Le recours au Comité des droits de l'homme de l'O.N.U. : une illusion?

The international charter of human freedoms became a legal reality via the coming into force of the following three documents : the International Convention on Economic, Social and Cultural Rights, the International Convention on Civil and Political Rights and the optional protocol attached to it. The Human Rights Committee was created under the Convention on Civil and Political Rights. In accordance with the controlling machinery set up under the optional protocol, the Committee must examine complaints from individuals who feel that their rights as defined and protected by the Convention, have been violated. Besides Uruguay, Canada is the country that submits the greatest number of complaints to the Human Rights Committee. To this days, six « communications » putting it into question have been at the origin of the adoption of « final views » two of which have demonstrated a violation of rights laid down in the Convention. Yet various improvements have proved to be desirable so as to make resorting to the Committee more efficient. It is even conceivable that making the rule on exhausting internal recourses might allow the Committee to influence Canadian law by inciting Canada to amend its Constitution or to integrate the Convention into its national law so as to be usable before the courts. The Committee has thereby contributed to increasing the basic freedoms of Canadians via the Convention on Civil and Political Rights. Although their accomplishments have been praiseworthy, work done by the Human Rights Committee risks being incomplete if the status quo continues

Répercussions biopsychosociales du Sida et pistes d’intervention et de recherche

Le syndrome d'immunodéficience acquise (SIDA) constitue un problème mondial de santé publique d'une ampleur exceptionnelle. Son impact est considérable sur plusieurs plans : individuel, social, économique, démographique et culturel. Les écrits relatifs au SIDA démontrent bien l'impact émotionnel des pertes occasionnées par cette maladie fatale sur les personnes atteintes. Celles-ci éprouvent des sentiments intenses d'anxiété, de peur, de colère, d'impuissance et de désespoir. À cette détresse psychologique s'ajoute l'isolement des victimes. La réaction négative entretenue au sein de la société à l'égard du SIDA contribue à discriminer et stigmatiser les victimes de cette maladie. Le SIDA est en quelque sorte un drame personnel et un effondrement de la vie familiale et sociale. Les répercussions psychosociales de cette maladie exigent des stratégies d'intervention et de recherche appropriées aux divers problèmes soulevés par le syndrome.The acquired immunodeficiency syndrome (AIDS) is a world wide health problem of exceptional magnitude with considerable effect in many areas : individual, social, economic, demographic and cultural. Current literature clearly indicates the emotional impact of the losses occasionnée by those suffering from this fatal disease. There include strong anxiety, fear, anger powerlessness and hopelessness. To this psychological distress is added isolation of AIDS victims. The negative reaction of society contributes to discrimination and stigmatization of these victims. AIDS may be seen as a personnal tragedy which often spells the collapse of family life. The psychosocial repercussions of this disease require intervention and further research with respect to the many unresolved problems generated by this syndrome

Élaboration d’une intervention infirmière suivant une approche basée sur la théorie et les données empiriques pour promouvoir les interactions empreintes de sensibilité maternelle à l’unité de soins intensifs néonatals

Introduction: Sensitive mother-infant interactions are important predictors of long-term mother-infant relationship and infant development. Considering preterm infants’ immaturity, mother-infant interactions and maternal sensitivity may not develop optimally. A systematic review showed that current evidence on the effectiveness of parent-infant interventions promoting parental sensitivity in the neonatal intensive care unit (NICU) is of low to very low quality. Objective: The objective of this paper is to report the development process of a novel nursing intervention, using a theory and evidence-based approach, to enhance maternal sensitivity and preterm infant neurodevelopment in the NICU. Methods: The Medical Research Council’s guidance to develop and evaluate complex health interventions, that is an evidence and theory-based approach, was used for this study. Thus, based on the MRC framework, three main steps were conducted: 1- Identifying existing empirical evidence; 2- Identifying and developing theory; 3- Modeling processes and outcomes. Results: We developed a guided participation intervention for mothers to participate in their preterm infant’s care and positioning (‘GP_Posit’). ‘GP_Posit’ is based upon the Attachment theory, the Guided Participation theory as well as the Synactive theory of development. Conclusion: This novel intervention is being tested in a pilot randomized controlled trial (NCT03677752).Introduction : La relation mère-enfant, dont les interactions empreintes de sensibilité maternelle en sont l’un des principaux prédicteurs, figure parmi les facteurs pouvant améliorer le développement des nouveau-nés prématurés. En raison de l’immaturité des nouveau-nés prématurés, les interactions mère-enfant précoces et la sensibilité maternelle sont à risque de se développer de façon sous-optimale. Les résultats d’une revue systématique ont montré que les données actuelles sur l’efficacité des interventions parent-enfant favorisant la sensibilité parentale dès l’hospitalisation à l’unité de soins intensifs néonatals (USIN) sont de qualité faible à très faible. Objectif : L’objectif de cet article est de rapporter le processus de développement d’une nouvelle intervention infirmière, en utilisant une approche basée sur la théorie et les données empiriques, pour améliorer la sensibilité maternelle et le développement neurologique des nouveau-nés prématurés à l’USIN. Méthodes : Les lignes directrices du Medical Research Council pour le développement et l’évaluation d’interventions complexes en santé ont été suivies. Ainsi, trois principales étapes ont été suivies : 1- Identification des preuves empiriques existantes ; 2- Identification et développement théorique ; 3- Modélisation des processus et des résultats. Résultats : Nous avons développé une intervention de participation guidée pour que les mères participent aux soins et au positionnement de leur nouveau-né prématuré (‘GP_Posit’). ‘GP_Posit’ est basée sur la théorie de l’attachement, la théorie de la participation guidée ainsi que la théorie synactive du développement. Conclusion : Cette intervention est mise à l’essai dans un essai contrôlé randomisé pilote (NCT03677752)

From VIH-TAVIE™ to TAVIE-WOMAN™: Development of a Web-Based Virtual Nursing Intervention to Meet the Specific Needs of Women Living With HIV

The web-based virtual nursing intervention VIH-TAVIE™ was designed to help people living with HIV (PLWH) adhere to their antiretroviral treatment (ART). The content of the intervention is generic and gender neutral. However, it is recognised that women living with HIV (WLWH) experience their condition in a unique way and face gender-specific challenges regarding ART intake. Consequently, it seemed appropriate to adapt VIH-TAVIE™ specifically for women. The purpose of this paper is to present the qualitative results of an evaluative study of VIH-TAVIE™ that describe the experience of six WLWH who received the web-based computer-delivered intervention and to present the content and specificities of an offshoot intervention under development, TAVIE-Woman™. The following themes emerged from the content analysis of interviews with the WLWH about : 1) presence of actual nurse on site to facilitate transition to virtual mode; 2) virtual nurse humanises experience of computer-delivered intervention; 3) learners’ appreciation of medium and content; and 4) perceived benefits following participation in the intervention. To adapt VIH-TAVIETM for women, discussions were also held with a healthcare team in a mother-child university hospital centre. The gender-specific content added to TAVIE-WomanTM included digital storytelling of HIV-positive women, various topics about changing ARV medication during pregnancy, neonatal ART prophylaxis, disclosure  to children,  adapting to life with HIV, selecting a birth-control method, and social support. Ultimately, the purpose of TAVIE-WomanTM is to support WLWH by offering them 24/7 access to tailored education and reliable quality information

Routes of administration, reasons for use, and approved indications of medical cannabis in oncology : a scoping review

Introduction: Some patients diagnosed with cancer use medical cannabis to self-manage undesirable symptoms, including nausea and pain. To improve patient safety and oncological care quality, the routes of administration for use of medical cannabis, patients’ reasons, and prescribed indications must be better understood. Methods: Based on the Joanna Briggs Institute guidelines, a scoping review was conducted to map the current evi‑ dence regarding the use of medical cannabis in oncological settings based on the experiences of patients diagnosed with cancer and their healthcare providers. A search strategy was developed with a scientifc librarian which included fve databases (CINAHL, Web of Science, Medline, Embase, and PsycINFO) and two grey literature sources (Google Scholar and ProQuest). The inclusion criteria were: 1) population: adults aged 18 and over diagnosed with cancer; 2) phenomena of interest: reasons for cannabis use and/or the prescribed indications for medical cannabis; 3) context: oncological setting. French- or English-language primary empirical studies, knowledge syntheses, and grey literature published between 2000 and 2021 were included. Data were extracted by two independent reviewers and subjected to a thematic analysis. A narrative description approach was used to synthesize and present the fndings. Results: We identifed 5,283 publications, of which 163 met the eligibility criteria. Two main reasons for medical cannabis use emerged from the thematic analysis: limiting the impacts of cancer and its side efects; and staying connected to others. Our results also indicated that medical cannabis is mostly used for three approved indications: to manage refractory nausea and vomiting, to complement pain management, and to improve appetite and food intake. We highlighted 11 routes of administration for medical cannabis, with oils and oral solutions the most fre‑ quently reported. Conclusion: Future studies should consider the multiple routes of administration for medical cannabis, such as inha‑ lation and edibles. Our review highlights that learning opportunities would support the development of healthcare providers’ knowledge and skills in assessing the needs and preferences of patients diagnosed with cancer who use medical cannabis

Improving the self-efficacy, knowledge, and attitude of nurses regarding concurrent disorder care : results from a prospective cohort study of an interprofessional, videoconference-based programme using the ECHO model

Several challenges have been identified for patients with concurrent disorders to access adequate services and for nurses to care for them. These challenges contribute to a pressing need for continuing educational interventions, particularly within the mental health nursing workforce. To address this issue, an innovative interprofessional videoconferencing programme based on the ECHO model (Extension for Community Healthcare Outcomes) was implemented in Quebec, Canada to support and build capacity among healthcare professionals for CD management. The aim of this prospective cohort study was to examine nurses’ self-efficacy, knowledge, and attitude scores over a 12-month period. All nurses who registered in the programme between 2018 and 2020 were invited to participate in the study (N = 65). The data were collected online using a self-administered survey at baseline, after 6 months, and then 12 months following entry-to-programme. Twenty-eight nurses participated in the study (96.4% women), with a mean age of 39.1 (SD = 6.2). Compared to other professions (n = 146/174), the group of nurses also showed significant improvements in their knowledge and attitude scores, with respective effect sizes of 0.72 and 0.44 at 6 months, and 0.94 and 0.59 at 12 months. However, significant changes in self-efficacy were only found at the 12-month follow-up (P = 0.0213), among the nurses who attended more than 25% of the 20-session curriculum. ECHO is a promising intervention to improve the accessibility of evidence-based practice and to support nurses in suitably managing concurrent disorders. Further research is needed to establish the effectiveness of this educational intervention on clinical nursing practice and patient outcomes

A learning organization in the service of knowledge management among nurses: A case study

AbstractIt becomes critical for health care organizations to develop strategies that aim to design new work practices and to manage knowledge. The introduction of learning organizations is seen as a promising choice for better knowledge management and continuing professional development in health care. This study analyzes the effects of a learning organization on nurses’ continuing professional development, knowledge management, and retention in a health and social services centre in Quebec, Canada. The learning organization seemed to affect daily nursing work in a positive manner, despite its variable impact on other professionals and other sites outside the hospital centre. These changes were particularly pronounced with respect to knowledge transfer, support for nursing practices, and quality of health care, objectives that the learning organization had sought to meet since its inception. However, it seemed to have a limited effect on nurse retention

Preliminary Assessment of a Weather Forecast Tool for Building Operation

Although the potential of model predictive control (MPC) for the operation of buildings is widely recognized, as of today its adoption has been rather limited. This is partly due to the lack of user-friendly software tools for MPC, such as tools to facilitate the incorporation of forecast information in building automation systems. In view of this, CanmetENERGY, a research centre of Natural Resources Canada, has developed CanMETEO, a software tool free of charge aimed at obtaining weather forecast data and make it available in a useful and practical format for building operators. CanMETEO, which was released officially in August 2017, uses raw data produced by the Meterological Service of Environment Canada. This data, with high spatial resolution (e.g., 2 km x 2 km grids, and even denser for urban areas) enables the possibility of obtaining forecasts for very specific locations in the Canadian territory. Hundreds of weather variables (such as temperature, humidity, wind speed, cloud cover, among many others) are available for each point, which can be selected by the user via a graphical interface. The data is converted from GRIB files (a standard binary format used by meteorologists) into comma-separated value (CSV) files, which can be easily accessed. New forecasts become available every 6 hours, with a prediction horizon of 48 hours at hourly time steps; the retrieval of new weather forecasts can be setup in order to be performed automatically. These continuously updated CSV files may then be easily incorporated into building operation algorithms or simple optimization routines. Once the basic variables are obtained, post-processing calculations are applied in order to estimate solar irradiance on any given plane required by the user, for example, building façades and building-integrated photovoltaic panels. This feature also makes it possible to estimate the effect of solar gains on the thermal response of a building, and to estimate the output of photovoltaic panels. A preliminary evaluation of the tool, based on on-site measurements, is presented in this paper. It is expected that CanMETEO (currently used by Canadian research centre and universities) will provide one further step to the widespread adoption of predictive control as a viable, popular solution in building operation

Covalent organic frameworks

The first members of covalent organic frameworks (COF) have been designed and successfully synthesized by condensation reactions of phenyl diboronic acid C6H4[B(OH)2]2 and hexahydroxytriphenylene C18H6(OH)6. The high crystallinity of the products (C3H2BO)6 (C9H12)1 (COF-1) and C9H4BO2 (COF-5) has allowed definitive resolution of their structure by powder X-ray diffraction methods which reveal expanded porous graphitic layers that are either staggered (COF-1, P63/mmc) or eclipsed (COF-5, P6/mmm). They exhibit high thermal stability (to temperatures up to 500- to 600-C), permanent porosity, and high surface areas (711 and 1590 m2/g, respectively) surpassing those of related inorganic frameworks. A similar approach has been used for the design of other extended structures

The development of the MENTOR_D nursing intervention : supporting family involvement in delirium management

Background Although families are increasingly seen as allies to improve delirium management and reduce its consequences, their involvement in the postcardiac surgery setting is challenging considering patients' critical state and short hospital stay. To our knowledge, no theory-based nursing intervention exists that optimally supports the involvement of families in delirium management in the context of postcardiac surgery. Objectives We aimed to develop MENTOR_D, a nursing intervention to support the involvement of families in delirium management. Methods MENTOR_D was developed based on Sidani and Braden's (2011) intervention development framework. Narrative literature reviews paired with the clinical experience of an expert committee were used to inform these three steps: (1) develop an understanding of the problem under study; (2) define the objectives of the intervention and identify a theoretical framework for highlighting strategies to be used in the intervention; and (3) operationalize the intervention and identify its anticipated outcomes. Results As a result of the three steps, the MENTOR_D nursing intervention relies on a caring–mentoring relationship between a nurse and the family. The aim of MENTOR_D is to increase the presence of the family at their relative's bedside and their involvement in delirium management. MENTOR_D's content is delivered over three phases that are organised around the visits of the family at the patient's bedside. During these phases, families used their knowledge of the patient to tailor the delirium management actions. These actions include orientation and reminiscence and were aimed at diminishing anxiety and increasing sense of self-efficacy in families and diminishing delirium severity and improving recovery in patients. Conclusions A deep understanding of the underlying mechanisms of an intervention is key in its success to reach the targeted goals of effectiveness in practice. This understanding can be achieved through the careful development of a theory of the intervention before the operationalisation of its components and its testing. The proposed paper presents the theory of the MENTOR_D intervention, that is, its conceptualization and proposed mechanisms of action. Implications for practice As delirium continues to be a major complication, this intervention is a promising solution to increase families' involvement in delirium management and highlights the support that nurses can offer to facilitate this involvement. With its use in future studies and practice, it can be further refined