Evalutation de la formation DIAFIT

Le « diabetes mellitus » ou diabète sucré est un groupe de maladies métaboliques liées entre elles par la présence d'une hyperglycémie dans le sang. Celle-ci résulte d'une déficience et/ou d'une résistance à l'insuline qui, passé un certain délai, provoque des dégâts au niveau des vaisseaux sanguins et du système nerveux (Gariani et al., 2009). Selon l'Organisation mondiale de la santé, le diabète est une affection courante dont la fréquence croît à un rythme alarmant partout dans le monde : en l'an 2000, l'OMS estimait au moins 171 millions de diabétiques (Communiqué OMS, 2004). Cette progression massive résulterait du vieillissement de la population, de l'accroissement démographique, ainsi que de la tendance à l'obésité croissante, de la sédentarité et d'une alimentation peu équilibrée et riche en calories (Aide-mémoire OMS, 2002). Actuellement, 356 millions de personnes diabétiques sont recensées (Aide-mémoire OMS, 2011). Selon Vollenweider et al. (2006), la situation en Suisse présente environ 300'000 personnes atteintes, soit une personne sur vingt. Leur étude lausannoise CoLaus (pour Cohorte Lausannoise), qui a recruté plus de 6'000 personnes âgées de 35 à 75 ans, montre une prévalence de diabète de 6.6%. Ce chiffre se situe dans la moyenne européenne. Ainsi, le diabète est une maladie chronique qui nécessite des soins médicaux de longue durée et une éducation thérapeutique du patient intégrée à ces soins afin qu'il puisse au mieux gérer la vie de tous les jours et d'éventuelles complications soit aigües soit à long terme (ADA, 2011). Toutefois, le diabète n'empêche pas de mener une vie active et saine. Bien entendu, cela nécessite une prise en charge efficace qui implique différentes mesures liées au mode de vie, telles qu'un poids approprié, une alimentation équilibrée et de l'activité physique (ADA, 2011). Les médicaments ont eux aussi un rôle important : ils permettent de contrôler efficacement la glycémie afin d'éviter les complications survenant lors de diabète déséquilibré à long terme, de contrôler la pression artérielle ainsi que le taux de lipides dans le sang (ADA, 2011). Il a été prouvé que l'activité physique représente un point cardinal au traitement du diabète de type 2, de par les modifications physiologiques qu'elle entraîne lors de sa pratique régulière et conforme aux recommandations (Boulé et al., 2001). Ceci sera décrit ultérieurement dans ce travail de master. DIAfit est un programme spécifique suisse de réadaptation physique qui vise les personnes souffrant d'un diabète de type 2. Le but de ce programme est de permettre aux patients d'entreprendre une activité physique dans une structure spécialisée, avec un encadrement personnalisé. Ce travail de master vise à évaluer la première formation DIAfit pour soignants réalisée en Suisse romande. Tout comme le soulignent Chochard & Davoine (2008), l'évaluation est un outil indispensable pour le développement d'un programme de formation. Toujours selon les auteurs, l'évaluation permet de juger la pertinence de la formation, d'améliorer la qualité du programme de formation, et de constater si les nouvelles connaissances acquises sont appliquées dans le milieu professionnel

Minority Student Perceptions of Professional Pscyhology Application Packets: A Qualitative Study

This article reports the results of a qualitative study designed to determine issues salient in Black and Hispanic American students\u27 review and evaluation of program-application packets in professional psychology. The study served as an extension to the Yoshida et al. (1989) quantitative investigation. Students interested in pursuing doctoral studies in counseling or school psychology (N = 22) served as the sample. The qualitative methodology incorporated a think-aloud procedure and semistructured interviews. A theme analysis of transcribed interviews identified both major and minor themes central to participants\u27 evaluation of the packets. Major themes included financial aid, program requirements and course descriptions, demography of the student body, and the quality and clarity of application material. Specific suggestions on developing an application packet to send to inquiring prospective students are put forth. It is recommended that such a packet could serve as a costeffective minority-recruitment strategy

Prospective Minority Students\u27 Perceptions of Application Packets for Professional Psychology Programs: A Qualitative Study

This article reports the results of a qualitative study designed to determine issues salient in Black and Hispanic American students\u27 review and evaluation of program-application packets in professional psychology. The study served as an extension to the Yoshida et al. (1989) quantitative investigation. Students interested in pursuing doctoral studies in counseling or school psychology (N = 22) served as the sample. The qualitative methodology incorporated a think-aloud procedure and semistructured interviews. A theme analysis of transcribed interviews identified both major and minor themes central to participants\u27 evaluation of the packets. Major themes included financial aid, program requirements and course descriptions, demography of the student body, and the quality and clarity of application material. Specific suggestions on developing an application packet to send to inquiring prospective students are put forth. It is recommended that such a packet could serve as a cost-effective minority-recruitment strategy

Daughters\u27 Perspectives on Maternal Substance Abuse: Pledge to Be a Different Kind of Mother

The purpose of this grounded theory (Strauss & Corbin, 1998) study was to explore the experiences of racially and culturally diverse young mothers whose own mothers abused substances two decades ago when substance abuse peaked in inner city, urban neighborhoods in the United States and to identify the factors that have influenced how they parent their own children today. Semi-structured interviews were conducted with ten drug-free mothers who report having been raised by a mother who was addicted to drugs, primarily crack cocaine during their childhoods. The emergent grounded theory is that exposure to maternal substance abuse has a significant and unique impact on female children throughout their lifespan, with particular emphasis at the onset of motherhood. Among the goals the young mothers expressed is that they wanted to be there for their children, protect their daughters from sexual abuse, and raise sons who do not abuse women

An Embankment on Soft Clays with Sand Drains Numerical Characterization of the Parameters from In-situ Measurements

The deformation parameters of a soft lacustrine deposit, with vertical sand drains, are evaluated by means of field measurements obtained during and after the construction of a railway embankment. The geotechnical system, modelled as linearly elastic and in plane strain, is analyzed by means of the finite element method and the estimation problem is solved adopting a Bayesian approach. The experimental data, the a priori estimation of the parameters and their uncertainties are considered in the back-analysis. The results provide the optimal values of the parameters, a measure of their uncertainties and, consequently, an index of the effectiveness of the field measurement program

Protease em dietas para frango de corte

Orientadora : Profª. Drª. Simone Gisele de OliveiraDissertação (mestrado) - Universidade Federal do Paraná, Setor de Ciências Agrárias, Programa de Pós-Graduação em Ciências Veterinárias. Defesa: Curitiba, 15/02/2017Inclui referências ao final de cada capítuloResumo: Entre vários aspectos na produção avícola, a nutrição apresenta papel importante, que abrange o conhecimento do potencial nutritivo dos nutrientes e exigências nutricionais. No potencial nutritivo, os programas nutricionais têm buscado novas estratégias para melhorar a digestibilidade dos alimentos e proporcionar condições que favoreçam a expressão do máximo potencial genético das aves, sem acréscimos onerosos aos custos de produção. O presente trabalho tem por objetivo avaliar o efeito de diferentes níveis de inclusão de protease na dieta de frangos de corte sobre o desempenho destes animais de 1 a 40 dias. Ainda se avaliou a cama de frango pelos aspectos químicos através da excreção das aves. No experimento foram utilizados 480 pintos macho Cobb distribuídos em delineamento inteiramente casualizado com cinco tratamentos e oito repetições de doze aves cada. As dietas administradas nos tratamentos foram fareladas com inclusão de protease (0, 50, 100, 150 e 200 ppm) na ração. As aves alimentadas com maior inclusão de protease apresentaram melhor conversão alimentar (CA). Todavia, o ganho de peso (GP) das aves diminuiu com o aumento da inclusão da protease na dieta, assim como o consumo de ração (CR). Foi avaliado o desempenho das aves de 1 a 40 dias de idade. Na fase total de criação das aves os seus índices zootécnicos avaliados estatisticamente não foram significativos para (P<0,05). Ao final do experimento, foram coletadas cinco amostras de cama dos respectivos tratamentos e encaminhados para análise química (proteína bruta, cálcio, fósforo, sódio, potássio, boro, cobre, manganês, ferro, zinco e matéria seca). As análises químicas dos elementos, comprovou que o as enzimas podem ajudar a melhorar a disponibilidade dos minerais aos animais, diminuindo a excreção destes na cama. Quanto aos minerais mais sensíveis, são elementos de fácil complexação, o que demonstrou uma excreção considerada desses elementos na cama de frango. O experimento realizado foi confirma alguns dos resultados realizados ao longo dos anos, sendo confirmados com inúmeros projetos, na qual a protease era o principal fator a ser avaliado na dieta de frangos de corte. Os animais tiveram uma melhor conversão alimentar com a inclusão de protease, entretanto esse ganho se deu ao custo de um menor ganho de peso desses animais, sendo assim um resultado que não é favorável para a cadeia produtiva de frangos de corte. Palavras-chave: aves, desempenho, protease, análise químicaAbstract: Among several aspects in poultry production, nutrition plays an important role, which includes knowledge of the nutritional potential of nutrients and nutritional requirements. In nutritional potential, nutritional programs have sought new strategies to improve the digestibility of food and provide conditions that favor the expression of the maximum genetic potential of the birds, without costly additions to the costs of production. The objective of the present work was to evaluate the effect of different levels of protease inclusion in the broiler diet on the performance of these animals from 1 to 40 days. The chicken bed was also evaluated for chemical aspects through the excretion of the birds. In the experiment were used 480 male Cobb chicks distributed in a completely randomized design with five treatments and eight replicates of twelve birds each. The diets administered in the treatments were smoked with inclusion of protease (0, 50, 100, 150 and 200 ppm) in the diet. Birds fed higher protease inclusion had better feed conversion (CA). However, the weight gain (GP) of the birds decreased with the increase of the protease inclusion in the diet, as well as the feed consumption (CR). The performance of birds from 1 to 40 days of age was evaluated. In the total phase of bird breeding, their statistically evaluated zootechnical indexes were not significant for (P <0.05). At the end of the experiment, five bed samples of the respective treatments were collected and submitted to chemical analysis (crude protein, calcium, phosphorus, sodium, potassium, boron, copper, manganese, iron, zinc and dry matter). The chemical analysis of the elements, proved that the enzymes can help improve the availability of minerals to animals, reducing the excretion of these in bed. As for the most sensitive minerals, they are elements of easy complexation, which demonstrated a considered excretion of these elements in the bed of chicken. The experiment was confirmed some of the results achieved over the years, and confirmed with numerous projects, in which protease was the main factor to be evaluated in the diet of broilers. The animals had a better feed conversion with the inclusion of protease, however, this gain was due to the lower weight gain of these animals, which is not a favorable result for the productive chain of broilers. Key words: birds, performance, protease, chemical analysi

Postremission sequential monitoring of minimal residual disease by WT1 Q-PCR and multiparametric flow cytometry assessment predicts relapse and may help to address risk-adapted therapy in acute myeloid leukemia patients

Risk stratification in acute myeloid leukemia (AML) patients using prognostic parameters at diagnosis is effective, but may be significantly improved by the use of on treatment parameters which better define the actual sensitivity to therapy in the single patient. Minimal residual disease (MRD) monitoring has been demonstrated crucial for the identification of AML patients at high risk of relapse, but the best method and timing of MRD detection are still discussed. Thus, we retrospectively analyzed 104 newly diagnosed AML patients, consecutively treated and monitored by quantitative polymerase chain reactions (Q-PCR) on WT1 and by multiparametric flow cytometry (MFC) on leukemia-associated immunophenotypes (LAIPs) at baseline, after induction, after 1st consolidation and after 1st intensification. By multivariate analysis, the factors independently associated with adverse relapse-free survival (RFS) were: bone marrow (BM)-WT1 ≥ 121/10(4) ABL copies (P = 0.02) and LAIP ≥ 0.2% (P = 0.0001) (after 1st consolidation) (RFS at the median follow up of 12.5 months: 51% vs. 82% [P < 0.0001] and 57% vs. 81%, respectively [P = 0.0003]) and PB-WT1 ≥ 16/10(4) ABL copies (P = 0.0001) (after 1st intensification) (RFS 43% vs. 95% [P < 0.0001]) Our data confirm the benefits of sequential MRD monitoring with both Q-PCR and MFC. If confirmed by further prospective trials, they may significantly improve the possibility of a risk-adapted, postinduction therapy of AML