L'agression sexuelle envers les enfants. Hébert, M ; Cyr, M. ; Tourigny, M. (Dir.) 2011. Tome 1. Presses de l'Université du Québec

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Pertes et reconstructions identitaires des foyers post-divorce

La présente étude s’intéresse au parcours des foyers post-divorce via deux objectifs. Premièrement, nous voulons mettre en avant les éléments organisateurs permettant à ces foyers de passer d’un état à un autre. Pour ce faire, nous recourons à la méthode par théorisation ancrée, bien qu’en nous en écartant partiellement. Deuxièmement, nous cherchons à savoir quels sont les champs lexicaux qui peuvent être extraits des transcriptions d’entretiens avec ces foyers. Pour ce second objectif, nous recourons à la méthode Alceste, via le logiciel Iramuteq. Celui-ci nous permet un croisement des données d’entretiens avec des métadonnées issues notamment du FACES-III et du Jeu du Pique-Nique. Tous ces éléments sont discutés au regard des apports de la littérature scientifique. Mais aussi, au regard de la clinique du deuil, à laquelle il est fait appel pour éclairer ces parcours. En outre, nous contextualisons les notions de famille, mariage et divorce dans une perspective historique prenant ses bases au Moyen Âge

Diagnosing serious infections in acutely ill children in ambulatory care (ERNIE 2 study protocol, part A): diagnostic accuracy of a clinical decision tree and added value of a point-of-care C-reactive protein test and oxygen saturation

Background: Acute illness is the most common presentation of children to ambulatory care. In contrast, serious infections are rare and often present at an early stage. To avoid complications or death, early recognition and adequate referral are essential. In a recent large study children were included prospectively to construct a symptom-based decision tree with a sensitivity and negative predictive value of nearly 100%. To reduce the number of false positives, point-of-care tests might be useful, providing an immediate result at bedside. The most probable candidate is C-reactive protein, as well as a pulse oximetry. Methods: This is a diagnostic accuracy study of signs, symptoms and point-of-care tests for serious infections. Acutely ill children presenting to a family physician or paediatrician will be included consecutively in Flanders, Belgium. Children testing positive on the decision tree will get a point-of-care C-reactive protein test. Children testing negative will randomly either receive a point-of-care C-reactive protein test or usual care. The outcome of interest is hospital admission more than 24 hours with a serious infection within 10 days. Aiming to include over 6500 children, we will report the diagnostic accuracy of the decision tree (+/- the point-of-care C-reactive protein test or pulse oximetry) in sensitivity, specificity, positive and negative likelihood ratios, and positive and negative predictive values. New diagnostic algorithms will be constructed through classification and regression tree and multiple logistic regression analysis. Discussion: We aim to improve detection of serious infections, and present a practical tool for diagnostic triage of acutely ill children in primary care. We also aim to reduce the number of investigations and admissions in children with non-serious infections

Comparison of PM-HIP to Cast Alloy 625 for Nuclear Applications

PM-HIP, or Powder Metallurgy and Hot Isostatic Pressing, metals have been a low cost alternative to forged and cast structural metals within various industries. The nuclear industry has recently developed interest in PM-HIP alloys, but further research needs to be done to quantify their mechanical properties and characterize the microstructure. Specifically, we must understand the mechanical and microstructural evolution of PM-HIP materials after long-term operation at the elevated temperatures that PM-HIP components will experience in service. We focus on Ni-base alloy Inconel 625, and compare the PM-HIP version to the cast version. Our methodology consists of annealing samples to various temperatures, 400,600, and 800 °C, at various times, 100, 1,000, and 10,000 hours, to see the temperature and time effect on these alloys. We conduct microhardness testing and optical microscopy to evaluate the strength and grain size, respectively. We have found that average grain size in PM-HIP 625 samples are consistently smaller than that in cast 625, and this grain size difference persists with heat treatment. Future work will involve scanning electron microscopy (SEM) imaging and tensile testing of the annealed specimens, as well as irradiation exposure

A simulation model to study maternal hyperoxygenation during labor

To investigate the effect of maternal hyperoxygenation on fetal oxygenation and fetal heart rate decelerations during labor, using a simulation model. Design Use of a mathematical model that simulates feto–maternal hemodynamics and oxygenation, designed in Matlab R2012a. Setting Clinical and engineering departments in the Netherlands. Methods We simulated variable and late fetal heart rate decelerations, caused by uterine contractions with a different contraction interval. We continuously recorded oxygen pressure in different feto–placental compartments and fetal heart rate, during maternal normoxia and during hyperoxygenation with 100% oxygen. Main outcome measures Changes in oxygen pressure in the intervillous space, umbilical vein and arteries, fetal cerebral and microcirculation as well as fetal heart rate deceleration depth and duration. Results Maternal hyperoxygenation leads to an increase in fetal oxygenation: in the presence of variable decelerations, oxygen pressure in the intervillous space increased 9–10 mmHg and in the cerebral circulation 1–2 mmHg, depending on the contraction interval. In addition, fetal heart rate deceleration depth decreased from 45 to 20 beats per minute. In the presence of late decelerations, oxygen pressure in the intervillous space increased 7–10 mmHg and in the cerebral circulation 1–2 mmHg, depending on the contraction interval. The fetus benefited more from maternal hyperoxygenation when contraction intervals were longer. Conclusions According to the simulation model, maternal hyperoxygenation leads to an increase in fetal oxygenation, especially in the presence of variable decelerations. In addition, in the presence of variable decelerations, maternal hyperoxygenation leads to amelioration of the fetal heart rate pattern

Characterization of Left-Ventricular Thrombus Formation Using High Frequency Ultrasound

Heart failure is a leading cause of death in the United States, and cardiac thrombus, a common morbidity associated with heart failure, significantly increases a patient’s risk of embolic events. The objective of this project is to characterize left-ventricular (LV) thrombus development using high frequency ultrasound imaging in a murine model. C57BL/6J wild-type mice (n=6) were injected intraperitoneally with iron dextran five times a week for six weeks to increase oxidative stress in the heart. Granulocyte-colony stimulating factor (G-CSF) was subcutaneously injected daily during the second week to initiate stem cell migration and stimulate endothelial cell activation, thus increasing the hypercoagulability state of the blood. A high-frequency, small animal ultrasound system (Vevo2100, VisualSonics FUJIFILM Inc.) and a 40 MHz central frequency transducer were used to track LV thrombus progression and evaluate LV function weekly. Four out of six mice developed thrombus, but no significant differences in LV performance were observed when compared to mice that did not form a thrombus. Further investigation is necessary to study the role of attenuated heart function on thrombus formation. Future work will incorporate a murine model of myocardial infarction to investigate if a severely compromised heart increases the risk of or accelerates LV thrombus formation. This study will aid in identifying patients who are predisposed to thrombus formation following a heart attack, leading to more effective prevention and treatment methods