Faire alliance aujourd'hui : une lecture de deutéronome 29-30 à la lumière de la soif spirituelle contemporaine

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal

Quand le poker cesse d’être un jeu : Pratiques et discours d’aspirants joueurs professionnels

Cet article fait état d’une enquête portant sur une communauté électronique de joueurs de poker, qui échangent ensemble en ligne au sujet de leurs pratiques et habitudes de jeu. L’analyse du contenu des échanges qui prennent place dans le forum vise à éclairer le rapport particulier qu’entretiennent ces aspirants joueurs professionnels de poker avec le jeu ainsi que le rôle que joue la fréquentation d’un espace électronique de joueurs en regard du rapport qu’ils entretiennent avec le jeu. L’article montre que la pratique de ces joueurs est pensée comme un parcours, dans lequel on joue maintenant dans le but de s’améliorer pour devenir un jour un joueur gagnant. L’article trace les contours du cadre disciplinaire dans lequel les joueurs envisagent le jeu et se penche sur les principes qui fondent les règles auxquelles ceux-ci disent vouloir s’astreindre en vue de devenir des « joueurs gagnants ». L’analyse révèle en outre la caractère structurant de l’opposition entre « poissons » et « bons joueurs » dans les représentations et discours des joueurs qui fréquentent le forum et montre enfin que la participation à ces échanges permet aux joueurs de se retrouver entre eux, autour d’une même conception marginale du jeu, alors même que leur entourage semble plutôt susceptible de s’inquiéter de leurs habitudes de jeu et du rapport qu’ils entretiennent avec le poker.This article presents the results of an inquiry on an online community of poker players who exchange opinions about their practices and game habits in a discussion forum. A content analysis of these discussions aims to shed light on the peculiar relationship these aspiring professional poker players have with the game itself, and on how it is affected by the attendance of an online space. The article will show that the players’ pratices are thought of as a journey, on which one plays in order to improve his game and become a “winning player”. It will also outline the disciplinary framework through which the players view the game by looking into the founding principles of the rules that players constrain themselves to in their objective to become “winning players”. The analysis also reveals the structuring character of the opposition between “pigeons” and “good players” in the discourses and representations of players who attend the forum. It will ultimately demonstrate that the participation in these electronic exchanges may enable players to gather around a shared marginal conception of the game, while their family circle often seem to worry about their game habits and their relationship to the game

A collaborative model to implement flexible, accessible and efficient oncogenetic services for hereditary breast and ovarian cancer : the C-MOnGene study

Medical genetic services are facing an unprecedented demand for counseling and testing for hereditary breast and ovarian cancer (HBOC) in a context of limited resources. To help resolve this issue, a collaborative oncogenetic model was recently developed and implemented at the CHU de Québec-Université Laval; Quebec; Canada. Here, we present the protocol of the C-MOnGene (Collaborative Model in OncoGenetics) study, funded to examine the context in which the model was implemented and document the lessons that can be learned to optimize the delivery of oncogenetic services. Within three years of implementation, the model allowed researchers to double the annual number of patients seen in genetic counseling. The average number of days between genetic counseling and disclosure of test results significantly decreased. Group counseling sessions improved participants' understanding of breast cancer risk and increased knowledge of breast cancer and genetics and a large majority of them reported to be overwhelmingly satisfied with the process. These quality and performance indicators suggest this oncogenetic model offers a flexible, patient-centered and efficient genetic counseling and testing for HBOC. By identifying the critical facilitating factors and barriers, our study will provide an evidence base for organizations interested in transitioning to an oncogenetic model integrated into oncology care; including teams that are not specialized but are trained in genetics

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570