 received an allogeneic and 3 an autologous transplant. Four of these subjects were younger than 15 years of age and all had received cyclophosphamide and total body irradiation as conditioning regimen for marrow transplantation. All 5 patients died, and postmortem examinations revealed diffuse pulmonary lesions characteristic of the ARDS. These observations contribute to defining the clinical and pathologic characteristics of this serious complication of intensive anticancer treatment.

Plasma behaviour in the neighbourhood of the hot-spot during an active experiment

NASA Astrophysics Data System (ADS)

Sallago, Patricia

In order to study the physical quantities that characterize a plasma, several active experiments have been done by many researcher groups around the world. These experimental papers, describing their measurements and the observed phenomena under a variety of geomagnetical conditions, bring some clues about the plasma behaviour in the neighbourhood of the hot-spot during and soon after the turn-off of ionospheric heating devices. A review of these works was faced in the frame of the application of IAR (Argentinian Radioas-tronomy Institute), La Plata, Argentine, as a site of installation for the AMISR (Advanced Modular Incoherent Scatter Radar), in a contest of research projets called by NSF (National Scientific Foundation). The present contribution gives a possible theoretical explanation, based on the generation and propagation of Alfven waves, of the plasma behaviour in the neighbourhood of the hot-spot during an active experiment and, as a consequence, for some experimental results.

Guide de pratique clinique pour les lésions cérébrales traumatiques légères et les symptômes persistants

PubMed Central

Marshall, Shawn; Bayley, Mark; McCullagh, Scott; Velikonja, Diana; Berrigan, Lindsay

2012-01-01

Résumé Objectif Présenter les nouvelles lignes directrices sur la prise en charge des lésions cérébrales traumatiques légères (LCTL) et les symptômes persistants post-commotion (SPPC) afin de renseigner et d’orienter les médecins qui prennent en charge des patients qui se remettent d’une LCTL. Qualité des données On a effectué une recherche des guides de pratique clinique existants portant sur les LCTL et une synthèse critique des ouvrages scientifiques évaluant le traitement des SPPC. Étant donné la rareté des conseils sur la prise en charge des SPPC dans les travaux sur les lésions cérébrales traumatiques, une deuxième recherche documentaire a été faite pour recenser les guides de pratique clinique et les synthèses critiques concernant la prise en charge de ces symptômes communs dans la population en général. On a convoqué des professionnels de la santé provenant de différentes disciplines et régions du Canada et de l’étranger à une conférence consensuelle d’experts pour examiner les lignes directrices et les données probantes existantes et élaborer un guide complet pour la prise en charge des LCTL et des SPPC. Message principal À l’aide d’un processus Delphi modifié, on a produit 71 recommandations portant sur le diagnostic et la prise en charge des LCTL et des SPPC. De plus, on a inclus dans le guide de nombreuses ressources et des outils pour faciliter la mise en œuvre des recommandations. Conclusion Un guide de pratique clinique a été élaboré pour aider les professionnels de la santé à fournir des soins fondés sur les données probantes et les pratiques exemplaires à la population complexe de personnes qui ont des SPPC à la suite d’une LCTL.

Médecine des voyages

PubMed Central

Aw, Brian; Boraston, Suni; Botten, David; Cherniwchan, Darin; Fazal, Hyder; Kelton, Timothy; Libman, Michael; Saldanha, Colin; Scappatura, Philip; Stowe, Brian

2014-01-01

Résumé Objectif Définir la pratique de la médecine des voyages, présenter les éléments fondamentaux d’une consultation complète préalable aux voyages à des voyageurs internationaux et aider à identifier les patients qu’il vaudrait mieux envoyer en consultation auprès de professionnels de la médecine des voyages. Sources des données Les lignes directrices et les recommandations sur la médecine des voyages et les maladies liées aux voyages publiées par les autorités sanitaires nationales et internationales ont fait l’objet d’un examen. Une recension des ouvrages connexes dans MEDLINE et EMBASE a aussi été effectuée. Message principal La médecine des voyages est une spécialité très dynamique qui se concentre sur les soins préventifs avant un voyage. Une évaluation exhaustive du risque pour chaque voyageur est essentielle pour mesurer avec exactitude les risques particuliers au voyageur, à son itinéraire et à sa destination et pour offrir des conseils sur les interventions les plus appropriées en gestion du risque afin de promouvoir la santé et prévenir les problèmes médicaux indésirables durant le voyage. Des vaccins peuvent aussi être nécessaires et doivent être personnalisés en fonction des antécédents d’immunisation du voyageur, de son itinéraire et du temps qu’il reste avant son départ. Conclusion La santé et la sécurité d’un voyageur dépendent du degré d’expertise du médecin qui offre le counseling préalable à son voyage et les vaccins, au besoin. On recommande à ceux qui donnent des conseils aux voyageurs d’être conscients de l’ampleur de cette responsabilité et de demander si possible une consultation auprès de professionnels de la médecine des voyages pour tous les voyageurs à risque élevé.

Incidence des infections du site opératoire en Afrique sub-saharienne: revue systématique et méta-analyse

PubMed Central

Ngaroua; Ngah, Joseph Eloundou; Bénet, Thomas; Djibrilla, Yaouba

2016-01-01

Introduction Les Infections du Sites Opératoire (ISO) sont à l’origine de morbi-mortalité et des dépenses supplémentaires en santé. Les pays en développement en sont les plus touchés. L’objectif était d’estimer l’incidence poolée des ISO en Afrique Sub-saharienne et décrire ses principaux facteurs de risque. Méthodes Une revue systématique et une méta-analyse ont été effectuées à partir des bases de données de l’Organisation Mondiale de la Santé pour la Région Afrique, de PubMed et par recherche standard afin de sélectionner des articles électroniquespubliés entre 2006 et 2015. Seuls les articlestraitants de l’incidence et desfacteurs de risque des ISOdans les pays del’Afrique subsaharienneétaient retenus. Résultats Sur 95 articles trouvés, 11 ont répondu aux critères d’inclusion. Seulement 9 pays sur les 45 y ont contribués avec une grandereprésentation du Nigéria (5 articles sur 11). L’incidence des ISO variaient de 6,8% à 26% avec une prédominance en chirurgie générale. L’incidence poolée des ISO était de 14.8% (IC à 95%: 15,5-16,2%), avec une importante hétérogénéité selon la spécialité et le mode de surveillance. Les facteurs de risque les plus citésétaient la longue durée d’intervention et la classe de contamination d’Altemeir 3 et 4. Les autres facteurs concernaient l’environnement hospitalier, les pratiques de soins inadéquats et les pathologies sous-jacentes. Conclusion L’incidence des ISO est élevée en Afrique subsaharienne, des études dans cette région pourrait améliorer la connaissance, laprévention et la maitrise deces multiples facteurs de risques. PMID:27795768

Prises de risques chez les jeunes de Bobo Dioulasso: une analyse des facteurs associés à la précocité et au multipartenariat sexuel

PubMed Central

Adohinzin, Clétus Come; Meda, Nicolas; Belem, Adrien Marie Gaston; Ouédraogo, Georges Anicet; Sombie, Issiaka; Berthe, Abdramane; Fond-Harmant, Laurence

2016-01-01

Introduction Malgré les efforts d'éducation à la santé, les jeunes continuent d'adopter des comportements sexuels à risques, susceptibles d'avoir des répercussions importantes sur leur santé. Cette étude visait à analyser les facteurs associés à la précocité sexuelle et au multipartenariat chez les jeunes de 19-24 ans de Bobo-Dioulasso. Méthodes Il s'agit d'une étude quantitative et transversale. Les données d'enquête ont été recueillies en décembre 2014 à Bobo-Dioulasso (Burkina Faso), auprès de 573 jeunes de 15 à 24 ans. Ces enquêtés ont été sélectionnés par un sondage en grappes à deux degrés. Des facteurs à risques relatifs à la précocité sexuelle et au multipartenariat ont été analysés à l'aide du logiciel Stata IC 13. Le seuil de signification de P<0,05 a été utilisée. Résultats Plus de la moitié des enquêtés (54%) étaient sexuellement actifs dont 14% avant l'âge de 16 ans. Le multipartenariat sexuel avait été observé chez 24% des jeunes sexuellement actifs. Parmi les facteurs déterminants de la précocité sexuelle et du multipartenariat figuraient l'âge, le sexe, le niveau d'étude, et la situation économique des parents. Nos données avaient aussi montré que les rapports sexuels trop précoces étaient associés au multipartenariat sexuel (p<0,005). Conclusion Les actions visant à renforcer les capacités des jeunes à retarder les premiers rapports sexuels et à mieux évaluer les risques seront de toute importance. Les capacités des parents, des enseignants et des prestataires devraient être aussi renforcées pour l'amélioration de la qualité des relations entre eux et les jeunes. PMID:28292094

E-formation à la stérilisation en situation d’isolement: solution retenue par l’armée Française

PubMed Central

Rouault, Mederic; Vonesch, Marie-Audrey; Dussart, Claude

2017-01-01

Le service de Santé des Armées assure le soutien sanitaire des forces armées déployées en opération extérieure. Afin d'assurer la même qualité de soin sur le théâtre et en Métropole, le Service de Santé des Armées réalise la stérilisation des dispositifs médicaux réutilisables par ses propres moyens. Le pharmacien militaire en mission sur place provient de différents horizons: laboratoire de biologie médicale, recherche, ravitaillement sanitaire, pharmacie hospitalière ou encore officine pour certains réservistes. Une formation à la pratique de la stérilisation en situation d'isolement est donc nécessaire afin d'assurer une uniformité des connaissances. Notre travail s'est articulé en deux temps: détermination des besoins et des modalités de formation adaptés, puis construction de la formation proprement dite. Cette formation doit être accessible à un public dispersé géographiquement dont les niveaux d'expertise en stérilisation sont disparates. Le module « préparation opérationnelle à la stérilisation en Opération Extérieure » réalisé permet d'actualiser et d'uniformiser les connaissances des pharmaciens déployés. Il est composé de 11 sous-modules couvrant les différents aspects de la stérilisation en Opération Extérieure. Une évaluation, à l'aide de questions à choix multiples (QCM), est nécessaire pour vérifier le niveau de connaissance et de compréhension à la fin de la formation. Un taux de bonne réponse de 75% est demandé pour valider la formation. Le contenu de la formation a été approuvé par les référents nationaux en stérilisation et est d'ores et déjà disponible sur la plateforme de formation e-learning de l'Ecole du Val de Grace. PMID:28690738

Nucleosome mobilization by ISW2 requires the concerted action of the ATPase and SLIDE domains

PubMed Central

Hota, Swetansu K.; Bhardwaj, Saurabh K.; Deindl, Sebastian; Lin, Yuan-chi; Zhuang, Xiaowei; Bartholomew, Blaine

2013-01-01

The ISWI family of ATP-dependent chromatin remodelers represses transcription by changing nucleosome positioning. The interactions with extranucleosomal DNA and the requirement of a minimal length of extranucleosomal DNA by ISWI mediate the spacing of nucleosomes. ISW2 from Saccharomyces cerevisiae, a member of the ISWI family, has a conserved domain called SLIDE (SANT-like ISWI domain), whose binding to extranucleosomal DNA ~19 bp from the edge of nucleosomes is required for efficiently pushing DNA into nucleosomes and maintaining the unidirectional movement of nucleosomes, as reported here. Loss of SLIDE binding does not perturb ATPase domain binding to the SHL2 site of nucleosomes or its initial movement of DNA inside of nucleosomes. ISW2 has therefore two distinct roles in mobilizing nucleosomes, with the ATPase domain translocating and moving DNA inside nucleosomes, and the SLIDE domain facilitating the entry of linker DNA into nucleosomes. PMID:23334290

The emergence of precision therapeutics: New challenges and opportunities for Canada's health leaders.

PubMed

Slater, Jim; Shields, Laura; Racette, Ray J; Juzwishin, Donald; Coppes, Max

2015-11-01

In the era of personalized and precision medicine, the approach to healthcare is quickly changing. Genetic and other molecular information are being increasingly demanded by clinicians and expected by patients for prevention, screening, diagnosis, prognosis, health promotion, and treatment of an increasing number of conditions. As a result of these developments, Canadian health leaders must understand and be prepared to lead the necessary changes associated with these disruptive technologies. This article focuses on precision therapeutics but also provides background on the concepts and terminology related to personalized and precision medicine and explores Canadian health leadership and system issues that may pose barriers to their implementation. The article is intended to inspire, educate, and mobilize Canadian health leaders to initiate dialogue around the transformative changes necessary to ready the healthcare system to realize the benefits of precision therapeutics. © 2015 Collège canadien des leaders en santé

Dégénérescence Maculaire Liée à l' âge et Risque d' Accident Vasculaire Cérébral

PubMed Central

Biousse, Valérie; Bousser, Marie-Germaine; Gaudric, Alain

2010-01-01

La dégénérescence maculaire liée à l' âge (DMLA) et les accidents vasculaires cérébraux (AVC) affectent un nombre important de sujets de plus de 40 ans à travers le monde et contribuent largement aux dépenses de la santé. Les causes de la DMLA restent mystérieuses et de nombreuses études épidémiologiques ont suggéré une association entre DMLA et facteurs de risque cardio-vasculaire associés aux AVC. Il a également été suggéré que les patients atteints de DMLA ont un risque plus important d' AVC que la population générale du même âge. Les arguments en faveur de cette association entre DMLA et AVC sont résumés dans cet article. PMID:18401309

ERDA authorization, Fiscal Year 1977. Part I. Conservation. Hearings before the Subcommittee on Energy Research, Development and Demonstration of the Committee on Science and Technology, U. S. House of Representatives, Ninety-Fourth Congress, Second Session

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1976-01-01

The hearing was the first in a series of nine before the subcommittee in connection with the fiscal year 1977 ERDA authorization bill. The ERDA conservation program and its funding are reviewed and Representative Ray Thornton, presiding, announced that Congress was expected to pass significant energy conservation legislation to augment the existing ERDA program. Included here is a statement on the issue by Mr. Austin N. Heller, Asst. Administrator for Conservation, ERDA, who was accompanied by his division directors--Mr. Francis Parry, Mr. John Brogan, Dr. Maxine Savitz, Dr. John Belding, and Mr. George Murray. Another statement was presented by Rogermore » W. Sant, Asst. Administrator for Energy, FEA. Additional statements are presented in Appendix I by Mr. Lowell Endahl, National Rural Electric Cooperative Association, and Mr. Wes Uhlman, Mayor of Seattle, Wash. Additional information is presented in three other appendixes. (MCW)« less

[Consequences of an institutionalized childhood: the case of the "Duplessis orphans"].

PubMed

Boucher, Sophie; Paré, Nikolas; Perry, J Christopher; Sigal, John J; Ouimet, Marie-Claude

2008-01-01

Whereas the immediate consequences of institutionalized placements on children have been documented, no study has investigated adults who were raised in orphanages or institutions. In Quebec, les enfants de Duplessis offer a unique testimony of the long term consequences of an institutionalized childhood. Stories collected from 40 men and 41 women who grew up in institution in Duplessis'era indicate a high number of abuse and aversive experiences, including physical, psychological and sexual aggressions. In addition, the environment was poor in stimulation and opportunities to develop positive attachment relationships with adults. When matched and compared to adults from the Santé-Québec survey, les enfants de Duplessis report a higher number of health problems associated with stress and more psychological distress. Moreover, our results indicate that those who had fewer strengths and aptitudes in childhood are the most affected by unfavourable experiences.

CONCLUSIONS ET RECOMMANDATIONS À L’ISSUE DE LA CONSULTATION DE L’OMS SUR LA LUTTE CONTRE LA CARENCE MARTIALE CHEZ LE NOURRISSON ET LE JEUNE ENFANT DANS LES PAYS D’ENDÉMIE PALUSTRE

PubMed Central

Allen, L.; Black, R.E.; Brandes, N.; Brittenham, G.; Chazot, G.; Chunming, C.; Crawley, J.; de Benoist, B.; Dalmiya, N.; Darnton-Hill, I.; Dewey, K.; El-Arifeen, S.; Fontaine, O.; Geissler, C.; Haberle, H.; Harvey, P.; Hasler, J.; Hershko, C.; Hurrell, R.; Juma, M.A.; Lönnerdal, B.; Lozoff, B.; Lynch, S.; Salgado, H. Martines; McLean, E.; Metz, J.; Oppenheimer, S.; Premji, Z.; Prentice, A.; Ramsan, M.; Ratledge, C.; Stoltzfus, R.; Tielsch, J.; Winachagoon, P.

2011-01-01

Cet article présentent les résultats d'une Consultation d'Experts dont l'objectif était d'évaluer l'efficacité et l'innocuité des suppléments de fer administrés aux nourrissons et aux jeunes enfants dans les zones d’endémie palustre, ainsi que les conséquences d’une telle mesure pour la santé publique. Les participants à cette Consultation, qui s’est déroulée à Lyon (France) les 12–14 juin 2006, se sont entendus sur plusieurs questions importantes concernant l’administration d’une supplémentation martiale aux nourrissons et aux jeunes enfants dans les zones d’endémie palustre. Les conclusions du présent rapport s’appliquent plus particulièrement aux pays où le paludisme est endémique. PMID:18630054

The 120-S minute: using analysis of work activity to prevent psychological distress among elementary school teachers.

PubMed

Messing, K; Seifert, A M; Escalona, E

1997-01-01

Primary school teachers in Québec suffer psychological distress, as shown by the Québec Health Survey (M. Gervais, 1993; Santè Québec, 1995). The authors applied and extended the French model (F. Guérin, A. Laville, F. Daniellou, J. Duraffourg, & A. Kerguelen, 1991) of analysis of work activity to observing classroom teaching (14 women in 10 classrooms for a total of 48 hr 24 min) to identify stressful elements. The authors observed a rapid sequence of actions, eye fixations of short duration, little physical or mental relaxation, multiple simultaneous activities, and uncomfortable temperature and humidity levels. Teachers use many strategies to teach, to create a learning environment, and to maintain attention in classrooms under adverse conditions. Examination of these strategies led to recommendations to improve relations between the teachers and their supervisors and to make the classroom an easier place to teach.

Algorithmes de couplage RANS et ecoulement potentiel

NASA Astrophysics Data System (ADS)

Gallay, Sylvain

Dans le processus de developpement d'avion, la solution retenue doit satisfaire de nombreux criteres dans de nombreux domaines, comme par exemple le domaine de la structure, de l'aerodynamique, de la stabilite et controle, de la performance ou encore de la securite, tout en respectant des echeanciers precis et minimisant les couts. Les geometries candidates sont nombreuses dans les premieres etapes de definition du produit et de design preliminaire, et des environnements d'optimisations multidisciplinaires sont developpes par les differentes industries aeronautiques. Differentes methodes impliquant differents niveaux de modelisations sont necessaires pour les differentes phases de developpement du projet. Lors des phases de definition et de design preliminaires, des methodes rapides sont necessaires afin d'etudier les candidats efficacement. Le developpement de methodes ameliorant la precision des methodes existantes tout en gardant un cout de calcul faible permet d'obtenir un niveau de fidelite plus eleve dans les premieres phases de developpement du projet et ainsi grandement diminuer les risques associes. Dans le domaine de l'aerodynamisme, les developpements des algorithmes de couplage visqueux/non visqueux permettent d'ameliorer les methodes de calcul lineaires non visqueuses en methodes non lineaires prenant en compte les effets visqueux. Ces methodes permettent ainsi de caracteriser l'ecoulement visqueux sur les configurations et predire entre autre les mecanismes de decrochage ou encore la position des ondes de chocs sur les surfaces portantes. Cette these se focalise sur le couplage entre une methode d'ecoulement potentiel tridimensionnelle et des donnees de section bidimensionnelles visqueuses. Les methodes existantes sont implementees et leurs limites identifiees. Une methode originale est ensuite developpee et validee. Les resultats sur une aile elliptique demontrent la capacite de l'algorithme a de grands angles d'attaques et dans la region post

Conversion du methanol en ethanol par carbonylation suivie d'hydrogenolyse

NASA Astrophysics Data System (ADS)

Gaucher, Melissa

Ce projet de maîtrise s'inscrit dans le cadre des nouvelles filières énergétiques renouvelables et s'effectue au sein de la Chaire de recherche industrielle sur l'éthanol cellulosique créée par trois partenaires industriels (Enerkem, CRB et Ethanol Greenfield) et le gouvernement du Québec en collaboration avec l'Université de Sherbrooke. La stratégie d'un des partenaires, Enerkem, est de convertir par gazéification des résidus de biomasse non homogène en Syngas, ce gaz est ensuite converti en méthanol puis en éthanol. L'objectif principal de ce projet est la conversion catalytique de l'acétate en alcool. Un catalyseur commercial, composé de cuivre et de chrome, a permis l'obtention des conversions de plus de 95 % et une sélectivité pour l'éthanol de plus de 50 % avec l'acétate de méthyle, de 99 % avec l'acétate d'éthyle et de 50 % avec l'acétate de butyle. Les conditions optimales trouvées impliquent une température de 215 °C, une pression de 350 psig, une vitesse spatiale de 1800 h -1 H2 STP et un ratio H2 : Acétate de 7. Un catalyseur alternatif, à base de cuivre et de zinc, a aussi été testé. L'objectif secondaire est la carbonylation du méthanol en acétate. Cette étape a été réalisée en phase gazeuse où des rendements très élevés, soit plus de 2000 kg d'acétate de méthyle par kg de métal précieux à l'heure (kg AM/ kg métal précieux/h), ont été obtenus. Les conditions d'opérations testées impliquent une température variant entre 200-240 °C, une pression entre 250-600 psig, des ratios McOH : CO de 1 à 2,5. Mots clés: Carbonylation, Éthanol, Hydrogénolyse, Catalyse hétérogène.

Conception et optimisation d'une peau en composite pour une aile adaptative =

NASA Astrophysics Data System (ADS)

Michaud, Francois

Les preoccupations economiques et environnementales constituent des enjeux majeurs pour le developpement de nouvelles technologies en aeronautique. C'est dans cette optique qu'est ne le projet MDO-505 intitule Morphing Architectures and Related Technologies for Wing Efficiency Improvement. L'objectif de ce projet vise a concevoir une aile adaptative active servant a ameliorer sa laminarite et ainsi reduire la consommation de carburant et les emissions de l'avion. Les travaux de recherche realises ont permis de concevoir et optimiser une peau en composite adaptative permettant d'assurer l'amelioration de la laminarite tout en conservant son integrite structurale. D'abord, une methode d'optimisation en trois etapes fut developpee avec pour objectif de minimiser la masse de la peau en composite en assurant qu'elle s'adapte par un controle actif de la surface deformable aux profils aerodynamiques desires. Le processus d'optimisation incluait egalement des contraintes de resistance, de stabilite et de rigidite de la peau en composite. Suite a l'optimisation, la peau optimisee fut simplifiee afin de faciliter la fabrication et de respecter les regles de conception de Bombardier Aeronautique. Ce processus d'optimisation a permis de concevoir une peau en composite dont les deviations ou erreurs des formes obtenues etaient grandement reduites afin de repondre au mieux aux profils aerodynamiques optimises. Les analyses aerodynamiques realisees a partir de ces formes ont predit de bonnes ameliorations de la laminarite. Par la suite, une serie de validations analytiques fut realisee afin de valider l'integrite structurale de la peau en composite suivant les methodes generalement utilisees par Bombardier Aeronautique. D'abord, une analyse comparative par elements finis a permis de valider une rigidite equivalente de l'aile adaptative a la section d'aile d'origine. Le modele par elements finis fut par la suite mis en boucle avec des feuilles de calcul afin de valider la

Reticulation des fibres lignocellulosiques

NASA Astrophysics Data System (ADS)

Landrevy, Christel

Pour faire face à la crise économique la conception de papier à valeur ajoutée est développée par les industries papetières. Le but de se projet est l'amélioration des techniques actuelles de réticulation des fibres lignocellulosiques de la pâte à papier visant à produire un papier plus résistant. En effet, lors des réactions de réticulation traditionnelles, de nombreuses liaisons intra-fibres se forment ce qui affecte négativement l'amélioration anticipée des propriétés physiques du papier ou du matériau produit. Pour éviter la formation de ces liaisons intra-fibres, un greffage sur les fibres de groupements ne pouvant pas réagir entre eux est nécessaire. La réticulation des fibres par une réaction de « click chemistry » appelée cycloaddition de Huisgen entre un azide et un alcyne vrai, catalysée par du cuivre (CuAAC) a été l'une des solutions trouvée pour remédier à ce problème. De plus, une adaptation de cette réaction en milieux aqueux pourrait favoriser son utilisation en milieu industriel. L'étude que nous désirons entreprendre lors de ce projet vise à optimiser la réaction de CuAAC et les réactions intermédiaires (propargylation, tosylation et azidation) sur la pâte kraft, en milieu aqueux. Pour cela, les réactions ont été adaptées en milieu aqueux sur la cellulose microcristalline afin de vérifier sa faisabilité, puis transférée à la pâte kraft et l'influence de différents paramètres comme le temps de réaction ou la quantité de réactifs utilisée a été étudiée. Dans un second temps, une étude des différentes propriétés conférées au papier par les réactions a été réalisée à partir d'une série de tests papetiers optiques et physiques. Mots Clés Click chemistry, Huisgen, CuAAC, propargylation, tosylation, azidation, cellulose, pâte kraft, milieu aqueux, papier.

Physical Science in Barcelona

NASA Astrophysics Data System (ADS)

Roca-Rosell, Antoni; Roqué, Xavier

2013-12-01

We provide a tour of Barcelona, Catalonia, Spain, following four routes through the city and one elsewhere in the city and beyond, focusing on sites of importance in physics. Route 1 covers the Old Town, its Gothic Quarter, Plaça del Rei, Plaça de Sant Jaume, and Jewish Quarter. Route 2 identifies sites on and close to La Rambla, the main promenade in the city. Route 3 goes from the medieval shipyards to the Board of Commerce to Citadel Park. Route 4 concentrates on the Extension ( Eixample) and covers the restored University, the Industrial University, and the new campus of the University of Barcelona. Elsewhere in the city and beyond are the Fabra Observatory; the Plaça de les Glòries with its large steel sculpture depicting the meridian arc from Dunkirk to Barcelona; Montjuïc, the site of the National Art Museum of Catalonia; and the National Museum of Science and Technology in Terrassa.

Medico-economic evaluation of healthcare products. Methodology for defining a significant impact on French health insurance costs and selection of benchmarks for interpreting results.

PubMed

Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Biot, Claire; Blachier, Corinne; Braun, Eric; Debroucker, Frédérique; Detournay, Bruno; Ferretti, Carine; Granger, Muriel; Jouan-Flahault, Chrystel; Lussier, Marie-Dominique; Meyer, Arlette; Muller, Sophie; Pigeon, Martine; De Sahb, Rima; Sannié, Thomas; Sapède, Claudine; Vray, Muriel

2014-01-01

Decree No. 2012-1116 of 2 October 2012 on medico-economic assignments of the French National Authority for Health (Haute autorité de santé, HAS) significantly alters the conditions for accessing the health products market in France. This paper presents a theoretical framework for interpreting the results of the economic evaluation of health technologies and summarises the facts available in France for developing benchmarks that will be used to interpret incremental cost-effectiveness ratios. This literature review shows that it is difficult to determine a threshold value but it is also difficult to interpret then incremental cost effectiveness ratio (ICER) results without a threshold value. In this context, round table participants favour a pragmatic approach based on "benchmarks" as opposed to a threshold value, based on an interpretative and normative perspective, i.e. benchmarks that can change over time based on feedback. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Paleodiet characterisation of an Etrurian population of Pontecagnano (Italy) by Isotope Ratio Mass Spectrometry (IRMS) and Atomic Absorption Spectrometry (AAS)(#).

PubMed

Scarabino, Carla; Lubritto, Carmine; Proto, Antonio; Rubino, Mauro; Fiengo, Gilda; Marzaioli, Fabio; Passariello, Isabella; Busiello, Gaetano; Fortunato, Antonietta; Alfano, Davide; Sabbarese, Carlo; Rogalla, Detlef; De Cesare, Nicola; d'Onofrio, Antonio; Terrasi, Filippo

2006-06-01

Human bones recovered from the archaeological site of Pontecagnano (Salerno, Italy) have been studied to reconstruct the diet of an Etrurian population. Two different areas were investigated, named Library and Sant' Antonio, with a total of 44 tombs containing human skeletal remains, ranging in age from the 8th to the 3rd century B.C. This time span was confirmed by 14C dating obtained using Accelerator Mass Spectrometry (AMS) on one bone sample from each site. Atomic Absorption Spectrometry (AAS) was used to extract information about the concentration of Sr, Zn, Ca elements in the bone inorganic fraction, whilst stable isotope ratio measurements (IRMS) were carried out on bone collagen to obtain the delta13C and delta15N. A reliable technique has been used to extract and separate the inorganic and organic fractions of the bone remains. Both IRMS and AAS results suggest a mixed diet including C3 plant food and herbivore animals, consistent with archaeological indications.

Technical-scientific investigations to detect the temporal vicissitudes of the funeral monument of Innocent VIII (Giovanbattista Cibo, 1484-1492), compared with that of Sixtus IV (Francesco della Rovere 1471-1484), both made by Antonio del Pollaiolo.

PubMed

Gabrielli, Nazzareno

2018-04-03

The restoration of the funeral monument of Innocent VIII (Giovan-Battista Cibo, 1484-1492) was executed by Sante Guido with the support of the Knights of Columbus. The praiseworthy intervention aimed at restoring the monument from polluting aerodynamic agents has at the same time enabled a careful study of the work regarding, above all, the authenticity of the current coloring in relation to the original presentation intended by Antonio del Pollaiolo. In particular, an attempt has been made to uncover the historical vicissitudes of the work: from its realization to the present restoration. In this regard, I would like to recall that, as reported by Pasquale Rotondi, the restoration of a work is a very special moment in which it is possible to carry out all the studies aimed at understanding the causes which have determined its state of conservation, as well as, of course, its constituent elements and its implementing methods.

Modelisation des emissions de particules microniques et nanometriques en usinage

NASA Astrophysics Data System (ADS)

Khettabi, Riad

La mise en forme des pieces par usinage emet des particules, de tailles microscopiques et nanometriques, qui peuvent etre dangereuses pour la sante. Le but de ce travail est d'etudier les emissions de ces particules pour fins de prevention et reduction a la source. L'approche retenue est experimentale et theorique, aux deux echelles microscopique et macroscopique. Le travail commence par des essais permettant de determiner les influences du materiau, de l'outil et des parametres d'usinage sur les emissions de particules. E nsuite un nouveau parametre caracterisant les emissions, nomme Dust unit , est developpe et un modele predictif est propose. Ce modele est base sur une nouvelle theorie hybride qui integre les approches energetiques, tribologiques et deformation plastique, et inclut la geometrie de l'outil, les proprietes du materiau, les conditions de coupe et la segmentation des copeaux. Il ete valide au tournage sur quatre materiaux: A16061-T6, AISI1018, AISI4140 et fonte grise.

French law: what about a reasoned reimbursement of serum vitamin D assays?

PubMed

Souberbielle, Jean-Claude; Benhamou, Claude Laurent; Cortet, Bernard; Rousière, Mickael; Roux, Christian; Abitbol, Vered; Annweiler, Cédric; Audran, Maurice; Bacchetta, Justine; Bataille, Pierre; Beauchet, Olivier; Bardet, Rémi; Benachi, Alexandra; Berenbaum, Francis; Blain, Hubert; Borson-Chazot, Françoise; Breuil, Véronique; Briot, Karine; Brunet, Philippe; Carel, Jean-Claude; Caron, Philippe; Chabre, Olivier; Chanson, Philippe; Chapurlat, Roland; Cochat, Pierre; Coutant, Régis; Christin-Maitre, Sophie; Cohen-Solal, Martine; Combe, Christian; Cormier, Catherine; Courbebaisse, Marie; Debrus, Grégory; Delemer, Brigitte; Deschenes, Georges; Duquenne, Marc; Duval, Guillaume; Fardellone, Patrice; Fouque, Denis; Friedlander, Gérard; Gauvain, Jean-Bernard; Groussin, Lionel; Guggenbuhl, Pascal; Houillier, Pascal; Hannedouche, Thierry; Jacot, William; Javier, Rose-Marie; Jean, Guillaume; Jeandel, Claude; Joly, Dominique; Kamenicky, Peter; Knebelmann, Bertrand; Lafage-Proust, Marie-Hélène; LeBouc, Yves; Legrand, Erick; Levy-Weil, Florence; Linglart, Agnès; Machet, Laurent; Maheu, Emmanuel; Mallet, Eric; Marcelli, Christian; Marès, Pierre; Mariat, Christophe; Maruani, Gérard; Maugars, Yves; Montagnon, France; Moulin, Bruno; Orcel, Philippe; Partouche, Henri; Personne, Virginie; Pierrot-Deseilligny, Charles; Polak, Michel; Pouteil-Noble, Claire; Prié, Dominique; Raynaud-Simon, Agathe; Rolland, Yves; Sadoul, Jean-Louis; Salle, Bernard; Sault, Corinne; Schott, Anne-Marie; Sermet-Gaudelus, Isabelle; Soubrier, Martin; Tack, Ivan; Thervet, Eric; Tostivint, Isabelle; Touraine, Philippe; Tremollières, Florence; Urena-Torres, Pablo; Viard, Jean-Paul; Wemeau, Jean-Louis; Weryha, Georges; Winer, Norbert; Young, Jacques; Thomas, Thierry

2016-12-01

The number of serum 25-hydroxyvitamin D (25OHD) assays has increased tenfold in France in less than 10 years, sometimes for invalidated reasons. In 2013, the French National Authority for Health (Haute autorité de santé, or HAS) limited the indications for serum 25OHD measurements to rickets/osteomalacia, older adults with recurrent falls, monitoring of kidney transplant in adults, and surgical treatment of obesity in adults. Our aim here was to note that other indications for serum 25OHD measurements are supported by previous literature and by a number of national and international recommendations, in particular the following: any situation of bone fragility, any chronic renal failure <45 mL/min/1.73m 2 , any situation of malabsorption, clinical signs consistent with vitamin D deficiency or vitamin D overload, and calcium phosphorus evaluation. We suggest that the measurement of serum 25OHD concentration should remain reimbursed as part of these extended indications.

Determination of Fosetyl and Phosphonic Acid at 0.010 mg/kg Level by Ion Chromatography Tandem Mass Spectrometry.

PubMed

Bauer, Anna; Luetjohann, Jens; Rohn, Sascha; Kuballa, Juergen; Jantzen, Eckard

2018-01-10

A new sensitive, fast, and robust method using ion chromatography tandem mass spectrometry (IC-MS/MS) for the determination of fosetyl and phosphonic acid in plant-derived matrices was developed. For compensation of matrix effects and differences in recovery rates the isotopically labeled internal standard (ILIS) 18 O 3 -labeled phosphonic acid was added to the samples prior to the extraction of the target compounds. The validation of the method for the matrices tomato, apple, lemon, sultana, avocado, and wheat was performed according to the actual EU guidance document SANTE/11945/2015. The precision and accuracy were determined in five replicates at spiking levels of 0.010 and 0.100 mg/kg with recovery rates between 76 and 105% and RSDs between 1.2 and 17.8%. In this paper, it was achieved for the first time to detect both fosetyl and phosphonic acid at the reporting level of 0.010 mg/kg most relevant for organic plant food commodities.

Alternative surgical approaches in epilepsy.

PubMed

Gigante, Paul R; Goodman, Robert R

2011-08-01

The mainstay of epilepsy surgery is the resection of a presumed seizure focus or disruption of seizure propagation pathways. These approaches cannot be applied to all patients with medically refractory epilepsy (MRE). Since 1997, vagus nerve stimulation has been a palliative adjunct to the care of MRE patients. Deep brain stimulation (DBS) in select locations has been reported to reduce seizure frequency in small studies over the past three decades. Recently published results from the SANTE (Stimulation of the Anterior Nuclei of Thalamus for Epilepsy) trial-the first large-scale, randomized, double-blind trial of bilateral anterior thalamus DBS for MRE-demonstrate a significant reduction in seizure frequency with programmed stimulation. Another surgical alternative is the RNS™ System (NeuroPace, Mountain View, CA), which uses a closed-loop system termed responsive neurostimulation to both detect apparent seizure onsets and deliver stimulation. Recently presented results from the RNS™ pivotal trial demonstrate a sustained reduction in seizure frequency with stimulation, although comprehensive trial results are pending.

Is carpal tunnel syndrome related to computer exposure at work? A review and meta-analysis.

PubMed

Mediouni, Zakia; de Roquemaurel, Alexis; Dumontier, Christian; Becour, Bertrand; Garrabe, Hélène; Roquelaure, Yves; Descatha, Alexis

2014-02-01

A meta-analysis on epidemiological studies was undertaken to assess association between carpal tunnel syndrome (CTS) and computer work. Four databases (PubMed, Embase, Web of Science, and Base de Donnees de Sante Publique) were searched with cross-references from published reviews. We included recent studies, original epidemiological studies for which the association was assessed with blind reviewing with control group. Relevant associations were extracted, and a metarisk was calculated using the generic variance approach (meta-odds ratio [meta-OR]). Six studies met the criteria for inclusion. Results are contradictory because of heterogeneous work exposure. The meta-OR for computer use was 1.67 (95% confidence interval [CI], 0.79 to 3.55). The meta-OR for keyboarding was 1.11 (95% CI, 0.62 to 1.98) and for mouse 1.94 (95% CI, 0.90 to 4.21). It was not possible to show an association between computer use and CTS, although some particular work circumstances may be associated with CTS.

Riftogenic magmatism of western part of the Early Mesozoic Mongolian-Transbaikalian igneous province: Results of geochronological studies

NASA Astrophysics Data System (ADS)

Yarmolyuk, V. V.; Kozlovsky, A. M.; Salnikova, E. B.; Travin, A. V.; Kudryashova, E. A.

2017-08-01

Geochronological studies of rocks from a bimodal high-alkali volcanic-plutonic complex collected in the area of Kharkhorin zone of the Early Mesozoic Mongolian-Transbaikalian igneous province (MTIP) are made. The age of alkali granites from Olziit sum is 211 ± 1 Ma (U-Pb ID-TIMS on zircon) to 209 ± 2 and 217 ± 4 Ma (40Ar/39Ar on alkali amphibole); the age of alkali granite-porphyries from the area of Sant sum is 206 ± 1 Ma (U-Pb ID-TIMS on zircon). These rock series formed syncronously to the analogous magmatism episode in the Northern Gobi and Western Transbaikalian rift zones of the MTIP. The similarity of the age and composition of igneous associations of the MTIP suggests a common mechanism of its formation related to the effect of a mantle plume on the continental lithosphere at the base of the entire igneous zone having a zonal structure.

Demonstration of the coast-down technique for determining train resistances

NASA Technical Reports Server (NTRS)

Dayman, B.

1983-01-01

Full-scale measurement or validation of the various factors of train running resistance is an essential step in decreasing train energy consumption. Such a measurement capability would enable railroads to evaluate the cost benefits of operational and train consistent configuration changes, and new vehicle and truck designs for decreasing aerodynamic drag and rolling resistance. A decrease in the rolling resistance affects more than just a decrease in energy consumption; it also will result in decreased mechanical wear, hence less wheel and rail maintenance and replacement costs. A demonstration of a simple coast-down technique (based on computer-reduction of distance history) was accomplished using specially configured trains on main line rail provided by the Atchison, Topeka and Sante Fe Railway Co. This demonstration test shows that this distance-history coast-down technique for trains is easy to execute in the field. The total running resistance history was accurately determined and subsequently separated into rolling resistance (mechanical friction) and aerodynamic drag.

[Diagnosis accuracy of endoscopy (laparoscopy, hysteroscopy, fertiloscopy, cystoscopy, colonoscopy) in case of endometriosis: CNGOF-HAS Endometriosis Guidelines].

PubMed

Tardieu, A; Sire, F; Gauthier, T

2018-03-01

To provide clinical practice guidelines from the French college of obstetrics and gynecology (CNGOF) with the Haute Autorité de santé (HAS), based on the best evidence available, concerning the diagnosis accuracy of endoscopy (laparoscopy, hysteroscopy, fertiloscopy, cystoscopy, colonoscopy) in case of endometriosis. English and French review of literature about the diagnosis accuracy of endoscopy in case of endometriosis. Laparoscopy is useful in case of suspected endometriosis in patients with symptoms or infertility when appropriate preoperative assessment is negative (grade C). Biopsies during diagnosis laparoscopy are recommended in case of typical or atypical lesions to confirm endometriosis (grade B). It is not recommended to perform fertiloscopy in case of suspected endometriosis (grade C). Hysteroscopy could be performed in case of suspected endometriosis and infertility to eliminate endometrial polyp or septate uterus (grade C). Colonoscopy is not recommended in case of suspected deep posterior endometriosis (grade C). Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Le consentement libre et éclairé aux soins en psychiatrie

PubMed Central

Neilson, Grainne; Chaimowitz, Gary

2015-01-01

Résumé Le patient a le droit d’être informé sur les soins de santé qui lui sont proposés et de participer activement à la prise de décisions relativement à ces soins. Le respect de la dignité et de l’autonomie de la personne passe par le respect de son droit de prendre des décisions à propos de ses soins psychiatriques, notamment de refuser un traitement, pour autant qu’elle soit apte à prendre des décisions. Il importe que le psychiatre connaisse les fondements éthiques du consentement libre et éclairé et les exigences prévues par le droit en cette matière, y compris la jurisprudence. Le consentement n’est pas immuable, pouvant changer avec le temps, au fil de l’évolution des conditions et des circonstances. Par conséquent, le consentement doit être un processus continu.

Role of Sample Processing Strategies at the European Union National Reference Laboratories (NRLs) Concerning the Analysis of Pesticide Residues.

PubMed

Hajeb, Parvaneh; Herrmann, Susan S; Poulsen, Mette E

2017-07-19

The guidance document SANTE 11945/2015 recommends that cereal samples be milled to a particle size preferably smaller than 1.0 mm and that extensive heating of the samples should be avoided. The aim of the present study was therefore to investigate the differences in milling procedures, obtained particle size distributions, and the resulting pesticide residue recovery when cereal samples were milled at the European Union National Reference Laboratories (NRLs) with their routine milling procedures. A total of 23 NRLs participated in the study. The oat and rye samples milled by each NRL were sent to the European Union Reference Laboratory on Cereals and Feedingstuff (EURL) for the determination of the particle size distribution and pesticide residue recovery. The results showed that the NRLs used several different brands and types of mills. Large variations in the particle size distributions and pesticide extraction efficiencies were observed even between samples milled by the same type of mill.

The European "clinical trial" regulation; relationship with the Jardé Act: a Giens workshop.

PubMed

Lemaire, François; Marchenay, Brigitte; Chassany, Olivier; Barthélémy, Philippe; Bouzzagou, Mohamed; Comet, Denis; Delval, Cécile; Dubray, Claude; Fouret, Cécile; Frija-Orvoen, Elisabeth; Gambotti, Laetitia; Lamarque, Véronique; d'Orsay, Geneviève; Plattner, Valérie; Sibenaler, Claire; Roux, Jacques; Thoby, Frédérique

2015-01-01

In May 2014, the European Union Parliament and Council published a new regulation on clinical trials on medicinal products for human use, which is designed to replace Directive 2001/20/EC. It will not come into effect until 2016. Nevertheless, it is essential to examine its relationship with national legislation, i.e. the Jardé Act, whose implementation has been delayed pending publication of the European regulation. The Giens workshop identified and examined the various issues that this relationship is bound to raise. In particular, it looked at trial methodology assessment procedures, the working relationship between the French National Agency of Drug Safety and Health Products (Agence Nationale de Sécurité du Médicament et des Produits de Santé, ANSM) and ethics committees during the authorization application evaluation phase, review of post-authorization/registration studies on medicinal products and medical devices, and data transparency. © 2015 Société Française de Pharmacologie et de Thérapeutique.

Identification of lead pigments in nanosamples from ancient paintings and polychromed sculptures using voltammetry of nanoparticles/atomic force microscopy.

PubMed

Doménech-Carbó, Antonio; Doménech-Carbó, María Teresa; Mas-Barberá, Xavier

2007-03-15

Voltammetry of nanoparticles coupled with atomic force microscopy was used to identify lead pigments in nanosamples proceeding from works of art. Upon mechanical attachment of few nanograms of sample to a graphite plate, well-defined voltammetric responses were obtained for lead orange, lead yellow, lead white, litharge, minium, Naples yellow, and tin-lead yellow, allowing for an unambiguous identification of such pigments. Atomic force images provide evidence for the occurrence of pigment-characteristic reduction processes accompanied by metal deposition on the graphite substrate. Electrochemical parameters are used for pigment identification. Application to the method for identifying lead pigments in different model binder+pigment specimens and pictorial samples from the canvas painting collection (anonymous, 17th century) of the Saint Joseph Church in Taormina (Italy), the frescoes painted by Antonio Acisclo Palomino y Velasco (1698) in the vault of the Sant Joan del Mercat church in València (Spain) and an anonymous polychromed sculpture (16th century) representing a Martyr Saint from Alacant (Spain) is described.

A Nucleotide-Driven Switch Regulates Flanking DNA Length Sensing by a Dimeric Chromatin Remodeler

PubMed Central

Leonard, John D.; Narlikar, Geeta J.

2015-01-01

SUMMARY The ATP-dependent chromatin assembly factor (ACF) is a dimeric motor that spaces nucleosomes to promote formation of silent chromatin. Two copies of its ATPase subunit SNF2h bind opposite sides of a nucleosome, but how these protomers avoid competition is unknown. SNF2h senses the length of DNA flanking a nucleosome via its HAND-SANT-SLIDE (HSS) domain, yet it is unclear how this interaction enhances remodeling. Using covalently connected SNF2h dimers we show that dimerization accelerates remodeling and that the HSS contributes to communication between protomers. We further identify a nucleotide-dependent conformational change in SNF2h. In one conformation the HSS binds flanking DNA, and in another conformation the HSS engages the nucleosome core. Based on these results, we propose a model in which DNA length sensing and translocation are performed by two distinct conformational states of SNF2h. Such separation of function suggests that these activities could be independently regulated to affect remodeling outcomes. PMID:25684208

Mental Health and Well-Being across the Military Spectrum (Bien-etre et sante mentale dans le milieu militaire)

DTIC Science & Technology

2011-04-01

il faut de toute urgence mener des actions complémentaires pour créer un environnement favorable pour l’ensemble des militaires. Dans le domaine du...changement souhaitable de comportement dans un environnement militaire de culture traditionnellement rude (macho) est un vrai défi, et il est recommandé

La traduction territoriale du Programme national nutrition santé (PNNS) en Midi-Pyrénées, France

PubMed Central

Basson, Jean-Charles; Haschar-Noé, Nadine; Theis, Ivan

2013-01-01

Inspired by the Hygienist Movement, which associates good health with regular, moderate exercise, the National Health and Nutrition Program identifies a lack of physical activity as a risk factor for many chronic diseases. As such, the Program encourages people to take care of their bodies by inciting a moral obligation to develop a physically active lifestyle and follow a healthy diet. With the overall goal of improving the health of the population by acting on nutrition, the Program focuses on primary prevention, screening and early treatment of conditions like heart disease, cancer, obesity, osteoporosis and diabetes. As an incentive program developed in keeping with the biopolitical views of the 1970s that saw education as an alternative means to hospitals for achieving good health, the Program is also a good public action tool for controlling costs. PMID:24289937

Integration of family planning with national health services. Integration de la planification familiale aux services nationaux de sante.

PubMed

Mandara, N

1984-09-01

After independence in the 1960s, most African government inherited health structures that were curative oriented, costly, and directed toward the urban population. Primary health care, oriented toward prevention, promotion, improvement of the environment, cure, and rehabilitation, has since been adopteed as a better approach to health in Africa. This approach aims to integrate health care with thee activities of other seectors and places relicance on available community resources. An unexpected change has been the transformation of social and political attitudes toward family planning as a basic human right, a concomitant to heealth, and an integral part of socioeconomic development. Family planning is gradually being integrated into the maternal and child health services of all countries in Sub-Saharan Africa. In some cases, the government has assumed service delivery responsibilities previously carried out by family planning associations, thereby changing the association's role to that of education and motivation. Other countries have faced duplication of services and wastage of resources as a result of integration. There is a need for an overall evaluation of the integrated family planning-maternal and child heath services to determine future priorities and strategies. Problems so far encountered have included coverage, acceptability, accessibility, quality and continuity of care, data collection, and limited resources. However, cost factors, the shortage of trained manpower, the lack of facilities, and prevailing cultural and religious attitudes suggest the advisibility of integrated rather than vertical health programs in Africa. For both planning and administrative purposes, it is necessary to have a central Maternal and Child Health-Family Planning unit within the Ministry of Health as well as regional and district units.

In vitro tuberization of Chlorophytum Borivilianum Sant & Fern (Safed musli) as influenced by sucrose, CCC and culture systems.

PubMed

Farshad Ashraf, Mehdi; Abd Aziz, Maheran; Abdul Kadir, Mihdzar; Stanslas, Johnson; Farokhian, Elmira

2013-08-01

This study focuses on the establishment of in vitro tuberization of Chlorophytum borivilianum using solid and liquid culture systems. A high in vitro tuberization rate on solid and stationary liquid Murashige and Skoog media was observed in the presence of 60 g l⁻¹ sucrose with 950, 1,265 and 1,580 µM 2-chloroethyl-trimethylammonium chloride (CCC). Application of a higher sucrose concentration of 90 g l⁻¹ showed a negative interaction with CCC on in vitro tuber number and days to in vitro tuber induction. For economic feasibility, 950 µM CCC with 60 g l⁻¹ sucrose was chosen as the best combination for in vitro tuberization in both solid and stationary liquid media. For optimization of in vitro tuber production,a comparison between solid, stationary liquid and shake liquid culture was carried out. Liquid culture with shaking at 80 r.p.m. resulted in a >2.5-fold increase in in vitro tuber production compared with solid culture.

La réfrigération des grandes machines supraconductrices

NASA Astrophysics Data System (ADS)

Gistau, Guy

1991-02-01

The large scale superconducting devices which are now in operation for deviation of heavy particles, acceleration of light particles or plasma confinement need very large powers of refrigeration. After a short survewing of the different functions of refrigerators and the special requirements for large units, the paper describes some existing or envisaged cooling systems which have an equivalent cooling power in the range of 5 kW at 4.5 K. Les grands appareils de physique utilisant les supraconducteurs demandent des puissances cryogéniques de plus en plus importantes. Après un examen des fonctions élémentaires assurées par un réfrigérateur liées au cahier des charges spécifique à chaque utilisation, les spécificités des grosses unités de réfrigération (fiabilité, efficacité, flexibilité, automatisme) sont mises en évidence. Les solutions proposées dans plusieurs grands projets nécessitant des puissances froides supérieures à 5 kW à 4,5 K sont discutées.

Optimisation des proprietes fonctionnelles des alliages a memoire de forme suite a l'application de traitements thermomecaniques

NASA Astrophysics Data System (ADS)

Demers, Vincent

L'objectif de ce projet est de determiner les conditions de laminage et la temperature de traitement thermique maximisant les proprietes fonctionnelles de l'alliage a memoire de forme Ti-Ni. Les specimens sont caracterises par des mesures de calorimetrie, de microscopie optique, de gene ration de contrainte, de deformation recuperable et des essais mecaniques. Pour un cycle unique, l'utilisation d'un taux d'ecrouissage e=1.5 obtenu avec l'application d'une force de tension FT = 0.1sigma y et d'une huile minerale resulte en un echantillon droit, sans microfissure et qui apres un recuit a 400°C, produit un materiau nanostructure manifestant des proprietes fonctionnelles deux fois plus grandes que le meme materiau ayant une structure polygonisee. Pour des cycles repetes, les memes conditions de laminage sont valables mais le niveau de deformation optimal est situe entre e=0.75-2, et depend particulierement du mode de sollicitation, du niveau de stabilisation et du nombre de cycles a la rupture requis par l'application.

Methodes de caracterisation des proprietes thermomecaniques d'un acier martensitique =

NASA Astrophysics Data System (ADS)

Ausseil, Lucas

Le but de l'etude est de developper des methodes permettant de mesurer les proprietes thermomecaniques d'un acier martensitique lors de chauffe rapide. Ces donnees permettent d'alimenter les modeles d'elements finis existant avec des donnees experimentales. Pour cela, l'acier 4340 est utilise. Cet acier est notamment utilise dans les roues d'engrenage, il a des proprietes mecaniques tres interessantes. Il est possible de modifier ses proprietes grâce a des traitements thermiques. Le simulateur thermomecanique Gleeble 3800 est utilise. Il permet de tester theoriquement toutes les conditions presentes dans les procedes de fabrication. Avec les tests de dilatation realises dans ce projet, les temperatures exactes de changement de phases austenitiques et martensitiques sont obtenues. Des tests de traction ont aussi permis de deduire la limite d'elasticite du materiau dans le domaine austenitique allant de 850 °C a 1100 °C. L'effet des deformations sur la temperature de debut de transformation est montre qualitativement. Une simulation numerique est aussi realisee pour comprendre les phenomenes intervenant pendant les essais.

Méthode d'estimation des tassements des sols fins sous les remblais d'infrastructures ferroviaires pour lignes à grande vitesse

NASA Astrophysics Data System (ADS)

Said Alami, Soukaina; Reiffsteck, Philippe; Cuira, Fahd

2018-02-01

Le besoin de maîtriser les déformations des sols sous les remblais destinés à recevoir les structures de lignes à grande vitesse, en fait un enjeu important pour ces projets. Toutefois, de nombreuses difficultés ont été soulevées liées principalement au grand nombre d'incertitudes qui entourent le phénomène. En effet, la caractérisation géologique et géotechnique dépend de sondages et d'essais où le risque de remaniement est important et dont l'interprétation est, souvent, délicate. Cet article présente une procédure de calcul qui permettrait en pratique d'évaluer le tassement sous remblai avec une bonne précision et qui a été validée sur un certain nombre d'ouvrages. Pour cela, des corrections sont introduites aux méthodes usuelles de calcul permettant d'approcher les valeurs mesurées sur chantier.

Les médicaments à libération prolongée pour les enfants et les adolescents ayant un trouble de déficit de l’attention avec hyperactivité

PubMed Central

Feldman, M; Bélanger, S

2009-01-01

Le trouble de déficit de l’attention avec hyperactivité (TDAH) touche un enfant canadien sur 20 et s’associe à un dossier scolaire et à un registre d’emploi défavorables, à des taux élevés de blessures et de consommation de drogues ou d’alcool, à des relations interpersonnelles médiocres, à de mauvaises issues en santé mentale et à une qualité de vie insatisfaisante. Des essais contrôlés démontrent que les médica-ments sont efficaces pour traiter les symptômes de TDAH tandis que des études d’observation indiquent qu’ils s’associent à de meilleures issues sociales et de santé. De nombreuses familles, ainsi que leur médecin traitant, préfèrent les médicaments à libération prolongée (LP) contre le TDAH aux médicaments à libération immédiate (LI) et à action brève. Toutefois, les préparations à LP sont souvent inabor-dables pour les familles, dont un nombre disproportionné fait partie de la strate à faible statut socioéconomique. Le présent document de principes vise à proposer une évaluation critique des données probantes sur l’efficacité relative des médicaments à LP par rapport aux médicaments à LI ainsi que des recommandations au sujet de leur utilisation convenable dans le traitement du TDAH. Lorsque les médicaments sont indiqués, il faut envisager d’utiliser des préparations à LP comme traitement de première intention contre le TDAH parce qu’elles sont plus efficaces et moins susceptibles d’être détournées. Les futures recherches et les analyses coûts-avantages doivent tenir compte à la fois de l’efficacité de médicaments dans des études contrôlées et de leur efficacité clinique en situation réelle ainsi que du potentiel de détournement et de mésusage de ces médicaments. L’industrie, les sociétés d’assurance et le gouvernement doivent collaborer pour rendre ces médicaments accessibles à tous les enfants et adolescents ayant un TDAH.

Épidémiologie des accidents domestiques graves de l'enfant admis en réanimation pédiatrique polyvalente à l'hôpital d'enfants de Rabat-Maroc

PubMed Central

Rafai, Mostafa; Mekaoui, Nour; Chouaib, Naoufal; Bakkali, Hicham; Belyamani, Lahcen; El Koraichi, Alae; El Kettani, Salma Ech-Cherif

2015-01-01

Introduction Les accidents domestiques de l'enfant représentent un vrai problème de santé publique dans les pays industrialisés. Au Maroc, la priorité en santé publique est toujours donnée aux pathologies infectieuses, et bien qu'elle soit très peu décrite, la pathologie accidentelle de l'enfant devient de plus en plus fréquente dans notre pays avec une mortalité importante. L'objectif est de mettre le point sur la prévalence, la gravité, les aspects étiologiques, les facteurs de risque et les circonstances de survenue de ces accidents, ainsi que les moyens de prévention active et passive. Méthodes Enquête rétrospective descriptive sur une période de douze mois portant sur tous les enfants pris en charge pour accident domestique grave au service de réanimation pédiatrique polyvalente de l'hôpital universitaire d'enfants de Rabat. Résultats Parmi 698 admissions, 108 cas d'accidents domestiques graves ont étaient colligés (soit 15,5%), L’âge moyen des enfants était de 04ans tout accident confondu, avec un sex-ratio de 1,08 en faveur des garçons. L’évolution générale était marquée par le décès de 16 enfants (soit 14,8%) parmi 164 décès toute pathologie confondue au cours de la même période d’étude (soit 9,75% des décès) avec une durée moyenne d'hospitalisation de 04jours. les brûlures constituaient le premier accident dans notre série par 37cas, et elles étaient la première cause de mortalité par huit cas; par ailleurs, la population la plus à risque de brûlure était les nourrissons (67,6%). L'inhalation intrabronchique d’épingle à foulard (accident particulier dans notre contexte islamique) à été retrouvée chez six cas. Conclusion Les accidents domestiques de l'enfant constituent rarement une préoccupation de premier plan dans la population alors qu'ils sont parfois très graves et source d'une mortalité importante. Le meilleur traitement reste la prévention active et passive. PMID:26015848

[Effectiveness of psychotherapy compared to pharmacotherapy for the treatment of anxiety and depressive disorders in adults: A literature review].

PubMed

Fansi, Alvine; Jehanno, Cedric; Lapalme, Micheline; Drapeau, Martin; Bouchard, Sylvie

Introduction In Quebec, mental disorders affect one in five people in their lifetime. Anxiety and depressive disorders are the main common or moderate mental health disorders. They affect both the individuals with the disorder and the people around them and have substantial economic impact. Psychotropic drugs are the treatment option most often proposed to patients presenting with moderate mental health disorders. Psychotherapy is nevertheless a treatment that should be given consideration.Physical and financial access to psychotherapy remains limited because only one third of professionals qualified to offer it practise in the public sector, and the coverage and reimbursement policy for this service is very restricted. In order to improve such coverage, the Ministère de la Santé et des Services sociaux (MSSS) mandated the Institut national d'excellence en santé et en services sociaux (INESSS) to assess the evidence on the effectiveness of psychotherapy compared with those of pharmacotherapy for the treatment of adults with anxiety and depressive disorders.Methods An update of a review of recent and good quality literature was conducted through a review of systematic reviews dealing with psychotherapy compared to pharmacotherapy in the treatment of anxiety and depression in adults. The period covered included 2009 to 2013. The literature search strategy, modelled on that of the reference review, was applied to Medline, Cochrane Library, CINAHL, Web of Science and health technology assessment agencies. Exploration of the grey literature focused on information available on the websites of various health assessment organizations.Results The level of scientific evidence overall was judged to be of moderate to high quality. In general, the data showed no significant difference between psychotherapy and pharmacotherapy in terms of symptoms reduction in patients with moderate anxiety or depressive disorders, indicating comparable effectiveness of these two modes of

What is the fault that has generated the earthquake on 8 September 1905 in Calabria, Italy? Source models compared by tsunami data

NASA Astrophysics Data System (ADS)

Pagnoni, Gianluca; Armigliato, Alberto; Tinti, Stefano; Loreto, Maria Filomena; Facchin, Lorenzo

2014-05-01

The earthquake that the 8 September 1905 hit Calabria in southern Italy was the second Italian earthquake for magnitude in the last century. It destroyed many villages along the coast of the Gulf of Sant'Eufemia, caused more than 500 fatalities and has also generated a tsunami with non-destructive effects. The historical reports tell us that the tsunami caused major damage in the villages of Briatico, Bivona, Pizzo and Vibo Marina, located in the south part of the Sant'Eufemia gulf and minor damage to Tropea and to Scalea, this one being village located about 100 km far from the epicenter. Other reports include accounts of fishermen at sea during the tsunami. Further, the tsunami is visible on tide gauge records in Messina, Sicily, in Naples and in Civitavecchia, a harbour located to the north of Rome (Platania, 1907) In spite of the attention devoted by researchers to this case, until now, like for other tsunamigenic Italian earthquakes, the genetic structure of the earthquake is still not identified and debate is still open. In this context, tsunami simulations can provide contributions useful to find the source model more consistent with observational data. This approach was already followed by Piatanesi and Tinti (2002), who carried out numerical simulations of tsunamis from a number of local sources. In the last decade studies on this seismogenic area were int ensified resulting in new estimates for the 1905 earthquake magnitude (7.1 according to the CPTI11 catalogue) and in the suggestion of new source models. By using an improved tsunami simulation model, more accurate bathymetry data, this work tests the source models investigated by Piatanesi and Tinti (2002) and in addition the new fault models proposed by Cucci and Tertulliani (2010) and by Loreto et al. (2013). The simulations of the tsunami are calculated by means of the code, UBO-TSUFD, that solves the linear equations of Navier-Stokes in approximation of shallow water with the finite

Compliance with French nutrition and health program recommendations is strongly associated with socioeconomic characteristics in the general adult population.

PubMed

Malon, Aurélie; Deschamps, Valérie; Salanave, Benoit; Vernay, Michel; Szego, Emmanuelle; Estaquio, Carla; Kesse-Guyot, Emmanuelle; Hercberg, Serge; Castetbon, Katia

2010-06-01

In many countries, nutrition policies such as the Programme National Nutrition Santé (PNNS), implemented in France since 2001, have been developed to prevent and reduce the risk of chronic disease. However, the way in which such programs might benefit persons having different socioeconomic characteristics is unknown. The French nutrition and health survey (Etude Nationale Nutrition Santé [ENNS]) represented an opportunity to address this issue. To describe compliance with PNNS recommendations in the general population and to investigate the relationship between social, economic, and educational characteristics and poor compliance with French nutrition recommendations. A national cross-sectional multistage sampling survey. Food intake was estimated through three 24-hour recalls. Adherence to French nutrition recommendations was estimated using the PNNS guideline score (15 possible points). Two thousand five hundred seventy-seven adults aged 18 to 74 years living in France in 2006-2007 were included in these analyses. All analyses were carried out in men and women separately. Sex-specific quartiles of score were estimated. Multiple logistic models were used to identify socioeconomic characteristics (ie, age, marital status, occupational status, education level, and holiday trip in the past 12 months) associated with poor compliance with recommendations (first PNNS guideline score quartile vs three other quartiles), estimating odds ratios (ORs), and their 95% confidence intervals (CIs). The mean PNNS guideline score was 7.67+/-0.17 in men and 8.55+/-0.12 in women. In both sex groups, a difference of approximately four attained recommendations (out of 13 maximum) was observed between the lowest and highest quartiles. In multivariate models, being in the first PNNS guideline score quartile was significantly associated with lower age and lower occupational status for both sexes. Moreover, women living without a partner were at higher risk of poor compliance with

Lutte contre la mortalité maternelle en milieu rural: décentralisation de l’offre des soins obstétricaux d’urgence au Burkina Faso

PubMed Central

Kaboré, Souleymane; Méda, Clément Ziemlé; Sombié, Issiaka; Savadogo, Léon Blaise; Karama, Robert; Bakouan, Koabié; Ouédraogo, Djénéba Sanon; Coulibaly, Norbert; Kargougou, Robert Lucien; Lankoandé, Emanuel; Sawadogo, Ramatou windsouri; Gosch, Karen

2017-01-01

Introduction Pour combler la pénurie en sages-femmes (SF) dans le district sanitaire de Tougan au Burkina Faso, il a été conçu une stratégie de décentralisation de l'offre des soins obstétricaux d'urgence basée sur des interventions ponctuelles de prise en charge des complications obstétricales au niveau des centres de santé (CS) en milieu rural par des SF. La présente étude a eu pour objectif de décrire cette expérience et d'analyser ses résultats. Méthodes Il s'agit d'une étude intervention de type transversal analytique basée sur une revue des données routinières de l'ensemble des parturientes prises en charge de 2013 à 2015. La collecte des données s'est déroulée du 5 au 20 janvier 2016. Un test Chi2, des rapports de cotes (OR) et leurs intervalles de confiance à 95% ont été calculés. Résultats Au total 416 parturientes présentant des complications obstétricales ont été prises en charge par les SF de zone. L'âge moyen des parturientes était de 26.4 ans. La distance médiane parcourue pour prendre en charge les parturientes était de quinze km pour un délai moyen d'intervention de 21.1 minutes (déviation standard = 7.13 minutes). Les dystocies représentaient la moitié (50.7%, IC95% = 45.8-55.6) des complications prises en charge suivies des hémorragies (26.4%, IC95% = 22.3%-31.0%). Plus de 77% des interventions avaient abouti à la résolution locale des complications obstétricales. Enfin, le résultat de l'intervention était fonction de la pathologie prise en charge (OR = 5.88; p < 0.001). Conclusion Cette stratégie a permis d'apporter une réplique à l'absence de SF dans les CS périphériques du district sanitaire de Tougan. Dans ce contexte particulier, cette intervention pourrait apporter une solution alternative au manque de ressources humaines en santé en milieu rural. PMID:28979638

Performance d’Hemocue Hb 201+ dans le diagnostic de l’anémie de l’enfant dans les structures sanitaires du niveau périphérique au Togo

PubMed Central

Dorkenoo, Ameyo; Layibo, Yao

2013-01-01

Contexte L’anémie est un problème de santé publique dans le monde entier, et notamment dans les pays en développement. Elle a des répercussions majeures sur la santé et sur le développement économique et social d’un pays. La prise en charge des patients anémiés étant nécessaire, il faut un diagnostic biologique précis, et donc un dosage du taux d’hémoglobine par des méthodes fiables. Objectif Évaluer les performances diagnostiques du test Hemocue Hb201+®. Méthodes Étude comparative de la mesure du taux d’hémoglobine à partir du photomètre Hemocue Hb 201+® et d’analyseurs d’hématologie chez 213 enfants de 6 à 59 mois souffrant d’un paludisme simple; la détermination du taux d’hémoglobine par les analyseurs est retenue comme méthode de référence pour évaluer Hemocue Hb201+®. Résultats 72.8% des valeurs obtenues par Hemocue Hb201+® étaient à ±1 g/dl de celles de la méthode de référence. Le coefficient de corrélation de Pearson était de 0.80. La prévalence de l’anémie était de 79.3% pour la méthode de référence et de 77.9% pour Hemocue Hb201+®. La sensibilité et la spécificité de l’analyseur Hemocue Hb201+® étaient respectivement de 95.1% et de 65.3%. Conclusion Les résultats de l’étude ont montré que le test Hemocue Hb201+® présentait une bonne sensibilité, une spécificité moyenne et une exactitude moyenne dans le diagnostic de l’anémie et dans le dosage de l’hémoglobine. Son utilisation peut être recommandée dans les structures périphériques afin de faciliter le diagnostic biologique de l’anémie et sa prise en charge dans les populations vivant dans les zones difficiles d’accès. PMID:29114478

Caracterisitiques des patients tuberculeux à l'ouest cameroun: 2000-2009

PubMed Central

Noubom, Michel; Nembot, Fabrice Djouma; Donfack, Hubert; Mfin, Patrick Stéphane Kouomboua; Tchasse, Floriane

2013-01-01

Introduction La tuberculose (TB) reste de nos jours un problème majeur de santé publique dans les pays en voie de développement. Elle devient de plus en plus importante à cause de l'infection au VIH. Cette étude avait pour but de caractériser les patients admis dans le plus grand Centre de Diagnostic et de Traitement de la Tuberculose (CDT) de l'Ouest Cameroun entre 2000 et 2009. Méthodes Les patients de 15 ans et plus admis au CDT de Baleng durant la période allant du 1er janvier 2000 au 31 décembre 2009 ont été inclus. Les données ont étés collectées grâce à une grille pré conçue. Le calcul des fréquences, moyennes et les comparaisons de groupes ont été faites pour ressortir les caractéristiques des participants. Résultats 2556 patients ont été inclus dans l’étude. 64,8% étaient de sexe masculin et l’âge médian étaient de 33ans. 2141 (83,7%) de patients présentaient une TPM+, 319 (12,5%) une TPM- et 96 (3,8%) une TEP. 64,7% des patients résidaient hors du district de santé d'implantation du CDT. 79,16% de patients tuberculeux ont fait le test de dépistage du VIH et la séroprévalence chez ceux testés était de 26,06%. Les différentes évolutions en fin de période de suivi de chaque patient ont été les suivantes: évolution favorable (guéri et traitement terminé) 1954(76,6%); perdus de vue 231(9,0%); décès 230(9,0%); transféré 92(3,6%); échec 49(1,9%). Conclusion Une proportion considérable de patients résident loin du CDT ce qui augmenterait le perdus de vue et les transferts pendant le traitement. En plus vulgariser les autres CDT de la région, il est nécessaire de renforcer le système de transfert pour éviter les perdus de vue entre deux CDT. PMID:24570799

Insuffisance cervicale et cerclage cervical.

PubMed

Brown, Richard; Gagnon, Robert; Delisle, Marie-France

2016-12-01

La présente directive clinique a pour but de fournir un cadre de référence que les cliniciens pourront utiliser pour identifier les femmes qui sont exposées aux plus grands risques de connaître une insuffisance cervicale, ainsi que pour déterminer les circonstances en présence desquelles la mise en place d'un cerclage pourrait s'avérer souhaitable. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans PubMed ou MEDLINE, CINAHL et The Cochrane Library en 2012 au moyen d'un vocabulaire contrôlé (p. ex. « uterine cervical incompetence ») et de mots clés appropriés (p. ex. « cervical insufficiency », « cerclage », « Shirodkar », « cerclage », « MacDonald », « cerclage », « abdominal », « cervical length », « mid-trimester pregnancy loss »). Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n'a été appliquée en matière de date ou de langue. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en janvier 2011. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques, dans des registres d'essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs (Tableau). RECOMMANDATIONS. Copyright © 2016. Published by Elsevier Inc.

Discussion Meeting on Thermodynamics of Alloys Held in Sant Feliu de Guixols, Spain on 23-26 May 1990. Abstracts

DTIC Science & Technology

1990-05-26

OFFICE OF THE U.S. ARMY EUROPEAN RESEARCH OFFICE OF THE U.S. AIR FORCE MINISTERIO DE EDUCACION Y CIENCIA I I Wednesday, May 23 8.30 Registration 9.00... especially regarding the structural but less the thermodynamic proper- ties). The third binary system Ag-Te has been investigated in detail by our group. No

Functional Magnetic Resonance Imaging (fMRI), Pre-intraoperative Tractography in Neurosurgery: The Experience of Sant' Andrea Rome University Hospital.

PubMed

D'Andrea, Giancarlo; Trillo', Giuseppe; Picotti, Veronica; Raco, Antonino

2017-01-01

The goal of neurosurgery for cerebral intraparenchymal neoplasms of the eloquent areas is maximal resection with the preservation of normal functions, and minimizing operative risk and postoperative morbidity. Currently, modern technological advances in neuroradiological tools, neuronavigation, and intraoperative magnetic resonance imaging (MRI) have produced great improvements in postoperative morbidity after the surgery of cerebral eloquent areas. The integration of preoperative functional MRI (fMRI), intraoperative MRI (volumetric and diffusion tensor imaging [DTI]), and neuronavigation, defined as "functional neuronavigation" has improved the intraoperative detection of the eloquent areas. We reviewed 142 patients operated between 2004 and 2010 for intraparenchymal neoplasms involving or close to one or more major white matter tracts (corticospinal tract [CST], arcuate fasciculus [AF], optic radiation). All the patients underwent neurosurgery in a BrainSUITE equipped with a 1.5 T MR scanner and were preoperatively studied with fMRI and DTI for tractography for surgical planning. The patients underwent MRI and DTI during surgery after dural opening, after the gross total resection close to the white matter tracts, and at the end of the procedure. We evaluated the impact of fMRI on surgical planning and on the selection of the entry point on the cortical surface. We also evaluated the impact of preoperative and intraoperative DTI, in order to modify the surgical approach, to define the borders of resection, and to correlate this modality with subcortical neurophysiological monitoring. We evaluated the impact of the preoperative fMRI by intraoperative neurophysiological monitoring, performing "neuronavigational" brain mapping, following its data to localize the previously elicited areas after brain shift correction by intraoperative MRI. The mean age of the 142 patients (89 M/53 F) was 59.1 years and the lesion involved the CST in 66 patients (57 %), the language pathways in 24 (21 %), and the optic radiations in 25 (22 %). The integration of tractographic data into the volumetric dataset for neuronavigation was technically possible in all cases. In all patients intraoperative DTI demonstrated a shift of the bundle position caused by the surgical procedure; its dislocation was both outward and inward in the range of +6 mm and -2 mm. We found a high concordance between fMRI/DTI and intraoperative brain mapping; their combination improves the sensitivity of each technique, reducing pitfalls and so defining "functional neuronavigation", increasing the definition of eloquent areas and also reducing the time of surgery.

Psychological Aspects of Deployment and Health Behaviours (Aspects psychologiques de la projection operationnelle et comportements lies a la sante)

DTIC Science & Technology

2012-05-01

traffic accident related to risky driving) and long-term consequences (e.g., lung cancer from smoking tobacco) are possible, and both are relevant to...contributing heavily to morbidity and mortality from a broad range of illness, including cancer (including the lung, oral cavity and throat, oesophagus...liver disease, and certain cancers . In high-income countries, alcohol use is second only to smoking among purely behavioural risk factors in its

A health profile of the Inuit of Nunavik: report of the Santé Québec Health Survey (1992).

PubMed

Jetté, M

1998-01-01

This general survey of health and well-being aimed primarily to provide a comprehensive insight into the health and social situation in Nunavik, with a view to setting up prevention and intervention programs more properly adapted to the needs of the Inuit of Nunavik. The data gathered through the use of questionnaires were combined with the anthropometric and biological readings of some 1,567 Inuit of all ages to generate the survey findings. In essence, the report demonstrated that, as the current Inuit lifestyle, save for the consumption of traditional foods, was setting the stage for the development of several types of illness previously absent from Nunavik, behavioral changes were warranted. Although the Inuit reported few problems of a physical nature, mental health issues appeared challenging. The prevalence of psychological distress, suicidal thoughts, and parasuicides was of sufficient import to justify direct, concerted, and immediate action.

The discontinuity in scientific psychology at the University of Rome, 1907-1947: From general psychology to psychotechnics.

PubMed

Morgese, Giorgia; Lombardo, Giovanni Pietro; Albani, Alessandra

2016-11-01

This article examines the areas of research conducted at the Laboratory of Experimental Psychology of the University of Rome from 1907 to 1947, directed first by Sante De Sanctis (1862-1935), and then, from 1931 on, by Mario Ponzo (1882-1960). The method used to distinguish the topics and areas of research that characterized the Roman School during this period is the textual analysis of the titles of the journal in which studies completed at the laboratory were published, namely, Contributi del Laboratorio di Psicologia sperimentale [Psychological Contributions of the Laboratory of Experimental Psychology]. This empirical analysis, which complements and supports the historiographical interpretation, demonstrates the disciplines that emerged under a system managed by the directors over 2 periods of time in the pursuit of scientific psychology in Rome and in Italy. This analysis highlights the process of adjustment from a traditional, general approach to a more theoretical-technical application. This article is a new contribution to the Italian debate on the periodization of the "crisis" in Italian psychology. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

A medical enigma : what "gale chinoise (Chinese scabies)" meant 150 years ago.

PubMed

Gaüzere, B-A; Aubry, P

2017-06-01

The meaning of the term "gale chinoise" mentioned in some articles about French overseas territories in the 19th century, remains unclear. In response to a query of an American colleague dermatologist trying to find out what it meant 150 years ago, we attempted to elucidate the nature of this ancient disease, which today would be translated literally as Chinese scabies. We submitted the query to a panel of civilian and military French tropical medicine specialists including dermatologists, through two networks : Association Amicale Santé Navale et d'Outre-Mer and Société de Pathologie Exotique. Very few answers were received from the approximately 400 colleagues in these networks. They mentioned : ciguatera, other types of ichtyosarcotoxism, smallpox, and leprosy. Several said they never encountered this term during many years spent in French Polynesia, and none was able to find irrefutable proof of their suggestion. Discussion and conclusion. Leprosy, smallpox, ciguatera? The identity of "gale chinoise" remains an enigma ; it might have been intended to designate several different diseases.

Un cas isolé de tuberculose appendiculaire

PubMed Central

Mountassir, Moujahid; Ennafae, Issam; Kechna, Hicham; Berrada, Samir; El Kandry, Siffedine

2011-01-01

La tuberculose est une affection qui sévit à l’état endémique dans notre pays, elle demeure un problème majeur de santé publique .la tuberculose appendiculaire primitive est une affection très rare. Nous rapportons le cas d'un patient de sexe masculin âgé de 17 ans, admis au service pour une prise en charge d'une douleur de la fosse iliaque droite évoluant dans un contexte fébrile avec conservation de l’état général posant le diagnostic d'une appendicite aigue. Une appendicectomie a été réalisée ; le compte rendu anatomopathologique était en faveur d'une tuberculose appendiculaire isolée. Le patient a été mis sous traitement anti-bacillaire complémentaire pendant neuf mois avec une bonne évolution clinique. Le diagnostic de tuberculose doit être évoqué en premier surtout dans les pays d'endémie tuberculeuse. PMID:22355426

[Regional health agencies: only sham autonomy two years later].

PubMed

Rolland, Christine; Pierru, Frédéric

2013-01-01

From the outset, reform of regional health agencies in France, has been torn between two conflicting approaches: traditional state planning and the more recent New Public Management. In fact, the "Hôpital Patients Santá Territoires" (Hospital Patients Health Territories) bill juxtaposes rather than supplants these conflicting approaches. Based on a sociological and qualitative survey conducted nationwide and in three regional health agencies, this article highlights the contradictions in which regional health agency management is entangled and how it tries to accommodate them in its everyday professional activity. Officially, and paradoxically, regional agencies are required to be "autonomous" and "innovative" to ensure more "territorialized" health policies, but in fact, they are caught in a meshwork of somewhat arbitrary national regulatory and budgetary controls that are very similar to the traditional French model of administration. In the light of the example of three different schemes of regional/territorial delegation regulations, this article shows how the various stakeholders are nevertheless trying to innovate even if, ultimately, they are faced with a more traditional, centralised healthcare system with decreased participation at the more local levels.

Bactériophages et phagothérapie: utilisation de virus naturels pour traiter les infections bactériennes

PubMed Central

Ravat, F.; Jault, P.; Gabard, J.

2015-01-01

Summary L’utilisation des bactériophages, prédateurs naturels des bactéries, est une technique pionnière efficace de lutte contre les infections bactériennes. Tombée dans l’oubli depuis un demi-siècle du coté occidental de l’ex-rideau de fer, elle fait toujours partie de l’arsenal thérapeutique des pays de l’ex-Europe de l’Est, au point de constituer une arme de choix dans la politique de santé publique de ces pays. l’émergence de bactéries multirésistantes et le risque de revenir à l’ère pré-antibiotique ont fait ressortir la phagothérapie de l’oubli injuste auquel elle avait été confinée. la biologie et la place du bactériophage dans la nature sont décrites ici. les tenants et les aboutissants de la phagothérapie et les conditions de son retour sur le devant de la scène sont explicitées. PMID:26668557

Exposure to contaminants and nutritional intakes in a French vegetarian population.

PubMed

Fleury, S; Rivière, G; Allès, B; Kesse-Guyot, E; Méjean, C; Hercberg, S; Touvier, M; Bemrah, N

2017-11-01

The NutriNet Santé study collected, on a voluntary basis, the dietary consumption of French vegetarian populations (N = 1766, including 188 vegan individuals) from 18 to 81 years (18-77 years for the vegan). Taking advantage of the availability of contamination data generated in the context of the second French total diet study, dietary exposures of French vegetarian populations to several contaminants were estimated. Results showed that exposures to persistent organic pollutants (PCBs, PCDD/Fs for instance) was dramatically lower than those of the general French population due to the non consumption of food of animal origins. On the other hand, exposures to phytoestrogens, some mycotoxins (T2 and HT2 toxins) and some trace elements (Cd, Al, Sn, Ni) were higher in the vegetarian population compared to those of the general population. Despite some limitations of this approach (both the consumption study and the total diet study were not aimed to estimate dietary exposure of the vegetarian populations), this study showed that dietary habits can dramatically influence the exposure of some contaminants. Copyright © 2017 Elsevier Ltd. All rights reserved.

[Jean-Charles Sournia, resident of Lyon Hospitals and Surgeons in Alep].

PubMed

Fischer, L P; Rougier, Jacques; Schott, Bernard; Babik, Hany; Fischer, Bénédicte

2002-01-01

The article deals with the life and activity of J. Ch. Sournia from 1938 to 1966. Born in Bourges (France) in 1917, he studied at "l'Ecole du Service de Santé Militaire" in Lyon. In 1938 he became a non-resident student of Lyon Hospitals and a resident in 1943. Assistant of thoracic surgery by Professors Paul Santy and Marcel Bérard he underwent an advanced training course by Pr Crawford in Sweden. There he met his Swedish wife-to-be. Appointed professor of Surgery he taught Surgery in Alep and Anatomy in Beyrouth. In the same time he was interested in the History of Syria and its archeology during the Byzantine Centuries (from the IVth to the VIIth A. D.). While his wife was teaching literature at Rennes University he was appointed surgery professor at the Medical College in Rennes and wrote "the Middle-East of Primitive Christianity-History and Archaeology by Byzantine Syria" (Fayard 1966) in which he focused his study on monks who lived for long years on pillar top to be closer to God, like St Simeon.

[Alzheimer's disease cerebro-spinal fluid biomarkers: A clinical research tool sometimes useful in daily clinical practice of memory clinics for the diagnosis of complex cases].

PubMed

Magnin, E; Dumurgier, J; Bouaziz-Amar, E; Bombois, S; Wallon, D; Gabelle, A; Lehmann, S; Blanc, F; Bousiges, O; Hannequin, D; Jung, B; Miguet-Alfonsi, C; Quillard, M; Pasquier, F; Peoc'h, K; Laplanche, J-L; Hugon, J; Paquet, C

2017-04-01

The role of biomarkers in clinical research was recently highlighted in the new criteria for the diagnosis of Alzheimer's disease. Cerebro-spinal fluid (CSF) biomarkers (total Tau protein, threonine 181 phosphorylated Tau protein and amyloid Aβ1-42 peptide) are associated with cerebral neuropathological lesions observed in Alzheimer's disease (neuronal death, neurofibrillary tangle with abnormal Tau deposits and amyloid plaque). Aβ1-40 amyloid peptide dosage helps to interpret Aβ1-42 results. As suggested in the latest international criteria and the French HAS (Haute Autorité de santé) recommendations, using theses CSF biomarkers should not be systematic but sometimes could be performed to improve confidence about the diagnostic of Alzheimer's disease in young subjects or in complex clinical situations. Future biomarkers actually in development will additionally help in diagnostic process (differential diagnosis) and in prognostic evaluation of neurodegenerative diseases. Copyright © 2016 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

An effective public health program to reduce urban heat islands in Québec, Canada.

PubMed

Beaudoin, Mélanie; Gosselin, Pierre

2016-09-01

In 2005, the Government of the Province of Québec, Canada, adopted the Climate Change Action Plan for 2006 - 2012. The Institut national de santé publique du Québec (National Institute of Public Health of Québec), charged with implementing the health adaptation component of the Plan, worked to mitigate urban heat islands (UHI) by funding and evaluating 40 pilot projects. These projects explored different methods of fighting UHIs by greening cities in a participative and mobilizing approach led mainly by non-governmental organizations and municipalities. An assessment of temperatures before and after implementing various methods demonstrated that some actions enabled significant gains of coolness and more efficiently mitigated heat (reduction of concrete/asphalt surfaces, increasing vegetation, etc.). An assessment of quality of life showed that projects were positively received by users, especially by those living in vulnerable situations. A lifecycle analysis showed that from the environmental perspective, UHI mitigation measures that do not require fertilization or maintenance are preferable. Finally, communication efforts that raise awareness of UHI and mitigation are of significant importance to program success.

Intravenous Remifentanil Analgaesia for an Obstetric Patient with Type I Neurofibromatosis and a Factor V Leiden Mutation

PubMed Central

Gálvez, José L.; Errando, Carlos L.; Serrano, Silvia; Martín-Ayuso, Marga; Valverde-Mantecón, José M.

2017-01-01

Type I neurofibromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system. We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofibromatosis and a factor V Leiden mutation. Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered. The remifentanil infusion was self-titrated by the patient using a visual analogue scale, with the dosage ranging from 0.01 to 0.25 μg/kg/minute. Due to rotational dystocia, Kjelland-type forceps were used during the delivery. After birth, the infant was found to have Apgar scores of 9 and 10, with no maternal or neonatal adverse effects observed. Although still controversial, remifentanil may be a successful alternative for analgaesia in similar cases; however, the specific risks and benefits for each patient should be considered prior to administration. PMID:29372092

Not Too Old, Not Too Young: Older Women's Perceptions of Physicians.

PubMed

MacRae, Hazel

2015-12-01

RÉSUMÉ Les femmes plus âgées interagissent avec les médecins plus souvent que les hommes âgés et les personnes plus jeunes; pourtant, la connaissance et la compréhension de leurs expériences avec les médecins sont limitées. Le but de cette étude était d'étudier les perceptions des femmes âgées de leurs interactions avec les médecins et d'identifier ce que les femmes veulent de leurs médecins. Les entrevues en profondeur avec 30 femmes âgées montrent que la majorité veulent être impliquée activement dans leurs propres soins de santé. Dans la relation patient-médecin, les femmes donnent généralement la priorité aux qualités personnelles de médecins et leur comportement à l'égard du patient. Pour de nombreuses femmes, l'âge et le sexe du médecin ont aussi leur importance.

Borderline ovarian tumors, fertility-sparing surgery and pregnancy outcome.

PubMed

Frega, A; Coluccia, A C; Di Martino, G; Catalano, A; Milazzo, G N; Assorgi, C; Manzara, F; Romeo, G D; Gentile, M; Marziani, R; Moscarini, M

2014-01-01

Borderline ovarian tumors (BOTs) represent a type of epithelial tumors having a biologic intermediate behavior between clearly malignant and straight benign tumors. Most of BOTs interest women during fertile age, for which it is necessary to consider a fertility sparing surgery. To evaluate the clinical aspects and pregnancy rate of women affected by borderline ovarian tumors who have undergone fertility sparing surgery. A study of 22 patients affected by BOTs who have been treated with a fertility sparing surgery was conducted between January 2005 and October 2011 at Sant'Andrea Hospital, "Sapienza" University of Rome. The patients' characteristics analyzed were: age, histological type, tumor size, adnexal surgery, pre-operative serum CA-125, diagnostic circumstances, number of patients who became pregnant and number of overall pregnancies. Among the 22 patients treated with a fertility sparing surgery, only sixteen wanted to get pregnant. Eleven patents out of 16 accomplished it. The pregnancy rate was 68.7%. Fertility sparing surgery can be considered a safe procedure for young women affected by borderline ovarian tumors.

Qualité De L'éducation En Afrique: Le Rôle Potentiel Des Tic

NASA Astrophysics Data System (ADS)

Karsenti, Thierry; Ngamo, Salomon Tchameni

2007-11-01

THE QUALITY OF EDUCATION IN AFRICA: THE ROLE OF ICTS IN TEACHING - This article reports on the presence of ICT in educational institutions, presents an overview of the types of ICT uses found in African schools, and explores the relations between ICT use and the quality of education. Data were obtained from a transnational research project ( Projet des écoles pionnières-TIC en Afrique / Pioneer ICT-Schools Project in Africa) funded by the International Research Development Centre (IDRC) of Canada. A total of 68,662 students, 2,627 teachers, 217 school administrators, and 428 additional education stakeholders in West and Central Africa participated in the study. The results show multiple uses of ICT in the participating schools, albeit centered on teaching ICT basic skills. A biaxial model with four quadrants is used to visualize the range of ICT usages in the schools. The analysis reveals a limited pedagogical use of ICT to teach academic subjects in most of the schools. Approximately 80% of the reported uses involved teaching ICT basic skills, while barely 17% involved subject-specific ICT integration for teaching and learning purposes.

Formulation de cas dans la psychose débutante : Quels outils pour le travail en équipe?

PubMed Central

Elowe, Julien; Mebdouhi, Nadir; Solida, Alessandra; Conus, Philippe

2017-01-01

Nous présentons d’abord brièvement le programme TIPP et les concepts généraux de la prise en charge précoce dans la psychose débutante. Un des objectifs de l’intervention dans la phase précoce des troubles psychotiques est notamment de proposer des soins spécifiques adaptés à cette phase de la maladie. En début de prise en charge, l’équipe de soins et en particulier le gestionnaire de cas (case manager), chef d’orchestre de la prise en charge, sont confrontés à une quantité importante d’information dont il faut dégager les lignes de forces pour mettre en place une prise en charge adaptée. Cet article propose un modèle qui peut constituer un outil de travail précieux pour les équipes travaillant dans l’intervention précoce pour faire émerger une formulation de cas et synthétiser les situations cliniques des patients, en extraire une histoire qui fasse sens et ainsi faciliter la mise en place d’un projet thérapeutique. PMID:28558256

Le patrimoine astronomique provençal

NASA Astrophysics Data System (ADS)

Rous, M.; Figon, P.; Guyot, S.

2012-12-01

L'OSU OAMP/Institut Pythéas porte les missions de conservation, inventaire et valorisation du patrimoine. Suite à la fusion de l'Observatoire de Marseille et du Laboratoire d'Astronomie Spatiale en 2000 pour créer le Laboratoire d'Astrophysique de Marseille, le déménagement des équipes sur le site de Château-Gombert en 2008 a soulevé le problème du devenir des collections des deux sites d'origine. Nous ferons le bilan des actions passées en matière de conservation et de valorisation de ce riche patrimoine : versement à l'inventaire général du Ministère de la Culture, classement de 22 instruments au titre des Monuments Historiques, inventaire et numérisation des archives anciennes, montage d'expositions et réalisation du catalogue Telescopium, 400 ans de lunettes et de télescopes. Nous présenterons les actions en cours: mesures de conservation préventive, inventaire des archives et des instruments. Nous parlerons enfin des projets: création d'un espace d'exposition permanente, participation à des expositions temporaires.

PLUME and research sotware

NASA Astrophysics Data System (ADS)

Baudin, Veronique; Gomez-Diaz, Teresa

2013-04-01

The PLUME open platform (https://www.projet-plume.org) has as first goal to share competences and to value the knowledge of software experts within the French higher education and research communities. The project proposes in its platform the access to more than 380 index cards describing useful and economic software for this community, with open access to everybody. The second goal of PLUME focuses on to improve the visibility of software produced by research laboratories within the higher education and research communities. The "development-ESR" index cards briefly describe the main features of the software, including references to research publications associated to it. The platform counts more than 300 cards describing research software, where 89 cards have an English version. In this talk we describe the theme classification and the taxonomy of the index cards and the evolution with new themes added to the project. We will also focus on the organisation of PLUME as an open project and its interests in the promotion of free/open source software from and for research, contributing to the creation of a community of shared knowledge.

Approche aux soins en milieu communautaire à des adultes ayant une déficience développementale

PubMed Central

Osmun, W.E.; Chan, Nelson; Solomon, Robert

2015-01-01

Résumé Objectif Passer en revue les obligations d’ordre médical, éthique et juridique dans les soins aux adultes ayant une déficience développementale (DD) qui vivent dans la communauté. Sources des données Des recherches ont été faites dans Google et MEDLINE à l’aide des mots disabled, disability, vulnerable et community. Les lois pertinentes ont fait l’objet d’un examen. Message principal Le traitement d’un patient ayant une DD varie en fonction de facteurs comme la pathogenèse du problème actuel du patient, ses affections concomitantes, la gravité de ses déficiences et ses soutiens sociaux habituels. Bien que l’on s’entende sur les bienfaits du transfert des soins institutionnels vers des soins communautaires pour les patients ayant une DD, il s’est révélé difficile de leur dispenser des soins de grande qualité en milieu communautaire. Par ailleurs, il existe peu de travaux de recherche sur les façons d’offrir efficacement des soins aux adultes ayant une DD. En tant que professionnels des soins primaires, les médecins de famille sont souvent le premier point de contact pour les patients et sont à la fois responsables de la coordination et de la continuité des soins. Compte tenu de l’importance accrue accordée aux soins préventifs et à la détection précoce des maladies, la participation active du patient revêt aussi une grande importance. Les valeurs et les objectifs du patient sont des éléments essentiels à prendre en compte, même s’ils vont à l’encontre de la bonne santé du patient ou des propres valeurs du clinicien. Les lois s’appliquant aux personnes vulnérables varient d’une province à l’autre. Par conséquent, l’obligation de signaler des mauvais traitements suspectés pourrait différer selon que la personne vulnérable habite dans un centre de soins ou la communauté, que la personne qui soupçonne le comportement abusif est un fournisseur de services ou un professionnel de la santé ou

[Health and access to health care of 18-25 years old people not in employment, education or training (NEETs) attending the French 'missions locales'].

PubMed

Robert, S; Lesieur, S; Chastang, J; Kergoat, V; Dutertre, J; Chauvin, P

2017-08-01

In France, "missions locales" are public assistance units for young people aged 16-25 years not in employment, education or training (NEET). The health status of the more than 1.5 million young adults attending these units annually is unknown. The purpose of this study was to describe the health status and health care use of this population in comparison with the general population of the same age. The Presaje survey was conducted in 2011 on a randomized sample of 1453 young adults aged 18-25 years who attended five "missions locales" in mainland France. Data were analyzed and compared with those of participants of the same age interviewed in a French national health survey (Baromètre Santé 2010, n=2899) and in a regional cohort (SIRS, n=204) conducted in the Greater Paris area, both in 2010. The overall social profiles of this NEET population was diverse, but with globally more difficult living conditions than in the general population. Health-related vulnerability factors identified were: insufficient health insurance; low educational level; numerous adverse experiences during childhood and social isolation. Some of their health indicators were remarkably poor in comparison with participants in the Baromètre santé study: 19.2 % (CI95 %=[17.2-21.3]) had a chronic disease-versus 8.2 % (CI95 %=[7.0-9.4]) (P<0.001); 31.9 % (CI95 %=[26.8-37.4]) were overweight or obese-versus 17.9 % (CI95 %=[16.3-19.6]) (P<0.001) and 19.6 % (CI95 %=[15.2-23.9]) were depressed-versus 7.3 %(CI95 %=[3.8-10.9]) (P<0.001). Compared with participants of the SIRS survey, fewer (70.4 %) (CI95 %=[68.0-72.7]) had a family doctor-versus 79.7 % (CI95 %=[73.1-86.2]) (P<0.05). Among the women in the Presaje survey, 38.0 % [30.5-45.4] had a regular gynecological follow-up-versus 80.9 % (CI95 %=[71.5-90.4]) in the SIRS survey (P<0.001). Careful attention must be given to the young NEET population. Many of these youths are not familiar with health care services despite

The experience of bedaquiline implementation at a decentralised clinic in South Africa.

PubMed

Cariem, R; Cox, V; de Azevedo, V; Hughes, J; Mohr, E; Durán, L Triviño; Ndjeka, N; Furin, J

2016-09-01

Multidrug-resistant tuberculosis (MDR-TB) is a serious public health problem, but the new drugs bedaquiline (BDQ) and delamanid offer hope to improve outcomes and minimise toxicity. In Khayelitsha, South Africa, patients are routinely started on BDQ in the out-patient setting. This report from the field describes BDQ use in the out-patient setting at the Nolungile Clinic. The clinic staff overall report a positive experience using the drug. Challenges have been based largely on the logistics of drug supply and delivery. BDQ can be started successfully in the out-patient setting, and can be a positive experience for both patients and providers. La tuberculose multirésistante (TB-MDR) est un problème de santé publique grave, mais les nouveaux médicaments que sont la bédaquiline (BDQ) et le délamanide apportent un espoir d'améliorer les résultats tout en réduisant la toxicité. A Khayelitsha, Afrique du Sud, les patients démarrent leur traitement par BDQ en consultation externe en routine. Ce rapport du terrain décrit l'utilisation de la BDQ à la consultation externe du dispensaire Nolungile. Dans l'ensemble, le personnel du centre de santé exprime une expérience positive du médicament. Les défis ont surtout été liés à la logistique de l'approvisionnement et de la distribution du médicament. La BDQ peut être mise en route avec succès dans le cadre d'une consultation externe et peut constituer une expérience positive pour les patients et les prestataires de soins. La tuberculosis multirresistente (TB-MDR) representa un grave problema de salud pública, pero la utilización de nuevos medicamentos como la bedaquilina (BDQ) y el delamanid ofrece perspectivas de mejores desenlaces terapéuticos y disminución de la toxicidad asociada. En Khayelitsha, Suráfrica, se inicia de manera sistemática el tratamiento ambulatorio con BDQ. En el presente informe del terreno, se describe la utilización de BDQ en tratamiento antituberculoso ambulatorio en el

Vulvovaginite : Dépistage et prise en charge de la trichomonase, de la candidose vulvovaginale et de la vaginose bactérienne.

PubMed

van Schalkwyk, Julie; Yudin, Mark H

2016-12-01

Analyser les données probantes et formuler des recommandations quant au dépistage et à la prise en charge de la candidose vulvovaginale, de la trichomonase et de la vaginose bactérienne. Parmi les issues évaluées, on trouve l'efficacité de l'antibiothérapie, les taux de guérison en ce qui concerne les infections simples et compliquées, et les implications de ces pathologies pendant la grossesse. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans MEDLINE, EMBASE, CINAHL et The Cochrane Library en juin 2013 au moyen d'un vocabulaire contrôlé (p. ex. « vaginitis », « trichomoniasis », « vaginal candidiasis ») et de mots clés (p. ex. « bacterial vaginosis », « yeast », « candidiasis », « trichomonas vaginalis », « trichomoniasis », « vaginitis », « treatment ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles. Aucune restriction n'a été appliquée en matière de date, mais les résultats ont été limités aux documents rédigés en anglais ou en français. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en mai 2014. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques et auprès de sociétés de spécialité médicale nationales et internationales. La qualité des résultats est évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). DéCLARATIONS SOMMAIRES: RECOMMANDATIONS. Copyright © 2016. Published by Elsevier Inc.

Summary of Research Findings on Children's Developmental Health = Resume des conclusions de la recherche sur la sante developpementale des effants.

ERIC Educational Resources Information Center

Bertrand, Jane

This kit is comprised of bilingual resources for child caregivers related to nourishing and nurturing a child's brain for optimal neurodevelopmental health. The kit is the result of a 30-month project to synthesize research on brain development and to develop resources in support of excellent caregiver practice in Canada. The kit contains the…

La prévention des blessures chez les enfants et les adolescents : une démarche de santé publique

PubMed Central

Yanchar, Natalie L; Warda, Lynne J; Fuselli, Pamela

2012-01-01

RÉSUMÉ La majorité des blessures dont sont victimes les enfants et les adolescents sont évitables. Le présent document de principes contient des renseignements généraux, des conseils et une déclaration d’engagement à l’égard de la prévention des blessures au Canada. Il sert de base sur laquelle construire en s’attardant d’abord aux définitions, à l’étendue et aux priorités en matière de prévention des blessures. Il contient également une description du fardeau et du profil des blessures non intentionnelles, de même que les principes d’interventions de prévention efficaces. La version intégrale renferme une liste de ressources en vue d’obtenir des données et de l’information probante (www.cps.ca). Enfin, le présent document de principes peut être utilisé pour la défense généralisée de la prévention des blessures.

Developpement d'une methode de Monte Carlo dependante du temps et application au reacteur de type CANDU-6

NASA Astrophysics Data System (ADS)

Mahjoub, Mehdi

La resolution de l'equation de Boltzmann demeure une etape importante dans la prediction du comportement d'un reacteur nucleaire. Malheureusement, la resolution de cette equation presente toujours un defi pour une geometrie complexe (reacteur) tout comme pour une geometrie simple (cellule). Ainsi, pour predire le comportement d'un reacteur nucleaire,un schema de calcul a deux etapes est necessaire. La premiere etape consiste a obtenir les parametres nucleaires d'une cellule du reacteur apres une etape d'homogeneisation et condensation. La deuxieme etape consiste en un calcul de diffusion pour tout le reacteur en utilisant les resultats de la premiere etape tout en simplifiant la geometrie du reacteur a un ensemble de cellules homogenes le tout entoure de reflecteur. Lors des transitoires (accident), ces deux etapes sont insuffisantes pour pouvoir predire le comportement du reacteur. Comme la resolution de l'equation de Boltzmann dans sa forme dependante du temps presente toujours un defi de taille pour tous types de geometries,un autre schema de calcul est necessaire. Afin de contourner cette difficulte, l'hypothese adiabatique est utilisee. Elle se concretise en un schema de calcul a quatre etapes. La premiere et deuxieme etapes demeurent les memes pour des conditions nominales du reacteur. La troisieme etape se resume a obtenir les nouvelles proprietes nucleaires de la cellule a la suite de la perturbation pour les utiliser, au niveau de la quatrieme etape, dans un nouveau calcul de reacteur et obtenir l'effet de la perturbation sur le reacteur. Ce projet vise a verifier cette hypothese. Ainsi, un nouveau schema de calcul a ete defini. La premiere etape de ce projet a ete de creer un nouveau logiciel capable de resoudre l'equation de Boltzmann dependante du temps par la methode stochastique Monte Carlo dans le but d'obtenir des sections efficaces qui evoluent dans le temps. Ce code a ete utilise pour simuler un accident LOCA dans un reacteur nucleaire de type

Cost-effectiveness of midwifery services vs. medical services in Quebec. LEquipe dEvaluation des Projets-Pilotes Sages-Femmes.

PubMed

Reinharz, D; Blais, R; Fraser, W D; Contandriopoulos, A P

2000-01-01

This study compared the cost-effectiveness of midwife services provided in birth centres operating as pilot projects with current hospital-based medical services in the province of Quebec. One thousand midwives' clients were matched with 1,000 physicians' clients on the basis of socio-demographic characteristics and obstetrical risk. Direct costs for the prenatal, intrapartum and postpartum periods were estimated. Effectiveness was assessed on the basis of three clinical indicators and four indices related to the individualization of care as assessed by women. Results show that the costs of midwife services were barely lower than or equal to those of physician services, but cost-effectiveness ratios were to the advantage of the midwife group, except for one clinical indicator (neonatal ventilation). Overall, this study provides rational support for the process of legalizing midwifery in the province.

Integration of midwives into the Quebec health care system. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

PubMed

Collin, J; Blais, R; White, D; Demers, A; Desbiens, F

2000-01-01

This paper reports on one aspect of the evaluation of the midwifery pilot projects in Quebec: the identification of the professional and organizational factors, as well as the mode of integrating midwives into the maternity care system, that would promote the best outcomes and the autonomy of midwives. The research strategy involved a multiple-case study, in which each midwifery pilot project represented a case. Based on a qualitative approach, the study employed various sources of data: individual interviews and focus groups with key informants, site observations and analyses of written documents. Results show that midwives were poorly integrated into the health care system during the evaluation. Four main reasons were identified: lack of knowledge about the practice of midwifery on the part of other health care providers; deficiencies in the legal and organizational structure of the pilot projects; competition over professional territories; and gaps between the midwives' and other providers' professional cultures. Recommendations are provided to facilitate the integration of midwives into the health care system.

[Advantages and disadvantages of water birth. A systematic review of the literature].

PubMed

Poder, T G; Larivière, M

2014-10-01

Water birth is under debate among professionals. For the proponents of this approach, immersion in water during labour and birth may increase maternal relaxation, reduce analgesia requirements and promote a model of obstetric care more focused on the needs of mothers, particularly the empowerment of women to realize their full potential. In contrast, major critics cite a risk of inhalation of water for the newborn and a risk of infection for the mother and the newborn. This review tracks the state of scientific knowledge about water birth in order to determine if it can be generalized in hospitals. A systematic review of the literature was conducted in PubMed, Embase and Cochrane Database. The period covered is from January 1989 to May 2013. The level of evidence of the studies was assessed with the analysis guide of the Haute Autorité de santé. The level of evidence of the studies identified goes from moderate to low, particularly as regard to studies analysing the expulsion phase. It is possible to recommend immersion in water during the labour phase. No recommendation can be made as regard to the foetal expulsion phase. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Changes in Smoking Behavior over Family Transitions: Evidence for Anticipation and Adaptation Effects.

PubMed

Bricard, Damien; Legleye, Stéphane; Khlat, Myriam

2017-06-07

The study of changes in smoking behaviors over the life course is a promising line of research. This paper aims to analyze the temporal relation between family transitions (partnership formation, first childbirth, separation) and changes in smoking initiation and cessation. We propose a discrete-time logistic model to explore the timing of changes in terms of leads and lags effects up to three years around the event in order to measure both anticipation and adaptation mechanisms. Retrospective biographical data from the Santé et Itinéraires Professionnels (SIP) survey conducted in France in 2006 are used. Partnership formation was followed for both genders by a fall in smoking initiation and an immediate rise in smoking cessation. Childbirth was associated with increased smoking cessation immediately around childbirth, and additionally, females showed an anticipatory increase in smoking cessation up to two years before childbirth. Couple separation was accompanied by an anticipatory increase in smoking initiation for females up to two years prior to the separation, but this effect only occurred in males during separation. Our findings highlight opportunities for more targeted interventions over the life course to reduce smoking, and therefore have relevance for general practitioners and public policy elaboration.

Cancer métaplasique du sein: à propos d'un cas

PubMed Central

Babahabib, Moulay Abdellah; Chennana, Adil; Hachi, Aymen; Kouach, Jaoud; Moussaoui, Driss; Dhayni, Mohammed

2014-01-01

Les carcinomes métaplasiques du sein sont des tumeurs rares. Ils constituent un groupe hétérogène de tumeurs définis selon l'organisation mondiale de la santé comme étant un carcinome canalaire infiltrant mais comportant des zones de remaniements métaplasiques (de type épidermoïde, à cellules fusiformes, chondroïde et osseux ou mixte), qui varient de quelques foyers microscopiques à un remplacement glandulaire complet. Les aspects cliniques et radiologiques ne sont pas spécifiques. Le traitement associe la chirurgie, la radiothérapie et la chimiothérapie. L'hormonothérapie n'a pas de place. Le pronostic est sombre. L'histopathologie combinée à l'immunohistochimie permet de poser un diagnostic sure. Etant donné que la prise en charge thérapeutique est limitée, une nouvelle approche moléculaire pourrait modifier cette contribution faible et mal cernée des traitements systémiques classiques. Les patientes atteintes de carcinome métaplasique mammaire pourraient bénéficier de traitements ciblés, ce qui reste à confirmer par des essais cliniques. PMID:25870723

Aspect Epidemiologique des Sequelles de Brulures a Marrakech, Maroc, a Travers Deux Observations

PubMed Central

Ettalbi, S.; Ibnouzahir, M.; Droussi, H.; Wahbi, S.; Bahaichar, N.; Boukind, E.H.

2009-01-01

Summary La brûlure est un accident qui reste toujours très fréquent au Maroc, ce qui fait d'elle un problème de la santé publique. Les brûlures, quand elles sont graves ou profondes, entraînent de façon quasi inéluctable des séquelles fonctionnelles et esthétiques. A travers deux observations de deux enfants présentant des séquelles de brûlures graves, ayant retenti péjorativement sur leurs scolarités, on a essayé de mettre en évidence quelques facteurs incriminés dans cette tragédie (feu, petites bouteilles de gaz et le manque d'infrastructure, du personnel médical et paramédical, du matériel ainsi que de la prévention) comme étant une grande cause dans la survenue de ces séquelles. Le but de notre travail est d'énumérer ces différents facteurs intriqués, ainsi que de proposer quelques solutions, tout en insistant sur la prévention. PMID:21991156

[Not Available].

PubMed

Ettalbi, S; Ibnouzahir, M; Droussi, H; Wahbi, S; Bahaichar, N; Boukind, E H

2009-06-30

La brûlure est un accident qui reste toujours très fréquent au Maroc, ce qui fait d'elle un problème de la santé publique. Les brûlures, quand elles sont graves ou profondes, entraînent de façon quasi inéluctable des séquelles fonctionnelles et esthétiques. A travers deux observations de deux enfants présentant des séquelles de brûlures graves, ayant retenti péjorativement sur leurs scolarités, on a essayé de mettre en évidence quelques facteurs incriminés dans cette tragédie (feu, petites bouteilles de gaz et le manque d'infrastructure, du personnel médical et paramédical, du matériel ainsi que de la prévention) comme étant une grande cause dans la survenue de ces séquelles. Le but de notre travail est d'énumérer ces différents facteurs intriqués, ainsi que de proposer quelques solutions, tout en insistant sur la prévention.

La problématique du coût des nouvelles thérapeutiques en oncologie: qu'en-est-il du Maroc?

PubMed Central

Brahmi, Sami Aziz; Zahra, Ziani Fatima; Seddik, Youssef; Afqir, Said

2016-01-01

Le cancer est un problème majeur de santé public en Afrique. Les progrès réalisé dans le traitement des cancers ces dix dernières années est indéniable. L’émergence des thérapies ciblés en oncologie a permit de modifier l'histoire naturelle de certains cancers réputés de mauvais pronostic. En dépit de leurs efficacité, ces thérapeutiques pose un problème majeur de coût qui les rend inaccessible à la majorité des patients dans les pays en voie développement. Au Maroc, le cancer est reconnu comme a une affection de longue durée et les patients bénéficient de ce fait d'une couverture médicale totale. L'implication de la société civile a permis aussi d'améliorer la prise en charge ainsi qu'un accès plus élargi aux médicaments innovants pour les patients les plus démunis. PMID:27642392

Traitement intra-artériel des métastases hépatiques de cancer colorectal

PubMed Central

Pellerin, O.; Geschwind, J.-F.

2015-01-01

Le cancer colorectal représente un problème majeur de santé publique. Son incidence annuelle mondiale est d’environ un million de cas et la mortalité annuelle est de plus de 500 000 cas par an. Le foie est l’organe le plus fréquemment touché par les métastases. Leur survenue est observée dans 40 à 60% des cas (contemporaines dans 25% des cas). Bien que la résection chirurgicale soit le seul traitement curatif, nombre de patients ne peuvent en bénéficier en raison de l’importante diffusion des métastases hépatiques. Chimiothérapies et biothérapies systémiques sont les options conventionnelles de la prise en charge des métastases hépatiques multiples. C’est dans ces situations cliniques que les thérapies intra-artérielles peuvent jouer un rôle important. Dans cet article, nous présenterons les différentes thérapies endovasculaires applicables aux métastases hépatiques de cancers colorectaux, avec leurs indications, résultats et complications éventuelles. PMID:21944243

Genetic diversity in natural populations of mangaba in Sergipe, the largest producer State in Brazil.

PubMed

Soares, A N R; Vitória, M F; Nascimento, A L S; Ledo, A S; Rabbani, A R C; Silva, A V C

2016-08-19

Mangaba (Hancornia speciosa Gomes) is found in areas of coastal tablelands in the Brazilian Northeast and Cerrado regions. This species has been subjected to habitat fragmentation that is mainly due to human activity, and requires conservation strategies. The aim of this study was to analyze the structure and inter- and intrapopulation genetic diversity of natural populations of H. speciosa Gomes using inter-simple sequence repeat (ISSR) molecular markers. A total of 155 individuals were sampled in 10 natural populations (ITA, PAC, IND, EST, BC, PIR, JAP, BG, NEO, and SANT) in the State of Sergipe, Brazil. Fifteen primers were used to generate 162 fragments with 100% polymorphism. Genetic analysis showed that the variability between populations (77%) was higher than within populations (23%). It was possible to identify five different groups by the unweighted pair group method with arithmetic mean and principal coordinate analysis, and only one individual (E10) remained isolated. Using ISSR markers it was possible to obtain a molecular profile of the populations evaluated, showing that these markers were effective and exhibited sufficient polymorphism to estimate the genetic variability of natural populations of H. speciosa Gomes.

[Home hospital for advanced stage cancer patients: costs and benefits].

PubMed

Tanneberger, S; Pannuti, F; Mirri, R; Panetta, A; Mariano, P; Giordani, S; Strocchni, E; Farabegoli, G

1997-03-01

15,290 patients have been treated in the Bologna home hospital (BHH) until June 30, 1996. The average daily costs in BHH were estimated as 118789 Liras (ranging from 108 569-129027 Lire depending on the nursing category). Care intensity and patient's quality of life in the BHH are high. 98% of patients were content with the setting in which they were nursed. A questionnaire on the degree of satisfaction with the care was completed by 134 BHH patients and 102 patients of Division Oncologia Medica. Azienda Ospedaliera Sant, Orsola Malpighi, Bologna. Satisfaction with respect to sleeping, meals and family communications was expressed more often by BHH patients. Less patients of the BHH evaluated "quality of life" reduced or bad (51% vs. 67%) or requested a transfer to the alternative setting (03% vs. 47%). Advocating step by step introduction of home care, quality of life aspects have priority. Certainly, home care deserves greatest attention providing care during the life with cancer. However the final decision about the settings of nursing has to be made by the patients themselves in accordance with his understanding of quality of life.

Domain Architecture of the Catalytic Subunit in the ISW2-Nucleosome Complex▿

PubMed Central

Dang, Weiwei; Bartholomew, Blaine

2007-01-01

ATP-dependent chromatin remodeling has an important role in the regulation of cellular differentiation and development. For the first time, a topological view of one of these complexes has been revealed, by mapping the interactions of the catalytic subunit Isw2 with nucleosomal and extranucleosomal DNA in the complex with all four subunits of ISW2 bound to nucleosomes. Different domains of Isw2 were shown to interact with the nucleosome near the dyad axis, another near the entry site of the nucleosome, and another with extranucleosomal DNA. The conserved DEXD or ATPase domain was found to contact the superhelical location 2 (SHL2) of the nucleosome, providing a direct physical connection of ATP hydrolysis with this region of nucleosomes. The C terminus of Isw2, comprising the SLIDE (SANT-like domain) and HAND domains, was found to be associated with extranucleosomal DNA and the entry site of nucleosomes. It is thus proposed that the C-terminal domains of Isw2 are involved in anchoring the complex to nucleosomes through their interactions with linker DNA and that they facilitate the movement of DNA along the surface of nucleosomes. PMID:17908792

Epidemiology and burden of rotavirus-associated hospitalizations in Ferrara, Italy.

PubMed

Gabutti, G; Marsella, M; Lazzara, C; Fiumana, E; Cavallaro, A; Borgna-Pignatti, C

2007-03-01

Objective of this study was to provide data on hospitalizations for rotavirus gastroenteritis (RVGE) in Ferrara, Italy. The study was conducted analyzing the hospital discharge forms of all children admitted to the Pediatric Department of the University of Ferrara, Arcispedale Sant'Anna, from January 2001 through December 2005. The database was searched for all gastrointestinal diseases and in particular RVGE. During the period under study 3277 children, of which 2038 <60 months of age, were hospitalized; 247 children < 5 years old were admitted for acute gastroenteritis and 89 (4.4% of all and 36% of gastroenteritis-related hospitalizations) had rapid screening tests positive for rotavirus. A seasonal pattern was observed for RVGE with an increase in winter and early spring. The average length of hospital stay was 5.7 days. The median cost of each hospitalized case of RVGE ranged between 1417 and 1595 Euros. The present research confirms that rotavirus gastroenteritis represents an important cause of hospitalization in children and is responsible for significant costs for the Public Health Care System. An effective vaccination program could significantly reduce the incidence of hospitalization and the associated costs.

The treatment of tuberculosis in Ferrara (Italy) in the 19th century.

PubMed

Vicentini, Chiara Beatrice; Mares, Donatella; Guidi, Enrica; Angelini, Lauretta; Contini, Carlo; Manfredini, Stefano

2010-12-01

The present work is a review of the remedies in use in Ferrara against tuberculosis in the 1800s. The work started from the discovery of accounts describing methods and remedies. These remedies were also in use world wide. Of particular interest is the work by Antonio Campana, a famous professor of Pharmaceutical Chemistry and Botany in Ferrara, who wrote a pharmacopoeia which had several editions between 1797 and 1841. The Farmacopea Ferrarese was addressed to the apothecaries of Ferrara. Nevertheless, due to its great reputation it had an international distribution. It provided us with an exhaustive view about the medical field in Ferrara in the early 1800s. The remedies adopted in the city in the second half of the century were in line with those present abroad. The work was also supported by the discovery of statistical accounts of the Sant'Anna hospital from 1871. The manuscript written by Alessandro Bennati enabled elucidation of the methods used to treat tuberculosis in the second half of the century. Bennati's work is an historical document completed by the work of the physician Cesare Minerbi.

[Concordance between hospital prescriptions and recommendations in the treatment of mania].

PubMed

Laforgue, Edouard-Jules; Bulteau, Samuel; Cholet, Jennyfer; Victorri-Vigneau, Caroline; Guitteny, Marie; Mauduit, Nicolas; Vanelle, Jean-Marie; Sauvaget, Anne

2017-06-01

There are differences between recommendations and practice in the pharmacological treatment of acute mania. The objective was to assess conformity of the anti-manic prescription between national recommendations (Haute Autorité de santé [French health authority, HAS] and "résumé des caractéristiques du produit" [product characteristics, RCP]) and clinical practice. We observed the drug prescriptions of in-patients for a manic episode. The main outcome measure was the concordance rate with the recommendations of the drugs prescriptions at the 48th hour. The secondary outcome repeated the same process with the hospital discharge statement of switches, associations, the presence of symptomatic and antidepressant treatments. Sixty-six episodes were included, 40 patients (60%) had a prescription complies with RCP recommendations H48 and 46 patients (70%) to HAS. These rates fall at hospital discharge. Off-label prescriptions, drug combinations and choices of not listed molecules are the most common reasons for non-conformity. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

Actin-related proteins regulate the RSC chromatin remodeler by weakening intramolecular interactions of the Sth1 ATPase.

PubMed

Turegun, Bengi; Baker, Richard W; Leschziner, Andres E; Dominguez, Roberto

2018-01-01

The catalytic subunits of SWI/SNF-family and INO80-family chromatin remodelers bind actin and actin-related proteins (Arps) through an N-terminal helicase/SANT-associated (HSA) domain. Between the HSA and ATPase domains lies a conserved post-HSA (pHSA) domain. The HSA domain of Sth1, the catalytic subunit of the yeast SWI/SNF-family remodeler RSC, recruits the Rtt102-Arp7/9 heterotrimer. Rtt102-Arp7/9 regulates RSC function, but the mechanism is unclear. We show that the pHSA domain interacts directly with another conserved region of the catalytic subunit, protrusion-1. Rtt102-Arp7/9 binding to the HSA domain weakens this interaction and promotes the formation of stable, monodisperse complexes with DNA and nucleosomes. A crystal structure of Rtt102-Arp7/9 shows that ATP binds to Arp7 but not Arp9. However, Arp7 does not hydrolyze ATP. Together, the results suggest that Rtt102 and ATP stabilize a conformation of Arp7/9 that potentiates binding to the HSA domain, which releases intramolecular interactions within Sth1 and controls DNA and nucleosome binding.

Les soins aux enfants et aux adolescents des familles des militaires canadiens : les considérations particulières

PubMed Central

Rowan-Legg, Anne

2017-01-01

Résumé Les familles des militaires font face à de nombreux facteurs de stress, tels que les réinstallations fréquentes, les longues pério des de séparation familiale, l’isolement géographique du réseau de soutien de la famille élargie et le déploiement en zones très dangereuses. Les enfants et les adolescents des familles des militaires vivent les mêmes trajectoires développementales et motivationnelles que leurs homologues civils, mais ils sont également aux prises avec des pressions et des facteurs de stress liés à leur développement qui sont inhabituels et qui leur sont imposés par les exigences de la vie militaire. Les effets de la vie militaire sur les familles et les enfants commencent à être admis et mieux caractérisés. Il est essentiel de comprendre les préoccupations propres aux enfants et aux adolescents des familles des militaires et de mobiliser les ressources nécessaires pour les soutenir afin de répondre à leurs besoins en matière de santé.

Challenges facing the United States of America in implementing universal coverage.

PubMed

Rice, Thomas; Unruh, Lynn Y; Rosenau, Pauline; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

2014-12-01

In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features--health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies--remain works in progress. The ACA did not introduce the stringent spending controls found in many European health systems. It also explicitly prohibits the creation of institutes--for the assessment of the cost-effectiveness of pharmaceuticals, health services and technologies--comparable to the National Institute for Health and Care Excellence in the United Kingdom of Great Britain and Northern Ireland, the Haute Autorité de Santé in France or the Pharmaceutical Benefits Advisory Committee in Australia. The ACA was--and remains--weakened by a lack of cross-party political consensus. The ACA's performance and its resulting acceptability to the general public will be critical to the Act's future.

Personalized Medicine and Adverse Drug Reactions: The Experience of An Italian Teaching Hospital.

PubMed

La Russa, Raffaele; Finesch, Vittorio; Di Sanzo, Mariantonia; Gatto, Vittorio; Santurro, Alessandro; Martini, Gabriella; Scopetti, Matteo; Frati, Paola

2017-01-01

The personalized medicine is a model of medicine based on inherent difference given by the genetic heritage that characterizes us, diversity that can affect also our response to administered therapy. Nowadays, the term "adverse drug reaction" is identified with any harmful effect involuntary resulting from the use of a medicinal product; pharmacogenomics, in this field, has the aim to improve the drug response and to reduce the adverse reaction. We analyzed all reports of adverse reaction collected in the Pharmacovigilance Centre database of an Italian University Hospital, at the Sant'Andrea Hospital Sapienza University of Rome, in a period of two years. Comparing the data result from our analysis with several studies found in literature, it is evident that adverse drug reactions represent an important problem in the management of a health care system. However, the development of pharmacogenetics and pharmacogenomics, allowing a personalized treatment, can improve clinical practice. This study highlights the great potential of pharmacogenomics in reducing adverse reactions and suggests the need for further pharmacogenomic clinical trials to better personalize drug treatment and to refine the current pharmacovigilance strategies. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

[Development of Human Health Discoveries. 10 years results of Young Innovative Company incubation].

PubMed

Marsac, Jean

2014-01-01

Medicine is evolving every day in its operating procedures and the services offered to patients, emphasizing personalized medicine, safety and medical benefits. The individual patient is more than ever the hub of healthcare organization. Medical innovation is thus a public health priority. However it requires an accurate assessment of medical utility and risk-benefit ratios, and in-depth analysis of economic and organizational impacts. Ten years of experience in the Paris Biotech Santé company incubator has identified key actions for effective support of research projects and the success of innovative companies. Strong expertise is needed to prepare development plans, ensure compliance with regulatory requirements and obtain research funding. During its first decade, this incubator has created 87 innovative companies employing 1500 people, raised more than 90 million euros of funding, and reached a cumulative company value of 1200 million euros. Key factors of success have been identified, but an analysis of the causes of failure shows that operational adjustments are mandatory, particularly a strong commitment from medical experts, in order to promote access to new and useful products for patients while at the same time assessing their social impact.

Canada-United States-Mexico Trilateral Cooperation on Childhood Obesity Initiative.

PubMed

Rabadán-Diehl, Cristina; Safdie, Margarita; Rodin, Rachel

2016-08-01

exigen la formación de alianzas multisectoriales. Aprovechando las bases sentadas por una larga tradición de colaboración trilateral, el Canadá, los Estados Unidos y México formaron una alianza para controlar la epidemia creciente de obesidad infantil en la subregión norteamericana. Esta iniciativa colaborativa, que se conoce por Iniciativa de Cooperación Trilateral contra la Obesidad Infantil, es la primera iniciativa en la Región en tratar de hacer frente al problema de las enfermedades crónicas no transmisibles convocando a un grupo de expertos técnicos y de expertos en asuntos normativos, con el liderazgo y respaldo de los secretarios y ministros de salud de los países implicados. La Iniciativa tiene por objetivos aumentar los niveles de actividad física y reducir el sedentarismo mediante a) una mayor movilización social y participación ciudadana, b) medidas de extensión comunitaria y c) modificaciones de las zonas edificadas (construidas por el hombre). En el presente artículo se describen los antecedentes de la Iniciativa y su creación; las metas, actividades y medidas específicas que ha habido hasta ahora; y las oportunidades y los pasos que hay que dar en lo sucesivo. Esta información podría resultar útil para quienes estén formando otras alianzas encaminadas a controlar la obesidad infantil u otros problemas de salud pública complejos en la Región. RÉSUMÉ L'obésité de l'enfant est un problème de santé publique important dans les pays des Amériques. En 2014, les États Membres de l'Organisation Panaméricaine de la Santé (OPS) ont approuvé un Plan d'action pour la prévention de l'obésité chez les enfants et les adolescents pour combattre la prévalence de ce trouble dans la Région des Amériques. Les interventions énoncées dans ce plan régional sont multidimensionnelles et nécessitent des partenariats multisectoriels. S'appuyant sur une riche histoire de collaboration trilatérale fructueuse, le Canada, les États-Unis et

Managing pinon-juniper ecosystems for sustainability and social needs; proceedings of the symposium 1993 April 26-30; Sante Fe, New Mexico

Treesearch

Earl F. Aldon; Douglas W. Shaw

1993-01-01

The purpose of this symposium was to assist the USDA Forest Service, other federal land management agencies, and the New Mexico State Land Office in the future development and management of the pinon-juniper ecosystem in the Southwest. Authors assessed the current state of knowledge about the pinon-juniper resource and helped develop future research and management...

Universal entanglement crossover of coupled quantum wires

NASA Astrophysics Data System (ADS)

Vasseur, Romain; Jacobsen, Jesper; Saleur, Hubert

2014-03-01

We consider the entanglement between two one-dimensional quantum wires (Luttinger Liquids) coupled by tunneling through a quantum impurity. The physics of the system involves a crossover between weak and strong coupling regimes characterized by an energy scale TB, and methods of conformal field theory therefore cannot be applied. The evolution of the entanglement in this crossover has led to many numerical studies, but has remained little understood, analytically or even qualitatively. This is, in part, due to the fact that the entanglement in this case is non-perturbative in the tunneling amplitude. We argue that the correct universal scaling form of the entanglement entropy S (for an arbitrary interval containing the impurity) is ∂S / ∂lnL = f(LTB) . In the special case where the coupling to the impurity can be refermionized, we show how the universal function f(LTB) can be obtained analytically using recent results on form factors of twist fields and a defect massless-scattering formalism. Our results are carefully checked against numerical simulations. This work was supported by the the French ANR (ANR Projet 2010 Blanc SIMI 4 : DIME), the US DOE (grant number DE-FG03-01ER45908), the Quantum Materials program of LBNL (RV) and the Institut Universitaire de France (JLJ).

Submillimeterwave Spectroscopy of Highly Astrophysical Interest Molecule: Hydroxyacetonitrile

NASA Astrophysics Data System (ADS)

Margules, L.; Motiyenko, R. A.; Guillemin, J.-C.

2013-06-01

Hydroxyacetonitrile is a simple derivative of methanol. This molecule has a strong astrophysical interest. In astrophysical environment, the formation of hydroxyacetonitrile (HOCH_2CN), has been shown to compete with aminomethanol (NH_2CH_2OH), a glycine precursor, through the Strecker synthesis, in addition its photochemistry leads to the formation of formylcyanide (CHOCN), ketenimine (CH_2CNH), formaldehyde (CH_2O), hydrogen cyanide (HCN), carbon monoxyde (CO). Its detection in the ISM will provide crucial hints in the formation process of complex organic molecules. The lack of data about this molecule, only studied up to 50 GHz, is mainly due to two reasons. First, this is not commercially available, the synthesis should be perform. Second, the most stable conformer is the gauche one. This exhibits large amplitude motion due to the two equivalent configurations possible. Due to tunneling effect, each level is split into 0^+ and 0^- substates. This makes the analysis of the spectra delicate. We will report here the very first results obtained. This work was supported by the CNES and the Action sur Projets de l'INSU, PCMI. Danger, G. et al.ApJ {756}, (2012) 11 Danger, G. et al.A&A {549}, (2012) A93 Cazzoli, G. et al.J. Chem. Soc., Faraday Trans. 2 {69}, (1973) 569

Les grands accélérateurs de particules

NASA Astrophysics Data System (ADS)

Patoux, A.; Perot, J.

1991-02-01

The different types of accelerators are recalled with emphasis on the most powerful : the synchrotron particle colliders. The use of superconductors in accelerator magnets as well as in RF cavities is discussed. The characteristics of the large accelerators, existing and planned, are given together with the level of industry involvement in their construction. Details concerning superconducting magnets and cryogenic plants are investigated. Finally, detectors, the most important tool for physics, are mentionned. Après avoir rappelé les différents types d'accélérateurs utilisés, l'accent est mis sur les plus puissants, c'est-à-dire les synchrotrons fonctionnant en anneaux de collision. Le rôle des supraconducteurs est analysé aussi bien pour les aimants que pour les cavités accélératrices. Les caractéristiques des principaux accélérateurs existants ou en projet sont données ainsi que l'implication de l'industrie dans leur fabrication. On insiste plus particulièrement sur les aimants supraconducteurs et les installations cryogéniques. Enfin les détecteurs, éléments indispensables à la physique, sont également évoqués.

CRTs – Cluster Randomized Trials or “Courting Real Troubles”

PubMed Central

Ranson, M. Kent; Sinha, Tara; Morris, Saul S.; Mills, Anne J.

2006-01-01

This paper addresses the logistical challenges of implementing public health interventions in the setting of cluster randomized trials (CRTs), drawing on the experience of carrying out a CRT within a community-based health insurance (CBHI) scheme in rural India. Our CRT is seeking to improve the equity impact – i.e., reduce the differential in claims submission for hospitalization between poor and less poor – of this CBHI in rural areas. Five main challenges are identified and discussed: 1) assigning control clusters, 2) blinding, 3) implementing interventions simultaneously, 4) minimizing leakage, and 5) piggy-backing on a changing scheme. These challenges are not likely to be unique to low-income settings, although the fifth challenge is particularly likely when working with relatively small and resource-constrained programs. While compromises to methodological best-practice may reduce internal validity, they make the intervention more ‘real’, and potentially more applicable, to other programs and settings. Further, careful documentation of compromises allows them to be considered in the final analysis. RÉSUMÉ Cet article traite des difficultés logistiques rencontrées dans la mise en oeuvre d'interventions de santé publique dans le cadre d'essais contrôlés randomisés par grappes. Il tire les enseignements d'une expérience menée au sein d'un système d'assurance-santé communautaire dans une région rurale de l'Inde. Il s'agit d'une intervention randomisée par grappes qui a pour but d'améliorer l'équité du système, à savoir réduire l'écart entre les demandes de remboursement des frais d'hospitalisation soumises par les populations pauvres et moins pauvres. Cinq grandes difficultés sont présentées et discutées dans l'article : 1) la mise en place des groupes de contrôle, 2) la création des conditions d'un test en aveugle, 3) la simultanéité des interventions, 4) le risque de contamination entre les groupes et 5) l'implantation sur

N° 341-Diagnostic et prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes.

PubMed

Kives, Sari; Gascon, Suzy; Dubuc, Élise; Van Eyk, Nancy

2017-02-01

Passer en revue les connaissances scientifiques actuelles et formuler des recommandations relatives au diagnostic et à la prise en charge de la torsion annexielle chez les filles, les adolescentes et les femmes adultes. L'étude porte sur les facteurs de risque, la précision diagnostique, les options de prise en charge et les issues de la torsion annexielle. RéSULTATS: Nous avons examiné les études publiées en faisant des recherches dans MEDLINE, Embase, CINAHL et la Bibliothèque Cochrane à l'aide d'une terminologie contrôlée et de mots-clés appropriés (« adnexal torsion », « ovarian torsion »). Nous avons limité les résultats aux revues systématiques, aux essais contrôlés aléatoires, aux essais cliniques contrôlés et aux études d'observation. Nous avons refait les recherches de façon régulière et intégré de nouvelles données à la directive jusqu'en décembre 2014. Nous avons également étudié la littérature grise (non publiée) trouvée sur les sites Web d'organismes d'évaluation des technologies de la santé et d'autres organismes connexes, dans des collections de directives cliniques et dans des registres d'essais cliniques, et obtenue auprès d'associations nationales et internationales de médecins spécialistes. Les résultats ont été examinés et évalués par le comité CANPAGO de la Société des obstétriciens et gynécologues du Canada (SOGC), sous la direction des auteures principales. Les recommandations ont été classées selon les critères établis par le Groupe d'étude canadien sur les soins de santé préventifs. AVANTAGES, DéSAVANTAGES ET COûTS: L'application de la directive devrait aider les praticiens à adopter une approche de diagnostic et de prise en charge optimale en matière de torsion annexielle, à réduire au minimum les effets néfastes et à améliorer l'issue qui attend les patientes. La présente directive a été évaluée et approuvée par le Comité de pratique - gynécologie de la SOGC

Des recommandations probantes pour surveiller l’innocuité des antipsychotiques de deuxième génération chez les enfants et les adolescents

PubMed Central

Pringsheim, Tamara; Panagiotopoulos, Constadina; Davidson, Jana; Ho, Josephine

2012-01-01

HISTORIQUE : Au Canada, l’utilisation d’antipsychotiques, notamment les antipsychotiques de deuxième génération (ADG), a augmenté de façon considérable depuis cinq ans chez les enfants ayant des troubles de santé mentale. Ces médicaments ont le potentiel de causer de graves complications métaboliques et neurologiques lorsqu’on les utilise de manière chronique. OBJECTIF : Synthétiser les données probantes relatives aux effets secondaires métaboliques et neurologiques précis associés à l’usage d’ADG chez les enfants et fournir des recommandations probantes sur la surveillance de ces effets secondaires. MÉTHODOLOGIE : Les auteurs ont procédé à une analyse systématique des essais cliniques contrôlés des ADG auprès d’enfants. Ils ont fait des recommandations à l’égard de la surveillance de l’innocuité des ADG d’après un modèle de classification fondé sur le système GRADE (système de notation de l’évaluation et de l’élaboration des recommandations). Lorsque les données probantes n’étaient pas suffisantes, ils fondaient leurs recommandations sur le consensus et l’avis d’experts. Un groupe consensuel multidisciplinaire a analysé toutes les données probantes pertinentes et est parvenu à un consensus à l’égard des recommandations. RÉSULTATS : Les recommandations probantes portant sur la surveillance de l’innocuité des ADG figurent dans les présentes lignes directrices. Les auteurs indiquent la qualité des recommandations relatives à des examens physiques et tests de laboratoire précis à l’égard de chaque ADG à des moments déterminés. CONCLUSION : De multiples essais aléatoires et contrôlés ont permis d’évaluer l’efficacité de bon nombre des ADG utilisés pour traiter les troubles de santé mentale en pédiatrie. Toutefois, leurs avantages ne sont pas sans risques : on observe à la fois des effets secondaires métaboliques et neurologiques chez les enfants traités au moyen d�

Medico-economic evaluation of health products in the context of the Social Security Financing Act for 2012.

PubMed

Dervaux, Benoît; Baseilhac, Eric; Fagon, Jean-Yves; Ameye, Véronique; Angot, Pierre; Audry, Antoine; Becquemont, Laurent; Borel, Thomas; Cazeneuve, Béatrice; Courtois, Jocelyn; Detournay, Bruno; Favre, Pascal; Granger, Muriel; Josseran, Anne; Lassale, Catherine; Louvet, Olivier; Pinson, Jean; de Pouvourville, Gérard; Rochaix, Lise; Rumeau-Pichon, Catherine; de Saab, Rima; Schwarzinger, Mickaël; Sun, Aristide

2013-01-01

The participants in round table 6 of the Giens Workshops 2012 drafted recommendations based on the collective interpretation of important elements of the decree concerning the medico-economic evaluation of health products published a few days earlier (02 October 2012). The medico-economic evaluation (MEE), becomes an additional determinant for fixing the prices of health products by the Health products economic committee (Comité économique des produits de santé, CEPS) via the hierarchisation of treatment strategies, and thus modifies the market access conditions. Limiting the analysis to medicinal products and medical devices for which a major, important or moderate improvement in the medical service rendered (ASMR) or of the expected service (ASA) has been requested and presenting a significant budget impact on the Social Security expenses, excludes health products with ASMR or ASA with a lower level requested which often create complex price fixing problems and often have a major budget impact. This latter concept remains to be defined in detail. The MEE envisaged for the first registration must include the need to confirm or refute the initial hypotheses especially concerning the actual position in the therapeutic strategy at the time of renewal of the registration. For the first registration, the conventional reference to European prices guaranteeing a minimum price to innovative medicinal products, the medico-economic models submitted by the industry to the French Drug Authority (Haute autorité de santé, HAS) must be used to guide the compilation of new data to be requested at the time of the registration renewal and to negotiate the level of the discounts in the framework of a price-volume agreement, if applicable. The MEE will allow comparing the result of the analysis to the model hypothesis at the time of the renewal of the registration, which may contribute to the renegotiation (either up or down) of the price of health goods. The costs related to

N° 342-L'hépatite B et la grossesse.

PubMed

Castillo, Eliana; Murphy, Kellie; van Schalkwyk, Julie

2017-03-01

Examiner l'épidémiologie, l'histoire naturelle, l'évaluation et le traitement de l'infection au virus de l'hépatite B (VHB) durant la grossesse. Cela aidera les fournisseurs de soins obstétricaux à conseiller leurs patientes quant aux risques périnataux et aux options de prise en charge offertes aux femmes enceintes atteintes de l'hépatite B. Les éléments évalués comprennent les seuils de traitement antiviral contre le VHB pour la prévention de la transmission périnatale et pour les interventions effractives durant la grossesse pour les femmes atteintes de l'hépatite B. RéSULTATS: Nous avons recherché dans MEDLINE, Embase et CINAHL des articles en anglais sur les sujets liés à l'infection par le VHB, à la grossesse et à la transmission périnatale publiés de 1966 à mars 2016. Nous n'avons tenu compte que des résultats qui proviennent de revues systématiques, d'essais contrôlés aléatoires ou d'essais cliniques contrôlés et d'études d'observation. Nous avons également étudié d'autres articles (non publiés) trouvés sur les sites Web d'organismes d'évaluation des technologies de la santé et d'autres organismes connexes, dans des collections de directives cliniques et dans des registres d'essais cliniques, et obtenus auprès d'associations nationales et internationales de médecins spécialistes. MéTHODES DE VALIDATION: La qualité des résultats a été évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1). Les recommandations pour la pratique sont classées selon la méthode décrite dans ce rapport. MISE à JOUR DE DIRECTIVES CLINIQUES: La directive clinique sera évaluée cinq ans après sa publication afin de déterminer si une mise à jour est nécessaire. Cependant, si de nouvelles données probantes importantes sont publiées avant la fin du cycle de cinq ans, le processus peut être accéléré pour mettre à jour rapidement certaines

Effet de la composition des materiaux composites sur la caracterisation et detection par ondes de Lamb

NASA Astrophysics Data System (ADS)

Ostiguy, Pierre-Claude

Les matériaux composites sont de plus en plus utilisés en aéronautique. Leurs excellentes propriétés mécaniques et leur faible poids leur procurent un avantage certain par rapport aux matériaux métalliques. Ceux-ci étant soumis à diverses conditions de chargement et environnementales, ils sont suceptibles de subir plusieurs types d'endommagements, compromettant leur intégrité. Des méthodes fiables d'inspection sont donc nécessaires pour évaluer leur intégrité. Néanmoins, peu d'approches non destructives, embarquées et efficaces sont présentement utilisées. Ce travail de recherche se penche sur l'étude de l'effet de la composition des matériaux composites sur la détection et la caractérisation par ondes guidées. L'objectif du projet est de développer une approche de caractérisation mécanique embarquée permettant d'améliorer la performance d'une approche d'imagerie par antenne piézoélectriques sur des structures composite et métalliques. La contribution de ce projet est de proposer une approche embarquée de caractérisation mécanique par ultrasons qui ne requiert pas une mesure sur une multitude d'échantillons et qui est non destructive. Ce mémoire par articles est divisé en quatre parties, dont les parties deux A quatre présentant les articles publiés et soumis. La première partie présente l'état des connaissances dans la matière nécessaires à l'acomplissement de ce projet de maîtrise. Les principaux sujets traités portent sur les matériaux composites, propagation d'ondes, la modélisation des ondes guidées, la caractérisation par ondes guidées et la surveillance embarquée des structures. La deuxième partie présente une étude de l'effet des propriétés mécaniques sur la performance de l'algorithme d'imagerie Excitelet. L'étude est faite sur une structure isotrope. Les résultats ont démontré que l'algorithme est sensible à l'exactitude des propriétés mécaniques utilisées dans le modèle. Cette

Second Projet de Renforcement Institutionnel du Secteur Minier de la République Islamique de Mauritanie (PRISM-II) Phase V

USGS Publications Warehouse

Taylor, Cliff D.

2015-12-30

This report contains the USGS results of the PRISM-II Mauritania Minerals Project and is presented in cooperation with the Ministry of Petroleum, Energy, and Mines of the Islamic Republic of Mauritania. The Report is composed of separate chapters consisting of multidisciplinary interpretive reports with accompanying plates on the geology, structure, geochronology, geophysics, hydrogeology, geochemistry, remote sensing (Landsat TM and ASTER), and SRTM and ASTER digital elevation models of Mauritania. The syntheses of these multidisciplinary data formed the basis for additional chapters containing interpretive reports on 12 different commodities and deposit types known to occur in Mauritania, accompanied by countrywide mineral resource potential maps of each commodity/deposit type. The commodities and deposit types represented include: (1) Ni, Cu, PGE, and Cr deposits hosted in ultramafic rocks; (2) orogenic, Carlin-like, and epithermal gold deposits; (3) polymetallic Pb-Zn-Cu vein deposits; (4) sediment-hosted Pb-Zn-Ag deposits of the SEDEX and Mississippi Valley-type; (5) sediment-hosted copper deposits; ( 6) volcanogenic massive sulfide deposits; (7) iron oxide copper-gold deposits; (8) uranium deposits; (9) Algoma-, Superior-, and oolitic-type iron deposits; (10) shoreline Ti-Zr placer deposits; (11) incompatible element deposits hosted in pegmatites, alkaline rocks, and carbonatites, and; (12) industrial mineral deposits. Additional chapters include the Mauritanian National Mineral Deposits Database are accompanied by an explanatory text and the Mauritania Minerals Project GIS that contains all of the interpretive layers created by USGS scientists. Raw data not in the public domain may be obtained from the Ministry of Petroleum, Energy, and Mines in Nouakchott, Mauritania.

La lettre d'affaires: Projet de principes d'une methodologie d'apprentissage (The Business Letter: How To Write One).

ERIC Educational Resources Information Center

Clijsters, Willy

Instruction in business letter-writing, particularly in the context of the business French course, is discussed. First, the kinds of business communications (face-to-face, print, and electronic) currently used are surveyed briefly, and a taxonomy of the content of business communication is presented. Conventions of French business letters are then…

Evaluation of the midwifery pilot projects in Quebec: an overview. L'Equipe d'Evaluation des Projets-Pilotes Sages-Femmes.

PubMed

Blais, R; Joubert, P

2000-01-01

In 1990, the province of Quebec adopted a law authorizing the evaluation of the practice of midwifery through eight pilot projects. The projects, which took the form of birth centres outside hospitals, started operating in 1994. The objectives of the evaluation were 1) to compare midwives' services to current physician services with regard to maternal and neonatal mortality and morbidity, the use of obstetrical intervention, individualization and continuity of care as perceived by clients, and cost; and 2) to identify the professional and organizational factors associated with the integration of midwives into the health care system. A mixed evaluative design was used: a multiple case study with each pilot project representing a case and a cohort study where 1,000 women followed by midwives in the birth centres were matched with 1,000 women followed by physicians in the usual hospital-based services. Various quantitative and qualitative data collection instruments were used. Overall, many results were favourable to midwifery practice, while some were favourable to medical care. Following the evaluation, the Government of Quebec decided to legalize the practice of midwifery.

Amelioration de l'efficacite energetique du procede d'electrolyse de l'aluminium conception d'un nouveau bloc cathodique

NASA Astrophysics Data System (ADS)

Blais, Mathieu

Au Quebec, les alumineries sont de grandes consommatrices d'energie electrique, soit pres de 14 % de la puissance installee d'Hydro-Quebec. Dans ce contexte, des petits gains en efficacite energetique des cuves d'electrolyse pourraient avoir un impact important sur la reduction globale de la consommation d'electricite. Le projet de maitrise decrit dans cette etude repond a la problematique suivante : comment l'optimisation de la geometrie d'un bloc cathodique en vue d'uniformiser la densite de courant peut augmenter l'efficacite energetique et la duree de vie de la cuve d'aluminium? Le but premier du projet est de modifier la geometrie en vue d'ameliorer le comportement thermoelectrique des blocs cathodiques et d'accroitre par le fait meme l'efficacite energetique du procede de production d'aluminium. La mauvaise distribution de la densite de courant dans la cuve est responsable de certains problemes energetiques ayant des impacts negatifs sur l'economie et l'environnement. Cette non-uniformite de la distribution du courant induit une usure prematuree de la surface de la cathode et contribue a reduire la stabilite magnetohydrodynamique de la nappe de metal liquide. Afin de quantifier les impacts que peut avoir l'uniformisation de la densite de courant a travers le bloc cathodique, un modele d'un bloc cathodique d'une cuve de la technologie AP-30 a ete concu et analyse par elements finis. A partir de son comportement thermoelectrique et de donnees experimentales d'une cuve AP-30 tirees de la litterature, une correlation entre le profil de densite de courant a la surface du bloc et le taux d'erosion local au meme endroit a ete creee. Cette relation correspond au modele predictif de la duree de vie de tout bloc du meme materiau a partir de son profil de densite de courant. Ensuite, une programmation a ete faite incorporant dans une meme fonction cout les impacts economiques de la duree de vie, de la chute de voltage cathodique et de l'utilisation de nouveaux materiaux

[SUPPORT, CO-OPERATIVE EDUCATION PROGRAMMES, PRAGMATIC CODE OF ETHICS: A CLINICAL APPROACH OF EXECUTIVE TRAINING].

PubMed

Cabaret, Véronique

2016-01-01

This article aims at introducing an educational sequence completed at l'Institut de Formation des Cadres de Santé (IFCS) at the CHRU in Lille in France, entitled "training project and educational project" present in the "training duties" module whose goal is to generate students'knowledge through co-operative education programmes. By creating this innovative sequence, the educational aim is to use the Institut ground as a ground of learning, associated with the various internship grounds, in order to get the most of co-operative education programmes. Besides, in a pragmatic code of ethics in training, the teaching staff draw their inspiration from a clinical approach of executive training: they regard students as true protagonists in a co-operative plan created for them, wishing to design it with them using their words. Thus, students are brought to criticize the IFCS educational project and debate it with the trainers who have built it. Each partner tries to understand the Other, being aware of their being different. By contributing every year to rewriting the educational project which directly concerns them, students build their professional positions as health executives. They play an active role in co-operative education programmes just like IFCS outside partners.

Collaboration between a human group and artificial intelligence can improve prediction of multiple sclerosis course: a proof-of-principle study

PubMed Central

Ferraldeschi, Michela; Salvetti, Marco; Zaccaria, Andrea; Crisanti, Andrea; Grassi, Francesca

2017-01-01

Background: Multiple sclerosis has an extremely variable natural course. In most patients, disease starts with a relapsing-remitting (RR) phase, which proceeds to a secondary progressive (SP) form. The duration of the RR phase is hard to predict, and to date predictions on the rate of disease progression remain suboptimal. This limits the opportunity to tailor therapy on an individual patient's prognosis, in spite of the choice of several therapeutic options. Approaches to improve clinical decisions, such as collective intelligence of human groups and machine learning algorithms are widely investigated. Methods: Medical students and a machine learning algorithm predicted the course of disease on the basis of randomly chosen clinical records of patients that attended at the Multiple Sclerosis service of Sant'Andrea hospital in Rome. Results: A significant improvement of predictive ability was obtained when predictions were combined with a weight that depends on the consistence of human (or algorithm) forecasts on a given clinical record. Conclusions: In this work we present proof-of-principle that human-machine hybrid predictions yield better prognoses than machine learning algorithms or groups of humans alone. To strengthen this preliminary result, we propose a crowdsourcing initiative to collect prognoses by physicians on an expanded set of patients. PMID:29904574

High School Students Are a Target Group for Fight against Self-Medication with Antimalarial Drugs: A Pilot Study in University of Kinshasa, Democratic Republic of Congo.

PubMed

Kabongo Kamitalu, Ramsès; Aloni, Michel Ntetani

2016-01-01

Aim. To assess the self-medication against malaria infection in population of Congolese students in Kinshasa, Democratic Republic of Congo (DRC). Methods. A cross-sectional study was carried out in University of Kinshasa, Kinshasa, Democratic Republic of Congo. Medical records of all students with malaria admitted to Centre de Santé Universitaire of University of Kinshasa from January 1, 2008, to April 30, 2008, were reviewed retrospectively. Results. The median age of the patients was 25.4 years (range: from 18 to 36 years). The majority of them were male (67.9%). Artemisinin-based combination treatments (ACTs) was the most used self-prescribed antimalarial drugs. However, self-medication was associated with the ingestion of quinine in 19.9% of cases. No case of ingestion of artesunate/artemether in monotherapy was found. All the medicines taken were registered in DRC. In this series, self-prescribed antimalarial was very irrational in terms of dose and duration of treatment. Conclusion. This paper highlights self-medication by a group who should be aware of malaria treatment protocols. The level of self-prescribing quinine is relatively high among students and is disturbing for a molecule reserved for severe disease in Congolese health care policy in management of malaria.

Pitted keratolysis, erythromycin, and hyperhidrosis.

PubMed

Pranteda, Guglielmo; Carlesimo, Marta; Pranteda, Giulia; Abruzzese, Claudia; Grimaldi, Miriam; De Micco, Sabrina; Muscianese, Marta; Bottoni, Ugo

2014-01-01

Pitted keratolysis (PK) is a plantar skin disorder mainly caused by coryneform bacteria. A common treatment consists of the topical use of erythromycin. Hyperhidrosis is considered a predisposing factor for bacterial proliferation and, consequently, for the onset of PK. The aim of this study was to evaluate the relationship between PK erythromycin and hyperhidrosis. All patients with PK seen in Sant'Andrea Hospital, between January 2009 and December 2011, were collected. PK was clinically and microscopically diagnosed. All patients underwent only topical treatment with erythromycin 3% gel twice daily. At the beginning of the study and after 5 and 10 days of treatment, a clinical evaluation and a gravimetric measurement of plantar sweating were assessed. A total of 97 patients were diagnosed as PK and were included in the study. Gravimetric measurements showed that in 94 of 97 examined patients (96.90%) at the time of the diagnosis, there was a bilateral excessive sweating occurring specifically in the areas affected by PK. After 10 days of antibiotic therapy, hyperhidrosis regressed together with the clinical manifestations. According to these data, we hypothesize that hyperhidrosis is due to an eccrine sweat gland hyperfunction, probably secondary to bacterial infection. © 2013 Wiley Periodicals, Inc.

Individual, Social, and Environmental Correlates of Active Transportation Patterns in French Women.

PubMed

Perchoux, Camille; Enaux, Christophe; Oppert, Jean-Michel; Menai, Mehdi; Charreire, Hélène; Salze, Paul; Weber, Christiane; Hercberg, Serge; Feuillet, Thierry; Hess, Franck; Roda, Célina; Simon, Chantal; Nazare, Julie-Anne

2017-01-01

The objectives were (1) to define physical activity (PA) and sedentary behaviors (SB) patterns in daily life contexts (work, leisure, and transportation) in French working women from NutriNet-Santé web-cohort and (2) to identify pattern(s) of active transportation and their individual, social, and environmental correlates. 23,432 participants completed two questionnaires to evaluate PA and SB in daily life contexts and individual representations of residential neighborhood and transportation modes. Hierarchical cluster analysis was performed which identified 6 distinct movement behavior patterns: (i) active occupation, high sedentary leisure, (ii) sedentary occupation, low leisure, (iii) sedentary transportation, (iv) sedentary occupation and leisure, (v) active transportation, and (vi) active leisure. Multinomial logistic regressions were performed to identify correlates of the "active transportation" cluster. The perceived environmental characteristics positively associated with "active transportation" included "high availability of destinations around home," "presence of bicycle paths," and "low traffic." A "positive image of walking/cycling," the "individual feeling of being physically active," and a "high use of active transport modes by relatives/friends" were positively related to "active transportation," identified as a unique pattern regarding individual and environmental correlates. Identification of PA and SB context-specific patterns will help to understand movement behaviors' complexity and to design interventions to promote active transportation in specific subgroups.

[Development of quality of care indicators to support chronic disease management].

PubMed

Beaulieu, Marie-dominique; Pomey, Marie-pascale; Del Grande, Claudio; Côté, Brigitte; Tremblay, Éric; Ghorbel, Monia; Hua, Phuong

2015-01-01

This article presents the results of a project conducted by the Institut national d'excellence en santé et en services sociaux of Québec to develop quality of care indicators for the management of six chronic illnesses. Indicators were identified through literature searches and analysis of clinical practice guidelines (CPGs). Interdisciplinary expert panels assessed their validity and the strength of the evidence on which they were based. Representatives of patients (N = 19) and professionals (N = 29) were consulted on their relevance and acceptability. Indicators were categorized according to the Chronic Care Model (CCM). A total of 164 indicators were developed, 126 specific to the illnesses under study and 38 on processes and outcomes generic to the CCM. There was convergence between patients and professionals on the relevance of a majority of indicators. Professionals expressed concerns on the indicators measured by means of patient surveys that they considered to be too subjective. The importance given to CPGs as the main source of indicators resulted in a great number of indicators of the technical quality ofcare. Using the CCM contributed to a broader perspective of quality. The consultation process identified some of the concerns of professionals about indicator measurement, thusguidingfuture implementation initiatives.

[Mobbing: ten-year evaluation experience in a University Hospital].

PubMed

Monaco, Edoardo; Girardi, Paolo; Falaschi, Paolo; Ferracuti, Stefano; Martocchia, Antonio; Battaglia, Valentina; Capitanelli, Ilaria; Catarinozzi, Elena; Piccari, Ines; Rossi, Marina; Prestigiacomo, Claudio

2017-11-01

Bullying is a manifestation of occupational stress and can therefore be considered as a real "organizational pathology." Include the activities of the surgery dedicated to Mobbing, Unit of Occupational Medicine Sant'Andrea Hospital, which began operations in June 2001. In over ten years of operation (July 2012), the sample, consisting of 50.7% for men and 49.3% women, is heterogeneous in age. The schooling of the sample is medium-high as more than 82% have higher education level. The business sector is the service sector accounted for most (84%) than in industry (9%) and agriculture (2%). Of the 1545 patients seen, 1320 completed the diagnostic path, while 225 have stopped. 814 users have been certified for compatibility bullying (63% of cases) with a net reduction of the awards from 2007 onwards. Considerations are expressed about the possible intervention strategies: the presence of dedicated experts at the counters of listening and professionals as the trusted advisor, to which workers in distress can call on for advice and guidance on how to defend itself from, in accordance with the implemented for years at the Ministry of Health, the establishment of such figures as the manager rehability that in other European countries, are scheduled for some time in work organization. Copyright© by Aracne Editrice, Roma, Italy.

Devising work schedules for a collective: favouring intergenerational collaboration among counsellors in a shelter for female victims of conjugal violence.

PubMed

Chatigny, Céline

2011-01-01

The work activity of counsellors in shelters for female victims of conjugal violence is explored. The consortium of shelters requested the study because of complaints of worker stress, difficulties in management and high employee turnover. This qualitative and participatory community study involved a team of specialists in ergonomics and social work from the Centre de recherche interdisciplinaire sur la biologie, la santé, la sociélté et l'environnement (CINBIOSE), brought together by the Community Outreach Service of Université du Québec à Montréal (UQAM). Presented here are the study findings pertaining to training. Twenty-two semi-structured interviews and 80 hours of observation of work and training were conducted with counsellors from two contrasting shelters. Observations revealed an intense collaborative activity involving communication by many means. Nonetheless, young counsellors interviewed complained of having few opportunities to develop their counselling skills because they were isolated on evening, night and weekend shifts. In collaboration with the ergonomists, one shelter experimented with new ways of devising the work schedule to favour learning and training. By transforming the training mechanism, job status and work schedules, the shelter made the conditions more conducive to the development of counsellors' skills and health, while eliminating turnover for at least the two following years.

'My body is mine': Qualitatively exploring agency among internally displaced women participants in a small-group intervention in Leogane, Haiti.

PubMed

Logie, Carmen H; Daniel, CarolAnn

2016-01-01

The 2010 earthquake resulted in the breakdown of Haiti's social, economic and health infrastructure. Over one-quarter of a million people remain internally displaced (ID). ID women experience heightened vulnerability to intimate partner violence (IPV) due to increased poverty and reduced community networks. Scant research has examined experiences of IPV among ID women in post-earthquake Haiti. We conducted a qualitative study to explore the impact of participating in Famn an Aksyon Pou Santé Yo (FASY), a small-group HIV prevention intervention, on ID women's agency in Leogane, Haiti. We conducted four focus groups with ID women, FASY participants (n = 40) and in-depth individual interviews with peer health workers (n = 7). Our study was guided by critical ethnography and paid particular attention to power relations. Findings highlighted multiple forms of IPV (e.g., physical, sexual). Participants discussed processes of intrapersonal (confidence), interpersonal (communication), relational (support) and collective (women's rights) agency. Yet structural factors, including patriarchal gender norms and poverty, silenced IPV discussions and constrained women's agency. Findings suggest that agency among ID women is a multi-level, non-linear and incremental process. To effectively address IPV among ID women in Haiti, interventions should address structural contexts of gender inequity and poverty and concurrently facilitate multi-level processes of agency.

Substance misuse subtypes among women convicted of homicide.

PubMed

de Melo Nunes, Adriana; Baltieri, Danilo Antonio

2013-01-01

The proportion of women incarcerated is growing at a faster pace than that for men. The reasons for this important increase have been mainly attributed to drug-using lifestyle and drug-related offenses. About half of female inmates have history of substance misuse and one third demonstrate high impulsiveness levels. The objectives of this study were to (a) identify subtypes of alcohol and drug problems and impulsiveness among women convicted of homicide, and (b) examine the association between psychosocial and criminological features and the resulting clusters. Data come from 158 female inmates serving a sentence for homicide in the Penitentiary of Sant'Ana in São Paulo State, Brazil. Latent class analysis was used to group participants into substance misuse and impulsiveness classes. Two classes were identified: nonproblematic (cluster 1: 54.53%, n = 86) and problematic (cluster 2: 45.57%, n = 72) ones. After controlling for several psychosocial and criminological variables, cluster 2 inmates showed an earlier beginning of criminal activities and a lower educational level than their counterparts. To recognize the necessities of specific groups of female offenders is crucial for the development of an adequate system of health politics and for the decrease of criminal recidivism among those offenders who have shown higher risk.

Association between Impulsivity and Weight Status in a General Population.

PubMed

Bénard, Marc; Camilleri, Géraldine M; Etilé, Fabrice; Méjean, Caroline; Bellisle, France; Reach, Gérard; Hercberg, Serge; Péneau, Sandrine

2017-03-01

The objective of this study is to examine the association between impulsivity and weight status in a large sample of the adult general population in France, and the influence of gender on this relationship. A total of 11,929 men and 39,114 women participating in the NutriNet-Santé cohort were selected in this cross-sectional analysis. The Barratt Impulsiveness Scale (BIS-11) was used to assess impulsivity. Weight and height were self-reported. The association between impulsivity and BMI was estimated using logistic regressions adjusted for socio-demographic and lifestyle factors. Individuals with high impulsivity levels (BIS-11 total score >71) were more likely to be obese (Odds Ratio (OR) = 1.80, 95% Confidence Interval (CI): 1.39, 2.33 in men; OR = 1.30, 95% CI: 1.15, 1.48 in women) compared to individuals in the average range of impulsivity. The strongest associations between impulsivity and obesity were observed in men, where highly impulsive participants were more likely to be class III obese (BMI > 40 kg/m²) (OR = 3.57, 95% CI: 1.86, 6.85). This large sample analysis supports the existence of a relationship between impulsivity and weight status and the importance of psychological factors in the prevention of obesity.

Collaboration between a human group and artificial intelligence can improve prediction of multiple sclerosis course: a proof-of-principle study.

PubMed

Tacchella, Andrea; Romano, Silvia; Ferraldeschi, Michela; Salvetti, Marco; Zaccaria, Andrea; Crisanti, Andrea; Grassi, Francesca

2017-01-01

Background: Multiple sclerosis has an extremely variable natural course. In most patients, disease starts with a relapsing-remitting (RR) phase, which proceeds to a secondary progressive (SP) form. The duration of the RR phase is hard to predict, and to date predictions on the rate of disease progression remain suboptimal. This limits the opportunity to tailor therapy on an individual patient's prognosis, in spite of the choice of several therapeutic options. Approaches to improve clinical decisions, such as collective intelligence of human groups and machine learning algorithms are widely investigated. Methods: Medical students and a machine learning algorithm predicted the course of disease on the basis of randomly chosen clinical records of patients that attended at the Multiple Sclerosis service of Sant'Andrea hospital in Rome. Results: A significant improvement of predictive ability was obtained when predictions were combined with a weight that depends on the consistence of human (or algorithm) forecasts on a given clinical record. Conclusions: In this work we present proof-of-principle that human-machine hybrid predictions yield better prognoses than machine learning algorithms or groups of humans alone. To strengthen this preliminary result, we propose a crowdsourcing initiative to collect prognoses by physicians on an expanded set of patients.

[Two books printed in Strasburg during the 16th century present in the inventory of the Paris College of Pharmacy Library].

PubMed

Lafont, Olivier

2017-03-01

The catalogue of the College of Pharmacy Library, written in 1780, mentioned two books printed in Strasburg during the 16th century. The first one was a Latin edition of PΠερι Υλης Ιατριχης of Dioscorides. The drop caps are enriched by the figuration of episodes from the Bible. The principal interest of this book comes from the identity of his donator, Ioannes Du Boys, apothecary of the Duke of Alençon, the brother of King Henry III. This apothecary was also the author of a pharmacopoeia entitled Methodus Miscendorum Medicamentorum. The second one was a compendium of various titles, which had, most of them, in common to have been written by Valerius Cordus. It contains many illustrations and some of them are especially expressive. Its main interest is nevertheless to be a part of a gift made by a group of Parisian apothecaries, in 1570. This gift is considered as the birth of apothecaries’ library, the direct ancestor of actual “BIU Santé pole Pharmacy”. The presence of these two books in the library constitutes a testimony of the importance of printers from Strasburg in history.

La prévention de l’étouffement et de la suffocation chez les enfants

PubMed Central

Cyr, Claude

2012-01-01

RÉSUMÉ L’étouffement, la suffocation et la strangulation sont responsables de graves blessures non intentionnelles chez les enfants et constituent des causes importantes de décès non intentionnels chez les nourrissons et les tout-petits. Presque la totalité des décès et des blessures attribuables à un étouffement, une suffocation ou une strangulation sont évitables. Le présent document de principes traite des définitions, de l’épidémiologie et des stratégies de prévention efficaces de ces blessures. Des recommandations qui combinent des démarches pour améliorer la sécurité, incluant des recherches, de la surveillance, des lois et des normes, la conception des produits et l’éducation, sont présentées. Les dispensateurs de soins pédiatriques devraient encourager les parents et autres personnes qui s’occupent d’enfants à apprendre la réanimation cardiorespiratoire (RCR) et les premiers soins en cas d’étouffement, et leur offrir des conseils préventifs adaptés à l’âge de leur enfant lors des bilans de santé réguliers afin de prévenir ces blessures.

Starchy food consumption in French adults: a cross-sectional analysis of the profile of consumers and contribution to nutritional intake in a web-based prospective cohort.

PubMed

Szabo de Edelenyi, Fabien; Julia, Chantal; Courtois, Frédéric; Méjean, Caroline; Péneau, Sandrine; Galan, Pilar; Hercberg, Serge; Kesse-Guyot, Emmanuelle

2014-01-01

French Nutritional Guidelines recommend eating starchy foods at each meal, according to appetite, and advise to vary sources. However, the proportion of energy from carbohydrates is currently too low in many Western European countries. Consumption of the different types of starchy foods was assessed among 80,209 adult participants in the French NutriNet-Santé cohort (78% women, mean age 42.9 ± 14.5). Description of starchy food consumption according to sociodemographics was provided as well as the contribution of starchy food to nutritional intake. Determinants of adherence to starchy food nutritional guidelines were estimated using multivariable polytomous logistic regression. Starchy foods contributed approximately 22% of the energy intake, 75% of the complex carbohydrate intake and 36.1% of the fibre intake. About 43% of the subjects had intakes in line with the French Nutritional Guidelines concerning starchy foods. Men met the recommendation more frequently (55 vs. 33% for women), but were also more likely to exceed the recommendation (9.5 vs. 1.3%), even after adjustment for energy intake. According to our multivariable model, starchy food consumption increased also with age. A higher consumption of starchy foods should be promoted in the French population in order to increase the part of the energy intake coming from complex carbohydrates.

Advancing the conversation: next steps for lesbian, gay, bisexual, trans, and queer (LGBTQ) health sciences librarianship

PubMed Central

Hawkins, Blake W.; Morris, Martin; Nguyen, Tony; Siegel, John; Vardell, Emily

2017-01-01

In recent years, librarians in various sectors have been moving forward a conversation on the distinct information needs and information-seeking behavior of our lesbian, gay, bisexual, trans, and queer (LGBTQ) patrons and how well the profession recognizes and meets those needs. Health sciences librarianship has been slower than other areas of the profession in creating an evidence base covering the needs of its LGBTQ patrons, with, until recently, only very limited literature on this subject. LGBTQ health sciences librarianship is now starting to attract new interest, with librarians working together to bring this emerging specialization to the attention of the broader professional community. In this paper, the authors report on a dedicated panel discussion that took place at the 2016 joint annual meeting of the Medical Library Association and Canadian Health Libraries Association/Association des bibliothèques de la santé du Canada in Toronto, Ontario, Canada; discuss subsequent reflections; and highlight the emerging role for health sciences librarians in providing culturally competent services to the LGBTQ population. Recommendations are also provided for establishing a tool kit for LGBTQ health sciences librarianship from which librarians can draw. We conclude by highlighting the importance of critically reflective practice in health sciences librarianship in the context of LGBTQ health information. PMID:28983195

Early diagnosis of amyotrophic lateral sclerosis mimic syndromes: pros and cons of current clinical diagnostic criteria.

PubMed

Cortés-Vicente, Elena; Pradas, Jesús; Marín-Lahoz, Juan; De Luna, Noemi; Clarimón, Jordi; Turon-Sans, Janina; Gelpí, Ellen; Díaz-Manera, Jordi; Illa, Isabel; Rojas-Garcia, Ricard

2017-08-01

To describe the frequency and clinical characteristics of patients referred to a tertiary neuromuscular clinic as having amyotrophic lateral sclerosis (ALS) but who were re-diagnosed as having an ALS mimic syndrome, and to identify the reasons that led to the revision of the diagnosis. We reviewed the final diagnosis of all patients prospectively registered in the Sant Pau-MND register from 1 January 2004 to 31 December 2015. A detailed clinical evaluation and a clinically-guided electrophysiological study were performed at first evaluation. Twenty of 314 (6.4%) patients included were re-diagnosed as having a condition other than ALS, in 18 cases already at first evaluation. An alternative specific diagnosis was identified in 17 of those 20, consisting of a wide range of conditions. The main finding leading to an alternative diagnosis was the result of the electrophysiological study. Fifty per cent did not fulfil the El Escorial revised criteria (EECr) for ALS. The most common clinical phenotype at onset in patients with ALS mimic syndromes was progressive muscular atrophy (PMA). Misdiagnosing ALS is still a common problem. Early identification of ALS mimic syndromes is possible based on atypical clinical features and a clinically-guided electrophysiological study. Patients should be attended in specialised centres. The application of EECr helps to identify ALS misdiagnoses.

Socioeconomic Indicators Are Independently Associated with Nutrient Intake in French Adults: A DEDIPAC Study

PubMed Central

Si Hassen, Wendy; Castetbon, Katia; Cardon, Philippe; Enaux, Christophe; Nicolaou, Mary; Lien, Nanna; Terragni, Laura; Holdsworth, Michelle; Stronks, Karien; Hercberg, Serge; Méjean, Caroline

2016-01-01

Studies have suggested differential associations of specific indicators of socioeconomic position (SEP) with nutrient intake and a cumulative effect of these indicators on diet. We investigated the independent association of SEP indicators (education, income, occupation) with nutrient intake and their effect modification. This cross-sectional analysis included 91,900 French adults from the NutriNet-Santé cohort. Nutrient intake was estimated using three 24-h records. We investigated associations between the three SEP factors and nutrient intake using sex-stratified analysis of covariance, adjusted for age and energy intake, and associations between income and nutrient intake stratified by education and occupation. Low educated participants had higher protein and cholesterol intakes and lower fibre, vitamin C and beta-carotene intakes. Low income individuals had higher complex carbohydrate intakes, and lower magnesium, potassium, folate and vitamin C intakes. Intakes of vitamin D and alcohol were lower in low occupation individuals. Higher income was associated with higher intakes of fibre, protein, magnesium, potassium, beta-carotene, and folate among low educated persons only, highlighting effect modification. Lower SEP, particularly low education, was associated with lower intakes of nutrients required for a healthy diet. Each SEP indicator was associated with specific differences in nutrient intake suggesting that they underpin different social processes. PMID:26978393

[The permanence of access to health care: a tradition of hospitality and innovative organizational model].

PubMed

Georges-Tarragano, C

2015-01-01

The PASS ("Permanence d'Accès aux Soins de Santé") are hospital-based units providing primary care services to patients who lack health care coverage. Using a "whole person" approach and providing a combination of health and social care, the PASS offer an appropriately adapted response to complex health problems within a context of marked social vulnerability and contribute to reducing health inequalities. The PASS are an example of an interdisciplinary approach to health care which contrasts with the segmentary approach typical of conventional hospital departments. Operating at the interface between primary and secondary care, the PASS have the potential to become key players in developing models of patient pathways. Their presence reduces inappropriate emergency attendances and hospitalisation by offering medical care in a timely fashion, in an outpatient-type setting. The PASS can provide a resource for research into optimum models of health care, where the social context of health needs are fully recognized and inform medical treatment appropriately. According to their potential development, PASS are living labs of an innovative organizational model of care. Copyright © 2014 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

INSIGHTS FROM THE FRONT LINES: A COLLECTION OF STORIES OF HTA IMPACT FROM INAHTA MEMBER AGENCIES.

PubMed

Schuller, Tara; Söderholm Werkö, Sophie

2017-01-01

This mini-theme contains six stories of health technology assessment (HTA) impact from member agencies of The International Network of Agencies for Health Technology Assessment (INAHTA), which were originally shared at the 2015 and 2016 INAHTA Congresses. The INAHTA impact story sharing is an innovative network activity where member agency representatives share experiences of HTA impact in a loosely structured story format. Through this process, members gain insights from other agencies on new ways of thinking about and approaching HTA impact assessment. A guide is provided to members to prepare their story, and the best story receives the David Hailey Award for Best Impact Story. This mini-theme contains stories of HTA impact from six member agencies in different parts of the world: the Health Assessment Division of the Ministry of Public Health (Uruguay), the Institute of Quality and Efficiency in Health Care (Germany), the Health Information and Quality Authority (Ireland), the Finnish Office for Health Technology Assessment (Finland), the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (Australia), and the Institut national d'excellence en santé et en services sociaux (Canada). Across the papers, common themes emerge about the importance of appropriate engagement of stakeholders and the broadening scope of HTA beyond reimbursement decision making.

Evaluability Assessment of an immunization improvement strategy in rural Burkina Faso: intervention theory versus reality, information need and evaluations.

PubMed

Sanou, Aboubakary; Kouyaté, Bocar; Bibeau, Gilles; Nguyen, Vinh-Kim

2011-08-01

An innovative immunization improvement strategy was proposed by the CRSN (Centre de Recherche en Santé de Nouna) to improve the low coverage rate for children aged 0-11 months in the health district of Nouna in Burkina Faso. This article reports on the Evaluability Assessment (EA) study that aimed to orient decisions for its evaluation in close relationship with the information needs of the stakeholders. Various methods were used, including document reviews, individual interviews, focus group discussions, meetings, literature reviews and site visits. A description of the intervention theory and philosophy is provided with its logic models and its reality documented. Lessons on the procedure include the importance of the position of the evaluability assessor, the value of replicating some steps of the assessment and the relationships between EA and process evaluation. The evaluability study concludes that the intervention had some evaluable components. To satisfy the stakeholders' needs, the initially planned community randomized controlled trial can be maintained and complemented with a process evaluation. There is a need to provide sufficient information on the cost of the intervention. This will inform decision makers on the possibility of replicating the intervention in other contexts. Copyright © 2010 Elsevier Ltd. All rights reserved.

Les perdus de vue en radiothérapie: expérience de l'Institut National d'Oncologie au Maroc

PubMed Central

Mezouri, Imane; Chenna, Hanane; Bellefqih, Sara; Elkacemi, Hanan; Kebdani, Tayeb; Benjaafar, Noureddine

2014-01-01

Les perdus de vue (PDV) sont toute personne incluse dans un programme et dont on est sans nouvelles depuis six mois. L'objectif de cette étude est de fournir une description objective du problème des malades PDV au service de radiothérapie à l'Institut National d'Oncologie (INO), elle permet d’étudier l'impact des facteurs socio-économiques, démographiques et ceux liés à la maladie entraînant l'abandon du traitement par le patient. Nous avons réalisé une étude rétrospective de 77 patients PDV parmi 2254 patient admis à l'INO du premier janvier au 31 décembre 2011 pour traitement par radiothérapie. La présente analyse a mis en évidence que les taux d'abandon sont associés à des facteurs liés à la maladie et qu’à la fois le patient et le médecin doivent être formés et être conscients de la façon dont les stades avancés de la maladie, le mauvais statut de performance ainsi que la combinaison des autres problèmes de santé peuvent suffisamment conduire le patient à l'abandon du traitement. PMID:25584129

Preserving temporal relations in clinical data while maintaining privacy

PubMed Central

Mirhaji, Parsa; Low, Alexander FH; Malin, Bradley A

2016-01-01

Objective Maintaining patient privacy is a challenge in large-scale observational research. To assist in reducing the risk of identifying study subjects through publicly available data, we introduce a method for obscuring date information for clinical events and patient characteristics. Methods The method, which we call Shift and Truncate (SANT), obscures date information to any desired granularity. Shift and Truncate first assigns each patient a random shift value, such that all dates in that patient’s record are shifted by that amount. Data are then truncated from the beginning and end of the data set. Results The data set can be proven to not disclose temporal information finer than the chosen granularity. Unlike previous strategies such as a simple shift, it remains robust to frequent – even daily – updates and robust to inferring dates at the beginning and end of date-shifted data sets. Time-of-day may be retained or obscured, depending on the goal and anticipated knowledge of the data recipient. Conclusions The method can be useful as a scientific approach for reducing re-identification risk under the Privacy Rule of the Health Insurance Portability and Accountability Act and may contribute to qualification for the Safe Harbor implementation. PMID:27013522

Challenges facing the United States of America in implementing universal coverage

PubMed Central

Unruh, Lynn Y; Rosenau, Pauline; Barnes, Andrew J; Saltman, Richard B; van Ginneken, Ewout

2014-01-01

Abstract In 2010, immediately before the United States of America (USA) implemented key features of the Affordable Care Act (ACA), 18% of its residents younger than 65 years lacked health insurance. In the USA, gaps in health coverage and unhealthy lifestyles contribute to outcomes that often compare unfavourably with those observed in other high-income countries. By March 2014, the ACA had substantially changed health coverage in the USA but most of its main features – health insurance exchanges, Medicaid expansion, development of accountable care organizations and further oversight of insurance companies – remain works in progress. The ACA did not introduce the stringent spending controls found in many European health systems. It also explicitly prohibits the creation of institutes – for the assessment of the cost–effectiveness of pharmaceuticals, health services and technologies – comparable to the National Institute for Health and Care Excellence in the United Kingdom of Great Britain and Northern Ireland, the Haute Autorité de Santé in France or the Pharmaceutical Benefits Advisory Committee in Australia. The ACA was – and remains – weakened by a lack of cross-party political consensus. The ACA’s performance and its resulting acceptability to the general public will be critical to the Act’s future. PMID:25552773

[City-hospital network and quality control of officinal preparations].

PubMed

Curti, C; Gallice, S; Lamy, E; Rathelot, P; Vanelle, P

2018-05-01

In a hospital environment, the quality control of the hospital preparations allows to release homogeneous batches in a secure way. These controls are totally integrated into the process of production and can also, in certain cases, be realized for high-alert magistral preparations. In community pharmacy, these controls were not required, but the Agence régionale de santé (ARS) recently incited compounding community pharmacies to realize this type of analyses. This decision motivated the creation of a collaboration between the pharmacy department of a French teaching hospital and a society including around thirty community pharmacies having a preparatory. Twenty community pharmacies distributed on all the territory have submitted one of their pediatric preparation, capsules of captopril 2mg, to the pharmacopoeia controls usually realized in the industry or hospital. All the analyzed batches were in agreement with European Pharmacopeia specifications. We shall present the rational of this work, the results as well as the numerous perspectives offered by this new type of collaboration joining completely the logic of a network city-hospital allowing the improvement of security of the medication circuit in France. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Advancing the conversation: next steps for lesbian, gay, bisexual, trans, and queer (LGBTQ) health sciences librarianship.

PubMed

Hawkins, Blake W; Morris, Martin; Nguyen, Tony; Siegel, John; Vardell, Emily

2017-10-01

In recent years, librarians in various sectors have been moving forward a conversation on the distinct information needs and information-seeking behavior of our lesbian, gay, bisexual, trans, and queer (LGBTQ) patrons and how well the profession recognizes and meets those needs. Health sciences librarianship has been slower than other areas of the profession in creating an evidence base covering the needs of its LGBTQ patrons, with, until recently, only very limited literature on this subject. LGBTQ health sciences librarianship is now starting to attract new interest, with librarians working together to bring this emerging specialization to the attention of the broader professional community. In this paper, the authors report on a dedicated panel discussion that took place at the 2016 joint annual meeting of the Medical Library Association and Canadian Health Libraries Association/Association des bibliothèques de la santé du Canada in Toronto, Ontario, Canada; discuss subsequent reflections; and highlight the emerging role for health sciences librarians in providing culturally competent services to the LGBTQ population. Recommendations are also provided for establishing a tool kit for LGBTQ health sciences librarianship from which librarians can draw. We conclude by highlighting the importance of critically reflective practice in health sciences librarianship in the context of LGBTQ health information.

Localisation buccale d’un lymphome de Burkitt: à propos d’un cas

PubMed Central

Kissi, Lamia; El Bouihi, Rajaa; Lamchahab, Mouna; Alaoui, Ahmed; Benyahya, Ihsane

2017-01-01

Le lymphome de Burkitt (LB) est une forme de lymphome malin non-Hodgkinien qui provient de l'évolution maligne et de la prolifération de cellules lymphoïdes de type B. Le diagnostic positif repose sur la biopsie d'une masse tumorale ou la ponction de la moelle osseuse révélant la présence de cellules tumorales. Le cas rapporté est celui d'un jeune homme d'une vingtaine d'années qui a été adressé pour des tuméfactions gingivales évoluant depuis 1 mois suite à des extractions dentaires. L'examen anatomopathologique après biopsie complété par l'immunohistochimie conclut à un lymphome de Burkitt. La prise en charge a consisté en une chimiothérapie. Bien que rare, le lymphome de Burkitt est une tumeur agressive qui représente un véritable problème de santé publique d'où la place importante qu'occupe le médecin dentiste dans le diagnostic précoce afin de permettre une prise en charge rapide et appropriée seule garante de la guérison. PMID:28451040

Socioeconomic Indicators Are Independently Associated with Nutrient Intake in French Adults: A DEDIPAC Study.

PubMed

Si Hassen, Wendy; Castetbon, Katia; Cardon, Philippe; Enaux, Christophe; Nicolaou, Mary; Lien, Nanna; Terragni, Laura; Holdsworth, Michelle; Stronks, Karien; Hercberg, Serge; Méjean, Caroline

2016-03-10

Studies have suggested differential associations of specific indicators of socioeconomic position (SEP) with nutrient intake and a cumulative effect of these indicators on diet. We investigated the independent association of SEP indicators (education, income, occupation) with nutrient intake and their effect modification. This cross-sectional analysis included 91,900 French adults from the NutriNet-Santé cohort. Nutrient intake was estimated using three 24-h records. We investigated associations between the three SEP factors and nutrient intake using sex-stratified analysis of covariance, adjusted for age and energy intake, and associations between income and nutrient intake stratified by education and occupation. Low educated participants had higher protein and cholesterol intakes and lower fibre, vitamin C and beta-carotene intakes. Low income individuals had higher complex carbohydrate intakes, and lower magnesium, potassium, folate and vitamin C intakes. Intakes of vitamin D and alcohol were lower in low occupation individuals. Higher income was associated with higher intakes of fibre, protein, magnesium, potassium, beta-carotene, and folate among low educated persons only, highlighting effect modification. Lower SEP, particularly low education, was associated with lower intakes of nutrients required for a healthy diet. Each SEP indicator was associated with specific differences in nutrient intake suggesting that they underpin different social processes.

Sex-Specific Sociodemographic Correlates of Dietary Patterns in a Large Sample of French Elderly Individuals.

PubMed

Andreeva, Valentina A; Allès, Benjamin; Feron, Gilles; Gonzalez, Rebeca; Sulmont-Rossé, Claire; Galan, Pilar; Hercberg, Serge; Méjean, Caroline

2016-08-08

This cross-sectional analysis provides up-to-date information about dietary patterns (DP) and their sociodemographic correlates in European elderly individuals. We studied 6686 enrollees aged 65+ (55% women) in the ongoing French population-based NutriNet-Santé e-cohort. Diet was assessed via three 24 h records. The sex-specific correlates of factor analysis derived DP were identified with multivariable linear regression. Using 22 pre-defined food groups, three DP were extracted. The "healthy" DP (fruit, vegetables, grains, nuts, fish) was positively associated with education, living alone, and being a former smoker (women), and negatively associated with being overweight, current smoker (men), age 75+ years, having hypertension, and obesity (women). The "western" DP (meat, appetizers, cheese, alcohol) was positively associated with BMI (men) and being a former/current smoker; it was negatively associated with age 75+ years (women) and living alone. The "traditional" DP (bread, potatoes, milk, vegetables, butter, stock) was positively associated with age and negatively associated with being a former/current smoker, education (men), and residing in an urban/semi-urban area. The findings support the diversity of DP among the elderly, highlighting sex-specific differences. The "healthy" DP explained the largest amount of variance in intake. Future studies could replicate the models in longitudinal and international contexts.

Les Noyaux Actifs de Galaxies en interférométrie optique à très longue base - Projet 'OHANA

NASA Astrophysics Data System (ADS)

Woillez, Julien

2003-12-01

Recent progress in sensitivity achieved by the new generation of optical long baseline interfero- meters (VLTI & Keck) allows new fields of astronomy to benefit from very high angular resolution observations at near infrared wavelength. Extragalactic astronomy, through active galactic nuclei observations, is one of those fields. As a preparation to coming active nuclei interferometric observations, I present a toolbox designed for the in- terpretation of the first data, knowing that their amount will stay small at the beginning whereas the observed objects are known to be complex. I will also present one of the two first observations of active nuclei : the Seyfert 2 nucleus NGC 1068 observed with MIDI, the newly commissioned 10 μm instrument of the VLTI. With the Seyfert 1 nucleus NGC 4151 by Keck interferometer, those two observations confirm the forecasted need of higher angular resolution to study the inner parts of the molecular torus found in active galactic nuclei. The broad line region will be one of the next components to be observed with an interferometer, provided that the extra angular resolution becomes available. In order to study the 3D structure of the region, I present an innovative tomographic technique based on reverberation mapping and interferometry : interferometric reverberation. The 'OHANA project (Optical Hawaiian Array for Nanoradion Astronomy) is the topic of the second part of this work as it will provide the extra angular resolution. The project also aims at demonstrating the use of single mode fibers in J, H and K bands to coherently combine adaptive corrected telescopes, already present on top of Mauna Kea, into a very sensitive and resolving interferometer. I present the preparatory phase of the project (Phase I) where the coupling between adaptive optics and single mode fibers is studied on CFHT, Gemini and Keck telescopes. Those tests allow me to confirm the sensitivity of the final instrument as well as to propose a diagnostic on the different adaptive optics systems. Then I present the 'OHANA beam combiner that is about to be used in the demonstration phase (phase II). This combiner is based on a new concept where the two interferometric outputs of a single mode coaxial combination are combined in a multiaxial scheme in order to obtain a single output, with only one coupler. The interferogram is then temporally coded and the photometry spatially. I present the ongoing developments of pahse II, namely a gaussian beam delay line and 2×300 m long single mode fibers, in J, H and K bands, used for the coherent transport.

Analytical measurements of fission products during a severe nuclear accident

NASA Astrophysics Data System (ADS)

Doizi, D.; Reymond la Ruinaz, S.; Haykal, I.; Manceron, L.; Perrin, A.; Boudon, V.; Vander Auwera, J.; tchana, F. Kwabia; Faye, M.

2018-01-01

The Fukushima accident emphasized the fact that ways to monitor in real time the evolution of a nuclear reactor during a severe accident remain to be developed. No fission products were monitored during twelve days; only dose rates were measured, which is not sufficient to carry out an online diagnosis of the event. The first measurements were announced with little reliability for low volatile fission products. In order to improve the safety of nuclear plants and minimize the industrial, ecological and health consequences of a severe accident, it is necessary to develop new reliable measurement systems, operating at the earliest and closest to the emission source of fission products. Through the French program ANR « Projet d'Investissement d'Avenir », the aim of the DECA-PF project (diagnosis of core degradation from fission products measurements) is to monitor in real time the release of the major fission products (krypton, xenon, gaseous forms of iodine and ruthenium) outside the nuclear reactor containment. These products are released at different times during a nuclear accident and at different states of the nuclear core degradation. Thus, monitoring these fission products gives information on the situation inside the containment and helps to apply the Severe Accident Management procedures. Analytical techniques have been proposed and evaluated. The results are discussed here.

Lasers à électrons libres de courtes longueurs d'onde: état de l'art et perspectives

NASA Astrophysics Data System (ADS)

Couprie, M. E.

2003-06-01

Les Lasers à Électrons Libres (LEL) sont des sources de rayonnement cohérent et accordable, basées sur l'interaction d'un faisceau d'électrons relativistes circulant dans le champ magnétique magnétique périodique et permanent créé par un “onduleur”. et d'une onde optique. L'onde lumineuse peut être issue de l'émission de rayonnement synchroton émise par le paquet d'électrons a chaque passage pour un système super-radiant en mode SASE (Self Amplified Spontaneous Emission- Emission Spontanée Auto-Amplifiée) ou issue du rayonnement synchrotron stocké dans une cavité optique, en mode oscillateur, ou d'une onde laser externe, en mode génération d'harmonique. Sous certaines conditions, l'onde lumineuse est amplifiée, au détriment de l'énergie cinétique des électrons, ce qui conduit à l'effet laser. L'état de l'art des sources Laser à Electrons Libres dans l'UV et le VUV est présenté, en indiquant les complémentarités résultant des différentes configurations tant du point de vue des sources que de leurs utilisations. Les projets de sources de courte longueur d'onde proposés sont ensuite discutés.

Comparing methods for Earthquake Location

NASA Astrophysics Data System (ADS)

Turkaya, Semih; Bodin, Thomas; Sylvander, Matthieu; Parroucau, Pierre; Manchuel, Kevin

2017-04-01

There are plenty of methods available for locating small magnitude point source earthquakes. However, it is known that these different approaches produce different results. For each approach, results also depend on a number of parameters which can be separated into two main branches: (1) parameters related to observations (number and distribution of for example) and (2) parameters related to the inversion process (velocity model, weighting parameters, initial location etc.). Currently, the results obtained from most of the location methods do not systematically include quantitative uncertainties. The effect of the selected parameters on location uncertainties is also poorly known. Understanding the importance of these different parameters and their effect on uncertainties is clearly required to better constrained knowledge on fault geometry, seismotectonic processes and at the end to improve seismic hazard assessment. In this work, realized in the frame of the SINAPS@ research program (http://www.institut-seism.fr/projets/sinaps/), we analyse the effect of different parameters on earthquakes location (e.g. type of phase, max. hypocentral separation etc.). We compare several codes available (Hypo71, HypoDD, NonLinLoc etc.) and determine their strengths and weaknesses in different cases by means of synthetic tests. The work, performed for the moment on synthetic data, is planned to be applied, in a second step, on data collected by the Midi-Pyrénées Observatory (OMP).

L’évaluation systématique des instruments pour mesurer la douleur chez les personnes âgées ayant des capacités réduites à communiquer*

PubMed Central

Aubin, Michèle; Giguère, Anik; Hadjistavropoulos, Thomas; Verreault, René

2007-01-01

La douleur chronique est souvent sous-détectée et insuffisamment traitée dans les milieux de soins de longue durée. Les outils d’autorapport (ou autoévaluation) de la douleur, comme l’échelle visuelle analogique, n’ont été validés que partiellement chez les populations âgées, en raison de la prévalence élevée de déficits visuels, auditifs, moteurs et cognitifs que l’on y trouve. Des outils d’observation des patients ont été développés pour pallier ces difficultés d’utilisation des échelles d’autorapport de la douleur. Le présent projet vise l’identification de ces échelles et leur évaluation sur la base de la validité de contenu (12 questions), de la validité de construit (12 questions), de la fiabilité (13 questions) et de l’utilité clinique (10 questions). Parmi les 24 instruments recensés, plusieurs apparaissent prometteurs pour évaluer la douleur chez les personnes âgées atteintes de démence sévère. Des efforts additionnels de validation sont cependant requis avant leur intégration à la pratique régulière en soins de longue durée. PMID:17717611

Séroprévalence et facteurs associés à l’acceptation du Conseil et Dépistage Volontaire du VIH chez l’enfant à Lubumbashi, République Démocratique du Congo

PubMed Central

Ngwej, Dieudonné Tshikwej; Mukuku, Olivier; Malonga, Françoise Kaj; Luboya, Oscar Numbi; Kakoma, Jean-Baptiste Sakatolo; Wembonyama, Stanis Okitotsho

2017-01-01

Résumé Introduction Malgré le dépistage du VIH proposé lors de la naissance ou au cours des consultations préscolaires, la proportion des enfants qui croissent ou décèdent sous statut sérologique au VIH inconnu est importante en République Démocratique du Congo (RDC). L’objectif de cette étude était de déterminer la séroprévalence au cours d’un dépistage volontaire et d’identifier les facteurs associés à l’acceptation du conseil et dépistage du VIH (CDV) en dehors de la maladie ou de toute exposition au VIH dans une population pédiatrique à Lubumbashi, RDC. Méthodes Il s’agissait d’une étude prospective transversale à visée analytique menée du 1er août 2006 au 31 septembre 2007. Elle avait été réalisée dans 4 centres communautaires de CDV répartis dans 4 zones de santé de la ville de Lubumbashi en RDC (Lubumbashi, Ruashi, Kampemba et de Kenya). L’étude avait consisté à faire le dépistage volontaire du VIH chez les enfants de moins de 15 ans. Les caractéristiques sociodémographiques et les paramètres relatifs au conseil et dépistage volontaire ont été étudiés. Les analyses statistiques descriptives usuelles et une régression logistique ont été réalisées. Résultats Sur 463 enfants dépistés du VIH, 41 (8,9%; IC 95%: 6,5%-11,9%) ont été testés positifs. L’acceptation du conseil et dépistage volontaire du VIH en dehors de la maladie ou de l’exposition au VIH était significativement plus élevée lorsque l’enfant était âgé de plus de 2 ans (Odds ratio ajusté (ORa) = 3,6 [IC 95%: 1,1-12,2]), lorsque le statut sérologique du VIH des parents était négatif ou inconnu (ORa = 27,4 [IC 95%: 9,4-80,0]), lorsque l’un ou l’autre ou les deux parents biologiques étaient en vie (ORa = 24,9 [IC 95%: 2,4-250,8]) et lorsque la connaissance du lieu de dépistage était fait par des moyens autres que le professionnel de santé (ORa = 2,9 [IC 95%: 1,0-7,9]). Conclusion Notre étude montre une forte

Le domaine des co-infections et des maladies concomitantes du Réseau canadien pour les essais VIH des IRSC : lignes directrices canadiennes pour la prise en charge et le traitement de la co-infection par le VIH et l’hépatite C chez les adultes

PubMed Central

Hull, Mark; Giguère, Pierre; Klein, Marina; Shafran, Stephen; Tseng, Alice; Côté, Pierre; Poliquin, Marc; Cooper, Curtis

2014-01-01

HISTORIQUE : De 20 % à 30 % des Canadiens qui vivent avec le VIH sont co-infectés par le virus de l’hépatite C (VHC), lequel est responsable d’une morbidité et d’une mortalité importantes. La prise en charge du VIH et du VHC est plus complexe en raison de l’évolution accélérée de la maladie hépatique, du choix et des critères d’initiation de la thérapie antirétrovirale et du traitement anti-VHC, de la prise en charge de la santé mentale et des toxicomanies, des obstacles socioéconomiques et des interactions entre les nouvelles thérapies antivirales à action directe du VHC et les antirétroviraux OBJECTIF : Élaborer des normes nationales de prise en charge des adultes co-infectés par le VHC et le VIH dans le contexte canadien. MÉTHODOLOGIE : Le Réseau canadien pour les essais VIH des Instituts de recherche en santé du Canada a réuni un groupe d’experts possédant des compétences cliniques en co-infection par le VIH et le VHC pour réviser les publications à jour ainsi que les lignes directrices et les protocoles en place. Après une vaste sollicitation afin d’obtenir des points de vue, le groupe de travail a approuvé des recommandations consensuelles, qu’il a caractérisées au moyen d’une échelle de qualité des preuves fondée sur la classe (bienfaits par rapport aux préjudices) et sur la catégorie (degré de certitude). RÉSULTATS : Toutes les personnes co-infectées par le VIH et le VHC devraient subir une évaluation en vue de recevoir un traitement du VHC. Les personnes qui ne sont pas en mesure d’entreprendre un traitement du VHC devraient être soignées pour le VIH afin de ralentir l’évolution de la maladie hépatique. La norme de traitement du VHC de génotype 1 est un régime comprenant de l’interféron pégylé et de la ribavirine dosée en fonction du poids, associés à un inhibiteur de la protéase du VHC. Pour les génotypes 2 ou 3, une bithérapie classique est recommandée pendant 24 semaines s�

[Representatives of consumer associations and the "hôpital, patients, santé et territoires" law: an outline of the issues and twelve proposals].

PubMed

Bréchat, Pierre-Henri; Gros, Jeannette; Haon, Michel; Jeunet, Odile; Magnin-Feysot, Christian

2010-01-01

Since 1996, consumers have been able to become involved in the development and implementation of national, regional and local healthcare policies, thereby demonstrating the possibility of establishing a model of democratic institution in healthcare at all levels of decision-making and policy implementation. Despite this 13-year political ambition, it is open to question whether the bill on the reform of the hospital will serve to extend the same dynamic for patients, healthcare institutions and local authorities. On 15 November 2008 and 18 April 2009, fifty-four consumer association representatives in the Franche-Comté region convened to conduct an audit of their commitments with a view to making proposals to adapt the bill aimed at reforming hospitals for the benefit of patients, healthcare and territories (HPST) before the bill is debated in Parliament (National Assembly and Senate). Despite significant investments since 1996 and some notable successes, for these representatives of consumer healthcare associations, the results are distinctly mixed. This is because they sometimes feel instrumentalized in healthcare facilities and believe that their opportunities for participation have declined since 2002. Their view is that this may diminish the power they wield at a time when the economy may be seen as becoming a substitute for public healthcare and participatory democracy. In a context of inequality in healthcare and at a time of economic crisis, this paradigm shift has tended to mobilize representatives of consumer associations. In their view, a strong counter-power is required to ensure fair and equal access to healthcare for all. They suggest twelve proposals concerning organization and professionalism at both territorial and national levels, articulated around the following principle : a representative of a consumers' association can become a regional reference in the management of the agency's regional healthcare system and may be given the means to coordinate the work of other representatives of consumer associations for each of the regional healthcare plans.

Public Expenditures for Mental Health Services in Canadian Provinces: Dépenses publiques pour les services de santé mentale dans les provinces canadiennes.

PubMed

Wang, Jian; Jacobs, Philip; Ohinmaa, Arto; Dezetter, Anne; Lesage, Alain

2018-04-01

The purpose of this study is to measure provincial spending for mental health services in fiscal year (FY) 2013 and to compare these cost estimates to those of FY 2003. This study estimated the costs of publicly funded provincial mental health services in FY 2013 and compared them to the estimates for FY 2003 from a previously published report. Our data were obtained from publicly accessible databases. The cross-year cost comparisons for provincial mental health services were restricted to general and psychiatric hospital inpatients, clinical payments to physicians and psychologists, and prescribed psychotropic medications. Total public expenditures were inflation adjusted and expressed per capita and as a percentage of the total provincial health spending. Total public spending for mental health and addiction programs/services was estimated to be $6.75 billion for FY 2013. The largest component of the expenditures was hospital inpatient services ($4.02 billion, 59.6%), followed by clinical payments to physicians or psychologists ($1.69 billion, 25%), and then publicly funded prescribed psychotherapeutic medications ($1.04 billion, 15.4%). Nationally, the portion of total public spending on health that was spent on mental health decreased from FY 2003 to FY 2013 from 5.4% to 4.9%. Our results reveal that mental health spending, as a proportion of public health care expenditures, decreased in the decade from FY 2003 to FY 2013. Due to large differences in how the provinces report community mental health services, we still lack a comprehensive picture of the mental health system.

Methodologie de conception numerique d'un ventilateur helico-centrifuge basee sur l'emploi du calcul meridien

NASA Astrophysics Data System (ADS)

Lallier-Daniels, Dominic

La conception de ventilateurs est souvent basée sur une méthodologie « essais/erreurs » d'amélioration de géométries existantes ainsi que sur l'expérience de design et les résultats expérimentaux cumulés par les entreprises. Cependant, cette méthodologie peut se révéler coûteuse en cas d'échec; même en cas de succès, des améliorations significatives en performance sont souvent difficiles, voire impossibles à obtenir. Le projet présent propose le développement et la validation d'une méthodologie de conception basée sur l'emploi du calcul méridien pour la conception préliminaire de turbomachines hélico-centrifuges (ou flux-mixte) et l'utilisation du calcul numérique d'écoulement fluides (CFD) pour la conception détaillée. La méthode de calcul méridien à la base du processus de conception proposé est d'abord présentée. Dans un premier temps, le cadre théorique est développé. Le calcul méridien demeurant fondamentalement un processus itératif, le processus de calcul est également présenté, incluant les méthodes numériques de calcul employée pour la résolution des équations fondamentales. Une validation du code méridien écrit dans le cadre du projet de maîtrise face à un algorithme de calcul méridien développé par l'auteur de la méthode ainsi qu'à des résultats de simulation numérique sur un code commercial est également réalisée. La méthodologie de conception de turbomachines développée dans le cadre de l'étude est ensuite présentée sous la forme d'une étude de cas pour un ventilateur hélico-centrifuge basé sur des spécifications fournies par le partenaire industriel Venmar. La méthodologie se divise en trois étapes: le calcul méridien est employé pour le pré-dimensionnement, suivi de simulations 2D de grilles d'aubes pour la conception détaillée des pales et finalement d'une analyse numérique 3D pour la validation et l'optimisation fine de la géométrie. Les résultats de calcul m

Mise en oeuvre et caracterisation de pieces autotrempantes elaborees avec de nouveaux alliages meres

NASA Astrophysics Data System (ADS)

Bouchemit, Arslane Abdelkader

: L'autotrempabilite des aciers en metallurgie des poudres (MP) permet d'obtenir des pieces ayant une microstructure de trempe (martensite et/ou bainite), et ce, directement lors du refroidissement a la sortie du four de frittage (frittage industriel : 10 45 °C/min [550 a 350 °C]). Cela permet entre autres d'eliminer les traitements thermiques d'austenisation et de trempe (a l'eau : ≈ 2700 °C/min ou a l'huile : ≈ 1100 °C/min [550 a 350 °C] [17]) generalement requis apres le frittage afin d'obtenir une microstructure martensitique. Ainsi, le procede de fabrication est simplifie, moins couteux et la distorsion des pieces due au refroidissement rapide lors de la trempe est evitee. De plus, l'utilisation des bains d'huile est eliminee ce qui rend le procede plus securitaire et ecologique. Les principaux parametres commandant l'autotrempabilite sont : le taux de refroidissement et la composition chimique de l'acier. De nos jours, les systemes de refroidissement a convection forcee combines aux fours industriels permettent d'obtenir des taux de refroidissement eleves a la sortie des fours (60 300 °C/min [550 a 350 °C]) [18, 19]. De plus, le taux de refroidissement critique induisant la formation de la structure de trempe est largement influence par la composition chimique de l'acier. Ainsi, plus l'acier est allie (jusqu'a une certaine limite), plus ce taux de refroidissement critique est moindre. Le molybdene, le nickel et le cuivre sont les elements usuellement utilises en MP. Cependant, le manganese et le chrome sont moins couteux et ont un impact plus marque sur l'autotrempabilite, malgre cela, ils sont rarement utilises a cause de leur susceptibilite a l'oxydation et la degradation de la compressibilite causee par le manganese. L'objectif principal de ce projet est de developper des melanges autotrempants en ajoutant des alliages meres (MA : MA1, MA2 et MA4) fortement allies au manganese (5 15 %m) et au chrome (5 15 %m) qui contiennent beaucoup de carbone