Les soutiens associés au maintien en emploi : perceptions des personnes aux prises avec un trouble mental grave

La réadaptation professionnelle des personnes aux prises avec un trouble mental grave est un domaine souvent délaissé. Malgré leur aspiration à un emploi, la présence de ces personnes sur le marché de l’emploi demeure faible. Le manque de soutien serait un des facteurs explicatifs. Ainsi, le but de cette étude était d’identifier les types de soutiens nécessaires au maintien en emploi de ces personnes. Six (6) participants ont été recrutés suivant une méthodologie qualitative. Dix types de soutiens ont été identifiés et classés selon leur association directe à l’emploi ou au milieu résidentiel et la communauté. En conclusion, les auteurs suggèrent une plus grande implication de la part des intervenants dans l’identification et le développement de soutiens favorisant le maintien en emploi de ces personnes.Professional rehabilitation of people with severe mental illness is a field of research often left aside. Despite the aspiration of people with severe mental illness to employment, their presence in the job market remains low. Lack of supports appears to be one explanation. Thus, the aim of this study was to identify the types of necessary supports to maintain these people in employment. Six (6) participants have been recruited following a qualitative methodology. Ten types of supports have been identified and classified according to their direct association to work or to the residential or community environment. To conclude, the authors suggest a greater involvement from mental health workers in the identification and development of supports that favour maintaining these people in employment.La readaptación profesional de las personas que luchan contra un problema mental grave es con frecuencia un campo abandonado. A pesar de su aspiración a un empleo, la presencia de estas personas en el mercado de trabajo permanece débil. La falta de apoyo es uno de los factores que explican esto. Por consiguiente, el propósito de este estudio fue identificar los tipos de apoyo necesarios para la conservación de estas personas en el trabajo. Se recrutaron seis (6) participantes siguiendo una metodología cuantitativa. Se identificaron y clasificaron diez tipos de apoyo según su asociación directa con el empleo o el medio residencial y la comunidad. En conclusión, los autores sugieren una mayor implicación por parte de los interventores en la identificación y el desarrollo de apoyos que favorezcan la conservación de estas personas en un empleo.A readaptação profissional de pessoas que sofrem de problemas mentais graves é uma área freqüentemente negligenciada. A presença destas pessoas no mercado de trabalho continua sendo fraca, apesar de seu interesse em conseguir um emprego. A falta de auxílio poderia ser um dos fatores que explica esse fato. Assim, o objetivo deste estudo foi identificar os tipos de auxílio necessários para a fixação destas pessoas no emprego. Seis participantes foram recrutados segundo uma metodologia qualitativa. Dez tipos de assistência foram identificados e classificados de acordo com sua relação direta com o emprego ou com o meio residencial e a comunidade. Em conclusão, os autores sugerem uma maior participação dos assistentes sociais na identificação e no desenvolvimento do auxílio que favoreça a permanência destas pessoas no emprego

Drug Stability Analysis by Raman Spectroscopy

Pharmaceutical drugs are available to astronauts to help them overcome the deleterious effects of weightlessness, sickness and injuries. Unfortunately, recent studies have shown that some of the drugs currently used may degrade more rapidly in space, losing their potency before their expiration dates. To complicate matters, the degradation products of some drugs can be toxic. Here, we present a preliminary investigation of the ability of Raman spectroscopy to quantify mixtures of four drugs; acetaminophen, azithromycin, epinephrine, and lidocaine, with their primary degradation products. The Raman spectra for the mixtures were replicated by adding the pure spectra of the drug and its degradant to determine the relative percent contributions using classical least squares. This multivariate approach allowed determining concentrations in ~10 min with a limit of detection of ~4% of the degradant. These results suggest that a Raman analyzer could be used to assess drug potency, nondestructively, at the time of use to ensure crewmember safety

Quantitative Measurements of Codeine and Fentanyl on a Surface-Enhanced Raman-Active Pad

The USA is in the midst of an opioid crisis that included over 60,000 overdose fatalities in 2017, mostly unintentional. This is due to excessive use of prescription opioids and the use of very strong synthetic opioids, such as fentanyl, mixed with illicit street drugs. The ability to rapidly determine if people or packages entering the country have or contain drugs could reduce their availability, and thereby decrease the use of illicit drugs. In an effort to address this problem, we have been investigating the ability of surface-enhanced Raman spectroscopy to detect trace amounts of opioids on clothing and packages. Here, we report the measurement of codeine and fentanyl at 100 ng/mL for 5 min on a pad impregnated with gold colloids, as well as a preliminary measurement of 500 pg of fentanyl on a glass surface using one of these pads. The calculated limit of detection for this measurement was 40 pg. This data strongly suggests that these pads, used with portable Raman analyzers, would be invaluable to airport security, drug raids, crime scenes, and forensic analysis

Drug Content Uniformity: Quantifying Loratadine in Tablets Using a Created Raman Excipient Spectrum

Raman spectroscopy has proven valuable for determining the composition of manufactured drug products, as well as identifying counterfeit drugs. Here we present a simple method to determine the active pharmaceutical ingredient (API) mass percent in a sample that does not require knowledge of the identities or relative mass percents of the inactive pharmaceutical ingredients (excipients). And further, we demonstrated the ability of the method to pass or fail a manufactured drug product batch based on a calculated acceptance value in accordance with the US Pharmacopeia method for content uniformity. The method was developed by fitting the Raman spectra of 30 Claritin® tablets with weighted percentages of the Raman spectrum of its API, loratadine, and a composite spectrum of the known excipients. The mean loratadine mass of 9.79 ± 40 mg per 100 mg tablet compared favorably to the 10.21 ± 0.63 mg per 100 mg tablet determined using high-performance liquid chromatography, both of which met the acceptance value to pass the 10 mg API product as labelled. The method was then applied to a generic version of the Claritin product that employed different excipients of unknown mass percents. A Raman spectrum representative of all excipients was created by subtracting the API Raman spectrum from the product spectrum. The Raman spectra of the 30 generic tablets were then fit with weighted percents of the pure loratadine spectrum and the created excipient spectrum, and used to determine a mean API mass for the tablets of 10.12 ± 40 mg, again meeting the acceptance value for the 10 mg API product. The data suggest that this simple method could be used to pass or fail manufactured drug product batches in accordance with the US Pharmacopeia method for content uniformity, without knowledge of the excipients

Immersion au cœur de l’invalidité : certificats médicaux et limitations fonctionnelles

Les assureurs exigent des certificats médicaux pour déterminer l’admissibilité à des prestations d’invalidité. Pourtant, les pratiques des médecins de famille en contexte de certification d’une incapacité au travail pour troubles mentaux varient. Par ailleurs, les certificats médicaux sont souvent incomplets ou ambigus, particulièrement la section relative aux limitations fonctionnelles. La présente étude vise à déterminer s’il existe une variabilité entre les médecins de famille quant à l’évaluation diagnostique, à la recommandation de traitement, à l’évaluation de l’incapacité au travail d’un même patient et de la durée d’une incapacité au travail et à analyser le type d’interprétation qu’ils font de la notion de limitations fonctionnelles. Vingt-trois médecins de famille du Québec ont complété quatre vignettes pour lesquelles ils doivent déterminer le diagnostic, le traitement, la nécessité ou non d’un arrêt de travail, la raison et dans l’affirmative les limitations fonctionnelles. Des analyses descriptives sont effectuées. Les résultats montrent que la décision de certifier une incapacité au travail ne fait pas bon consensus pour la moitié des vignettes contrairement à la catégorie diagnostique. La notion de limitations fonctionnelles semble confondue avec celle de symptômes. Ces résultats pourront servir à évaluer les pratiques actuelles en matière de certification d’une incapacité au travail

Drug Content Uniformity: Quantifying Loratadine in Tablets Using a Created Raman Excipient Spectrum

Raman spectroscopy has proven valuable for determining the composition of manufactured drug products, as well as identifying counterfeit drugs. Here we present a simple method to determine the active pharmaceutical ingredient (API) mass percent in a sample that does not require knowledge of the identities or relative mass percents of the inactive pharmaceutical ingredients (excipients). And further, we demonstrated the ability of the method to pass or fail a manufactured drug product batch based on a calculated acceptance value in accordance with the US Pharmacopeia method for content uniformity. The method was developed by fitting the Raman spectra of 30 Claritin® tablets with weighted percentages of the Raman spectrum of its API, loratadine, and a composite spectrum of the known excipients. The mean loratadine mass of 9.79 ± 40 mg per 100 mg tablet compared favorably to the 10.21 ± 0.63 mg per 100 mg tablet determined using high-performance liquid chromatography, both of which met the acceptance value to pass the 10 mg API product as labelled. The method was then applied to a generic version of the Claritin product that employed different excipients of unknown mass percents. A Raman spectrum representative of all excipients was created by subtracting the API Raman spectrum from the product spectrum. The Raman spectra of the 30 generic tablets were then fit with weighted percents of the pure loratadine spectrum and the created excipient spectrum, and used to determine a mean API mass for the tablets of 10.12 ± 40 mg, again meeting the acceptance value for the 10 mg API product. The data suggest that this simple method could be used to pass or fail manufactured drug product batches in accordance with the US Pharmacopeia method for content uniformity, without knowledge of the excipients