Une étude exploratoire des sources de stress et de soutien social chez les intervenantes communautaires en santé mentale

L'objectif de cette recherche exploratoire est d'identifier les principales sources de stress au travail et d'épuisement professionnel chez les intervenantes en santé mentale oeuvrant en milieu communautaire et d'examiner le soutien social qu'elles reçoivent. Les informations ont été recueillies au cours d'entrevues individuelles et d'entrevues de groupe auxquelles ont participé 19 intervenantes provenant de trois centres de crise de Montréal. Les principaux facteurs de stress qu'identifient les participantes ont trait à des dimensions relevant de l'intervention auprès des usagers et du rôle d'intervenante. Des difficultés spécifiques au travail en milieu communautaire sont aussi rapportées. Le soutien reçu des collègues de travail et la qualité des relations avec la direction ressortent comme facteurs importants de protection contre le stress et l'épuisèment.An exploratory study on sources of stress and social support among community mental health workers The objective of this exploratory research is to identify the main sources of work stress and burnout among community mental health workers and examine the social support they receive. Information has been collected through individual and group interviews with 19 community workers from three crisis centres in Montreal. The most stressing factors identified by participants are related to their intervention with users and their role as intervention worker. Difficulties related specifically to community work are also reported. Social support received from colleagues and quality of relations with superiors stand out as important factors of protection against stress and burnout

Le juste milieu : Représentations de l’espace des résidants du périurbain de l’agglomération de Québec

Usages et représentations spatiales d’un territoire se nourrissent mutuellement au cours du cycle de vie et jouent un rôle important dans la définition des aspirations et du choix résidentiels. Si des mesures incitatives visant à attirer les ménages plus près des quartiers centraux sont à mettre de l’avant afin de freiner l’étalement urbain, pour être efficaces, elles devront être fondées sur la compréhension des représentations spatiales de ces mêmes ménages. Comment les résidants du périurbain se représentent-ils la ville, la banlieue, la campagne ? Notre analyse se base sur une enquête qualitative auprès de 132 résidants de six secteurs résidentiels situés en dehors des limites de la ville de Québec. Cette enquête révèle que non seulement ces résidants ne sont pas d’anciens urbains, mais qu’ils ne souhaitent pas le devenir. Leurs représentations de la ville sont le plus souvent négatives alors qu’ils idéalisent la campagne. Les répondants ont du mal à qualifier clairement leur propre milieu de résidence, probablement à cause des mutations profondes subies par les agglomérations urbaines.The spatial uses and representations of a territory influence each other in a lifetime and also play an important role in the definition of residential choice and aspirations. If measures were taken to encourage households to move closer to inner-city neighborhoods, in order to curb urban sprawl, they should be underpinned by a deep understanding of inhabitants’ social representations of metropolitan territories. For example, how do exurbanites generally view the city, the suburbs and the countryside? Our own analysis is based on a qualitative survey of 132 households from six exurban residential settings located beyond the limits of the Quebec City metropolitan area. Not only do our results reveal that the great majority of these households are not former exurbs. City representations and meanings are predominantly negative, while those defining suburbs and the countryside are systematically positive. Respondents found it difficult to describe their own residential settings clearly

Développement et validation d’un outil clinique pour l’analyse quantitative de la posture auprès de personnes atteintes d’une scoliose idiopathique

La scoliose idiopathique (SI) est une déformation tridimensionnelle (3D) de la colonne vertébrale et de la cage thoracique à potentiel évolutif pendant la croissance. Cette déformation 3D entraîne des asymétries de la posture. La correction de la posture est un des objectifs du traitement en physiothérapie chez les jeunes atteints d’une SI afin d’éviter la progression de la scoliose, de réduire les déformations morphologiques et leurs impacts sur la qualité de vie. Les outils cliniques actuels ne permettent pas de quantifier globalement les changements de la posture attribuables à la progression de la scoliose ou à l’efficacité des interventions thérapeutiques. L’objectif de cette thèse consiste donc au développement et à la validation d’un nouvel outil clinique permettant l’analyse quantitative de la posture auprès de personnes atteintes d’une SI. Ce projet vise plus spécifiquement à déterminer la fidélité et la validité des indices de posture (IP) de ce nouvel outil clinique et à vérifier leur capacité à détecter des changements entre les positions debout et assise. Suite à une recension de la littérature, 34 IP représentant l’alignement frontal et sagittal des différents segments corporels ont été sélectionnés. L’outil quantitatif clinique d’évaluation de la posture (outil 2D) construit dans ce projet consiste en un logiciel qui permet de calculer les différents IP (mesures angulaires et linéaires). L’interface graphique de cet outil est conviviale et permet de sélectionner interactivement des marqueurs sur les photographies digitales. Afin de vérifier la fidélité et la validité des IP de cet outil, la posture debout de 70 participants âgés entre 10 et 20 ans atteints d'une SI (angle de Cobb: 15º à 60º) a été évaluée à deux occasions par deux physiothérapeutes. Des marqueurs placés sur plusieurs repères anatomiques, ainsi que des points de référence anatomique (yeux, lobes des oreilles, etc.), ont permis de mesurer les IP 2D en utilisant des photographies. Ces mêmes marqueurs et points de référence ont également servi au calcul d’IP 3D obtenus par des reconstructions du tronc avec un système de topographie de surface. Les angles de Cobb frontaux et sagittaux et le déjettement C7-S1 ont été mesurés sur des radiographies. La théorie de la généralisabilité a été utilisée pour déterminer la fidélité et l’erreur standard de la mesure (ESM) des IP de l’outil 2D. Des coefficients de Pearson ont servi à déterminer la validité concomitante des IP du tronc de l’outil 2D avec les IP 3D et les mesures radiographiques correspondantes. Cinquante participants ont été également évalués en position assise « membres inférieurs allongés » pour l’étude comparative de la posture debout et assise. Des tests de t pour échantillons appariés ont été utilisés pour détecter les différences entre les positions debout et assise. Nos résultats indiquent un bon niveau de fidélité pour la majorité des IP de l’outil 2D. La corrélation entre les IP 2D et 3D est bonne pour les épaules, les omoplates, le déjettement C7-S1, les angles de taille, la scoliose thoracique et le bassin. Elle est faible à modérée pour la cyphose thoracique, la lordose lombaire et la scoliose thoraco-lombaire ou lombaire. La corrélation entre les IP 2D et les mesures radiographiques est bonne pour le déjettement C7-S1, la scoliose et la cyphose thoracique. L’outil est suffisamment discriminant pour détecter des différences entre la posture debout et assise pour dix des treize IP. Certaines recommandations spécifiques résultents de ce projet : la hauteur de la caméra devrait être ajustée en fonction de la taille des personnes; la formation des juges est importante pour maximiser la précision de la pose des marqueurs; et des marqueurs montés sur des tiges devraient faciliter l’évaluation des courbures vertébrales sagittales. En conclusion, l’outil développé dans le cadre de cette thèse possède de bonnes propriétés psychométriques et permet une évaluation globale de la posture. Cet outil devrait contribuer à l’amélioration de la pratique clinique en facilitant l’analyse de la posture debout et assise. Cet outil s’avère une alternative clinique pour suivre l’évolution de la scoliose thoracique et diminuer la fréquence des radiographies au cours du suivi de jeunes atteints d’une SI thoracique. Cet outil pourrait aussi être utile pour vérifier l’efficacité des interventions thérapeutiques sur la posture.Idiopathic scoliosis (IS) is characterized by three-dimensional (3D) deformity of the spine and rib cage which can increase during growth. The morphologic changes of the trunk result in posture asymmetries. Correction of posture is an important goal of physiotherapy interventions among persons with IS to prevent scoliosis progression, to reduce morphologic deformities and their impact on quality of life. Currently, there are no tools that globally quantify changes in posture that may be attributable to scoliosis progression or to treatment effectiveness, that are usable in a clinical setting. The objective of this thesis was thus to develop and validate a new clinical quantitative posture assessment tool among persons with IS. More specifically, this project aims to determine reliability and concurrent validity of posture indices (PI) of this new tool and to verify their capacity to detect changes between standing and sitting positions. We conducted a literature review and selected 34 PI representing frontal and sagittal alignment of the different body segments. We constructed a software-based quantitative posture assessment tool to calculate different PI (angular and linear measurements). The software has a user-friendly graphical interface and allows calculation of PI from a set of markers selected interactively on digital photographs. For the reliability and validity studies, standing posture of 70 participants aged 10 to 20 years old with IS (Cobb angle: 15º to 60º) was assessed on two occasions by two physiotherapists. Markers placed on several bony landmarks as well as natural reference points (eyes, ear lobe, etc.) were used to measure the PI from photographs with the 2D tool and to calculate 3D PI obtained from trunk reconstructions with a surface topography system. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The generalizability theory was used to estimate the reliability and standard error of measurement (SEM) of PI of the 2D tool. Pearson correlation coefficients served to estimate concurrent validity of the 2D trunk PI with corresponding 3D PI and with those obtained from radiographs. Fifty participants were assessed for the comparative study between standing and sitting positions. We compared the average values of each PI in standing and long sitting positions using paired t-tests. Our results show a good level of reliability for the majority of PI of the 2D tool. Correlation between 2D and 3D PI was good for shoulder, scapula, trunk list, waist angles, thoracic scoliosis and pelvis but fair to moderate for thoracic kyphosis, lumbar lordosis and thoracolumbar or lumbar scoliosis. The correlation between 2D and radiograph measurements was good for trunk list, thoracic scoliosis and thoracic kyphosis. Our tool can detect differences between standing and sitting posture for ten out of thirteen PI. A few recommendations specific to this work are: camera height should be adjusted according to the subject’s height; training of judges is important to maximize accuracy in placement of markers; and measurement of sagittal vertebral curves may be facilitated by using markers mounted on pins. In conclusion, the tool developed in this thesis has good psychometric properties to evaluate posture. This tool should contribute to clinical practice by facilitating the analysis of standing and sitting posture. This tool may also be a good alternative to monitor thoracic scoliosis progression in a clinical setting and may contribute to a reduction in the use of x-rays in the follow-up of youths with thoracic IS. It may also be useful to verify the effectiveness of therapeutic interventions on posture

Se réinstaller après une relocalisation résidentielle involontaire : entre appréciation de son nouveau milieu et deuil de l’ancien

Souvent, lors de la réalisation de grands projets, plusieurs personnes sont contraintes de quitter leur logement. Toutefois, les impacts psychosociaux de ces déménagements forcés sont peu documentés. Nous proposons ici une analyse de la réinstallation dans une nouvelle demeure à la suite d’une relocalisation résidentielle involontaire, à partir de l’expérience de propriétaires relocalisés dans le cadre du réaménagement de la route 175. Après une description du processus d’acquisition des résidences, nous nous penchons sur le deuil que vivent les personnes relocalisées et qui est caractérisé par la solitude. Ensuite, nous nous intéressons aux raisons qui motivent le choix d’une nouvelle résidence et l’appréciation de celle-ci. L’expérience de la relocalisation semble liée à l’âge et aux significations du chez-soi ; les personnes âgées et les jeunes ménages paraissent particulièrement vulnérables.Frequently, when major projects are carried out, many people are forced out of their homes. The psychological and social impacts of these forced moves have rarely been documented. In this paper, we analyse the process of finding a new home after an involuntary residential relocation, based on the experiences of homeowners relocated as a result of the rebuilding of Quebec’s Highway 175. Following a description of the home acquisition process, we examine the grieving, characterized by solitude, that relocated people go through. We then take a look at the criteria that guide them in choosing a new home and their appreciation of it. The experience of relocation seems to be connected to age and what a home means; the elderly and young couples appear to be particularly vulnerable

Étude des carbures de molybdène en deux dimensions en vue d'applications catalytiques

L’utilisation de la biomasse comme source d’énergie renouvelable intéresse grandement les chercheurs depuis quelques années. Celle-ci est également très prometteuse pour l’industrie chimique qui peut transformer facilement les résidus de matière cellulosiques (riches en xyloses) en furfural. À partir de ce dernier, il est possible de synthétiser des produits utilisables dans divers domaines, tels les biocarburants, l’industrie chimique et les herbicides. Cependant, le coût élevé des catalyseurs de métaux nobles, essentiels pour obtenir ce type de produits, réduit l'intérêt pour l'utilisation de cette biomasse. Les présents travaux portent sur la caractérisation d’une alternative moins coûteuse, soit les carbures de métaux de transition (TMCs), particulièrement les carbures de molybdène de forme α-Mo2C bidimensionnels. Ceux-ci sont très intéressants, particulièrement pour leurs propriétés catalytiques, qui sont similaires à ceux des métaux nobles (Pt, Pd). À l’heure actuelle, très peu d’informations sur ceux-ci sont disponibles, dans la littérature, ce qui limite leur utilisation. Le but principal de ce projet est d’étudier les propriétés de surface des α- Mo2C en 2D sur un substrat de cuivre, en vue de leur utilisation en catalyse hétérogène. Par exemple, un catalyseur de α-Mo2C peut être utilisé pour éliminer sélectivement l'oxygène ou pour faire des réactions d’hydrogénations, pour produire des composés d’intérêt de manière beaucoup plus respectueuse pour l’environnement et à faible coût. Diverses techniques de nettoyage sur les échantillons de α-Mo2C/Cu ont été tentées. De plus, les résultats de l’adsorption de plusieurs réactifs, sur la surface de α-Mo2C/Cu, sont présentésafin d’étudier l’interaction réactifs/surfaces. Des résultats avec, entre autres, le furfural sont présentés.In recent years, researchers have been very interested in the use of renewable energies, mainly those from biomass. Thisis very promising for the chemical industry, which in two easy steps can transform cellulosic material residues (rich in xylose) into furfural. From furfural, it is possible to synthesize products applicable in various fields, such as biofuels, chemical industry orherbicides. However, the high cost of noble metal catalysts essential, to obtain products of interest, reduces the use of this biomass. In the present case, the work focusses on the characterization of a less expensive alternative, namely transition metal carbides (TMCs), particularly two-dimensional molybdenum carbides (α-Mo2C). These are very promising because of their ability to combine both the properties of transition metals and those of ceramics. They also have catalytic properties similar to those of noble metals, such as platinum and palladium in heterogeneous catalysis. At present, very little information is available in the literature, which limits this alternative. The main goal of this project is studying the surface properties of α-Mo2C2D crystalliteson a copper substrate, with a view to their use in heterogeneous catalysis. For example, an α-Mo2C catalyst can be used to selectively remove oxygen or to perform hydrogenation reactions, which is agreenerand low-costmethod, to produce compounds of interest. Various techniques for cleaning samples of α-Mo2C/Cu were attempted. In addition, the results of several reactants adsorbed on α-Mo2C/Cu are presented in order to probe the reactivity of the 2D samples. One particularly interesting molecule studiedis furfural, a major product of biomass

Clinical methods for quantifying body segment posture: a literature review

Purpose. Clinicians commonly assess posture in persons with musculoskeletal disorders and tend to do so subjectively. Evidence-based practice requires the use of valid, reliable and sensitive tools to monitor treatment effectiveness. The purpose of this article was to determine which methods were used to assess posture quantitatively in a clinical setting and to identify psychometric properties of posture indices measured from these methods or tools. Methods. We conducted a comprehensive literature review. Pertinent databases were used to search for articles on quantitative clinical assessment of posture. Searching keywords were related to posture and assessment, scoliosis, back pain, reliability, validity and different body segments. Results. We identified 65 articles with angle and distance posture indices that corresponded to our search criteria. Several studies showed good intra- and inter-rater reliability for measurements taken directly on the persons (e.g., goniometer, inclinometer, flexible curve and tape measurement) or from photographs, but the validity of these measurements was not always demonstrated. Conclusion. Taking measurements of all body angles directly on the person is a lengthy process and may affect the reliability of the measurements. Measurement of body angles from photographs may be the most accurate and rapid way to assess global posture quantitatively in a clinical setting.CIHR / IRS

Validity of a Quantitative Clinical Measurement Tool of Trunk Posture in Idiopathic Scoliosis

STUDY DESIGN: Concurrent validity between postural indices obtained from digital photographs (two-dimensional [2D]), surface topography imaging (three-dimensional [3D]), and radiographs. OBJECTIVE: To assess the validity of a quantitative clinical postural assessment tool of the trunk based on photographs (2D) as compared to a surface topography system (3D) as well as indices calculated from radiographs. SUMMARY OF BACKGROUND DATA: To monitor progression of scoliosis or change in posture over time in young persons with idiopathic scoliosis (IS), noninvasive and nonionizing methods are recommended. In a clinical setting, posture can be quite easily assessed by calculating key postural indices from photographs. METHODS: Quantitative postural indices of 70 subjects aged 10 to 20 years old with IS (Cobb angle, 15 degrees -60 degrees) were measured from photographs and from 3D trunk surface images taken in the standing position. Shoulder, scapula, trunk list, pelvis, scoliosis, and waist angles indices were calculated with specially designed software. Frontal and sagittal Cobb angles and trunk list were also calculated on radiographs. The Pearson correlation coefficients (r) was used to estimate concurrent validity of the 2D clinical postural tool of the trunk with indices extracted from the 3D system and with those obtained from radiographs. RESULTS: The correlation between 2D and 3D indices was good to excellent for shoulder, pelvis, trunk list, and thoracic scoliosis (0.81>rr<0.56; P<0.05). The correlation between 2D and radiograph spinal indices was fair to good (-0.33 to -0.80 with Cobb angles and 0.76 for trunk list; P<0.05). CONCLUSION: This tool will facilitate clinical practice by monitoring trunk posture among persons with IS. Further, it may contribute to a reduction in the use of radiographs to monitor scoliosis progression.CIHR / IRS

Differences in Standing and Sitting Postures of Youth with Idiopathic Scoliosis from Quantitative Analysis of Digital Photographs

The objective of this study was to explore whether differences in standing and sitting postures of youth with idiopathic scoliosis could be detected from quantitative analysis of digital photographs. Standing and sitting postures of 50 participants aged 10–20-years-old with idiopathic scoliosis (Cobb angle: 15° to 60°) were assessed from digital photographs using a posture evaluation software program. Based on the XY coordinates of markers, 13 angular and linear posture indices were calculated in both positions. Paired t-tests were used to compare values of standing and sitting posture indices. Significant differences between standing and sitting positions (p < 0.05) were found for head protraction, shoulder elevation, scapula asymmetry, trunk list, scoliosis angle, waist angles, and frontal and sagittal plane pelvic tilt. Quantitative analysis of digital photographs is a clinically feasible method to measure standing and sitting postures among youth with scoliosis and to assist in decisions on therapeutic interventions.CIHR / IRS

Reliability of a quantitative clinical posture assessment tool among persons with idiopathic scoliosis

Objective To determine overall, test–retest and inter-rater reliability of posture indices among persons with idiopathic scoliosis. Design A reliability study using two raters and two test sessions. Setting Tertiary care paediatric centre. Participants Seventy participants aged between 10 and 20 years with different types of idiopathic scoliosis (Cobb angle 15 to 60°) were recruited from the scoliosis clinic. Main outcome measures Based on the XY co-ordinates of natural reference points (e.g. eyes) as well as markers placed on several anatomical landmarks, 32 angular and linear posture indices taken from digital photographs in the standing position were calculated from a specially developed software program. Generalisability theory served to estimate the reliability and standard error of measurement (SEM) for the overall, test–retest and inter-rater designs. Bland and Altman's method was also used to document agreement between sessions and raters. Results In the random design, dependability coefficients demonstrated a moderate level of reliability for six posture indices (ϕ = 0.51 to 0.72) and a good level of reliability for 26 posture indices out of 32 (ϕ ≥ 0.79). Error attributable to marker placement was negligible for most indices. Limits of agreement and SEM values were larger for shoulder protraction, trunk list, Q angle, cervical lordosis and scoliosis angles. The most reproducible indices were waist angles and knee valgus and varus. Conclusions Posture can be assessed in a global fashion from photographs in persons with idiopathic scoliosis. Despite the good reliability of marker placement, other studies are needed to minimise measurement errors in order to provide a suitable tool for monitoring change in posture over time.CIHR / IRS

Cross-cultural validation of the Italian Spine Youth Quality of Life questionnaire: the ISYQOL international

Questionnaire; Quality of life; SpineQüestionari; Qualitat de vida; Columna vertebralCuestionario; Calidad de vida; Columna vertebralBACKGROUND: Adolescent idiopathic scoliosis and its treatments can severely impact health-related quality of life. The Italian Spine Youth Quality of Life (ISYQOL) questionnaire, initially developed in Italian and tested on Italian people, was created to measure quality of life in young persons with spine changes. ISYQOL was created using the Rasch analysis, a modern psychometric technique for questionnaires’ assessment and development, which showed that the ordinal scores of the ISYQOL Italian version provide sound quality of life measures. AIM: The current work aims to evaluate the cross-cultural equivalence of the ISYQOL questionnaire in seven different countries. DESIGN: Cross-sectional, international, multi-centre study. SETTING: Outpatient clinic. POPULATION: Five hundred fifty persons with adolescent idiopathic scoliosis from English Canada, French Canada, Greece, Italy, Spain, Poland, and Türkiye. METHODS: The ISYQOL Italian version was translated into six languages with the forward-backwards procedure. The conceptual equivalence of the items’ content was verified, and any inconsistency was resolved by consensus. The Rasch analysis was used here to evaluate that ISYQOL translations retained the good measurement properties of the Italian version of the questionnaire. In addition, the Differential Item Functioning (DIF) was checked to assess the psychometric equivalence of the ISYQOL items in patients from different countries. RESULTS: Four items of the translated ISYQOL were dropped from the questionnaire since they did not contribute to measuring due to their poor fit to the model of Rasch. Seven items were affected by DIF for nationality, a finding pointing out that these items do not work the same (i.e. are not equivalent) in the different countries. Thanks to the Rasch analysis, the DIF for nationality was amended, and ISYQOL International was eventually obtained. CONCLUSIONS: ISYQOL International returns interval quality of life measures in people with adolescent idiopathic scoliosis with high cross-cultural equivalence in the tested countries. CLINICAL REHABILITATION IMPACT: Rigorous testing showed that ISYQOL International ordinal scores return quality of life measures cross-culturally equivalent in English and French Canada, Greece, Italy, Spain, Poland, and Türkiye. A new, psychometrically sound patient-reported outcome measure is thus available in rehabilitation medicine to measure health-related quality of life in idiopathic scoliosis.For the ISYQOL French version, Claudie Forest received a grant awarded by the Programme d’Excellence en Médecine pour l’Initiation En Recherche (PREMIER) from the School of Rehabilitation at University of Montreal and Carole Fortin was supported by a Junior 1 salary award from Fonds de Recherche du Québec - Santé (FRQS). Antonio Caronni was supported by the IRCCS Istituto Auxologico Italiano – Milano, Italia, within the RESET research project (Ricerca Corrente 2020, Italian Ministry of Health)