Moving towards Sustainable Electronic Health Applications

Electronic healthcare applications, both web-based and mobile health (mHealth) provide new modalities for chronic disease. These tools allow patients to track their symptoms and help them manage their condition. The sustainability of these tools is often not considered during their development. To ensure these applications can be adopted and sustainable, where policy differs amongst states and provinces, we must present the benefits of our findings to highlight the justification for its development. For technology to be sustainable it has to utilize infrastructure that is secure, stable and to be agile so that it can be deployed quickly with minimal interruption to patients, family members and healthcare professionals

USE OF INHALANT ANESTHETICS IN THREE SNAKE SPECIES

Different snake species respond differently to various anesthetic agents. Hence, an anesthetic procedure developed for one species cannot necessarily be safely transferred to another species. The goal of this paper is to summarize our experience using inhalant anesthetics on three snake species, including both procedures that were successful and those we found to be less satisfactory. We found isoflurane delivered with a precision vaporizer to be the best agent to anesthetize black rat snakes (Elaphe o. obsoleta). Sex and mass did not seem to affect induction times in black rat snakes, but larger female rat snakes recovered faster from anesthesia than smaller females. Halothane delivered in the open method provided consistent anesthesia in northern water snakes (Nerodia s. sipedon), although it caused some mortality and should not be used on debilitated patients. Halothane delivered with a precision vaporizer may be used to anesthetize eastern massasauga rattlesnakes (Sistrurus c. catenatus). However, care must be taken to prevent mortality resulting from anesthetic overdose. Sex and mass had no effect on induction and recovery times in the rattlesnakes, but stressed animals require longer induction and recovery times

Dialectique négative et théorie critique : pour une réflexion utopique en science politique

Avant tout, ce travail comptait étudier le concept de théorie critique développé à l'École de Francfort afin d'en exposer la pertinence en science politique. Il nous a d'abord fallu saisir sa première définition, celle élaborée par Max Horkheimer durant les années 1930. En lisant les principaux essais de Horkheimer à ce sujet (dont les traductions françaises n'ont été publiées qu'en 1974 et 1978), et certains textes de ses collaborateurs (surtout ceux de Theodor Adorno), nous avons repéré deux thèmes qui ont eu une influence sur notre définition de la science politique: la méthode dialectique de la Phénoménologie de l'Esprit de Hegel, conçue pour permettre le développement d'une science philosophique, et la résurgence du concept d'utopie qui, par sa critique de la réalité politique et son recours à la négation, intéresse la science politique et lui confère un caractère dialectique, lui permet d'adopter un point de vue différent au sujet de la réalité qu'elle observe. En revendiquant ses origines au sein du même héritage que la philosophie politique, et pour se distinguer de la gestion sociale ou d'une connaissance purement technique de la société, la science politique doit reconnaître qu'elle constitue elle-même une science philosophique, qu'elle doit s'intéresser aux aspirations de l'humanité à une société rationnelle aussi bien qu'à la réalité politique quotidienne. Nous nous sommes donc attardés aux origines de la notion d'utopie, dans L'Utopie de Thomas More, puis à son utilisation, voire son dépassement, dans l'oeuvre de Marx. Nous avons aussi procédé à une relecture de la Phénoménologie hégélienne, en mettant en relief les principaux passages qui influenceront la Théorie critique horkheimerienne. Enfin, nous avons approfondi la définition de la Théorie critique en nous intéressant à des ouvrages plus récents, qui se rapprochent de l'oeuvre de Horkheimer ou de son concept de théorie critique, principalement ceux publiés par Axel Honneth et Michel Freitag. ______________________________________________________________________________ MOTS-CLÉS DE L’AUTEUR : Dialectique, Phénoménologie hégélienne, École de Francfort, Théorie critique, Utopie

L’habitation communautaire au Québec : défis et perspectives de développement

Compte rendu du symposium du CAP Habitat de l'ARUC-ÉS tenu le 11 novembre 2009. Sous la direction de Marie J. Bouchard et Vincent van Schendel.Le 11 novembre 2009, le CAP Habitat communautaire de l’ARUC-ÉS tenait, à l’Université du Québec à Montréal, un symposium au sujet des défis et perspectives de développement de l’habitation communautaire au Québec et réunissait différents acteurs du milieu. Les participants au symposium ont reçu un document de discussion en préparation de l’événement. Ce document, préparé par Magali Plante, Marie J. Bouchard et Marcellin Hudon est présenté en annexe du présent compte rendu. La journée de symposium, organisée autour de trois panels suivis de discussions entre les participants, a débuté par un mot de bienvenue de l’animatrice, Constance Ramacière. Marcellin Hudon, codirecteur du CAP, a ensuite énoncé les objectifs de la journée, puis Vincent van Schendel, coordonnateur à l’ARUC, a présenté brièvement l’ARUC-ÉS et le CAP Habitat. Marie J. Bouchard, codirectrice du CAP, a poursuivi avec la présentation de l’ARUC-ÉS, les grandes lignes de l’ouvrage Se loger autrement au Québec et les objectifs du symposium. Le premier panel, portant sur les populations visées et rejointes par l’habitation communautaire, était composé d’André Archambault, ancien directeur général de l’Auberge communautaire du Sud-Ouest et Yves Hurtubise, professeur associé à l’Université Laval. Le deuxième panel portait sur le parc immobilier et regroupait les présentations de deux consultants en habitation communautaire : Allan Gaudreault et Jean-Guy Laguë. Le dernier panel, au sujet du partenariat, de la gouvernance et de l’autonomie, était constitué d’André Fortin, de la Caisse d’économie solidaire Desjardins et de Winnie Frohn, professeure au Département d’études urbaines de l’UQAM

Influenza D virus M2 protein exhibits ion channel activity in Xenopus laevis oocytes

A new type of influenza virus, known as type D, has recently been identified in cattle and pigs. Influenza D virus infection in cattle is typically asymptomatic; however, its infection in swine can result in clinical disease. Swine can also be infected with all other types of influenza viruses, namely A, B, and C. Consequently, swine can serve as a mixing vessel for highly pathogenic influenza viruses, including those with zoonotic potential. Currently, the only antiviral drug available targets influenza M2 protein ion channel is not completely effective. Thus, it is necessary to develop an M2 ion channel blocker capable of suppressing the induction of resistance to the genetic shift. To provide a basis for developing novel ion channel- blocking compounds, we investigated the properties of influenza D virus M2 protein (DM2) as a drug target

Barriers to the management of Heart Failure in Ontario Long-Term Care Homes: an Interprofessional Care perspective

Background: With population aging, the prevalence of heart failure (HF) is risingin long-term care (LTC) homes. Given this burden, there is an urgent need to establish effective HF management programs.Methods and Findings: To understand what barriers would need to be addressed to develop such a program, we conducted a series of consultations among various LTC staff, as well as residents and their family caregivers. This article uses data obtained from the consultations to describe the interprofessional (IP) barriers that exist among the various LTC staff roles. Consultation methods included a Delphi survey followed by focus group interviews of LTC staff, and then personal interviews with LTC residents with HF and their family caregivers. Data were interpreted using an IP care framework in which interpersonal relationships among LTC staff provide the most direct influence on collaborative resident-centred practice, within the broader context of conditions within the LTC home, which in turn are housed in the broader context of systemic determinants.Conclusion: Across all data sets, the most consistently mentioned determinant was communication between the resident and the healthcare team, between different healthcare providers, between shifts, between medical specialists, and between the long-term care home and the hospital

Heart failure and cognitive impairment: Challenges and opportunities

As populations age, heart failure (HF) is becoming increasingly common, and in addition to a high burden of morbidity and mortality, HF has an enormous financial impact. Though disproportionately affected by HF, the elderly are less likely to receive recommended therapies, in part because clinical trials of HF therapy have ignored outcomes of importance to this population, including impaired cognitive function (ICF). HF is associated with ICF, manifested primarily as delirium in hospitalized patients, or as mild cognitive impairment or dementia in otherwise stable outpatients. This association is likely the result of shared risk factors, as well as perfusion and rheological abnormalities that occur in patients with HF. Evidence suggests that these abnormalities may be partially reversible with standard HF therapy. The clinical consequences of ICF in HF patients are significant. Clinicians should consider becoming familiar with screening instruments for ICF, including delirium and dementia, in order to identify patients at risk of nonadherence to HF therapy and related adverse consequences. Preliminary evidence suggests that optimal HF therapy in elderly patients may preserve or even improve cognitive function, though the impact on related outcomes remains to be determined

Feasibility Assessment for Implementation of Heart Failure Clinical Caremaps using Electronic Medical Records in Primary Practice

Objectives: The primary aim of this project is to evaluate the impact and level of use of Electronic Medical Records (EMRs) by family physicians (FPs) specifically with respect to HF management. This study provides pilot work towards successful implementation of HF clinical caremaps in EMRs to support decision making for FPs. Methods: A survey questionnaire was sent to 207 FPs from which 42 (20%) replies were received. The survey included questions on demographic information of the FP's practice, specifics about HF patients and their management, EMR use and whether they have improved management in HF patients.   Results: Among the 42 FPs who responded, 39 (93%) practice in the urban area of Hamilton and each have over 10 confirmed HF patients at their family practices, supporting the need for proper management of HF at the primary care level. FPs expressed concerns about difficulty in treating HF preserved vs. systolic HF, in managing HF patients with renal insufficiency and difficulty in the use of beta blockers. There was no consensus on whether EMRs have helped in improving the management of HF patients. Conclusions: There is a perceived need for management tools which can be integrated into EMRs to provide decision making support for FPs in managing HF.  Tools such as caremaps may help provide optimal care in managing HF patients as per the Canadian Cardiovascular Society guidelines

Development of a long term monitoring network of sensitive clay slopes in Québec in the context of climate change

The Government of Québec recently initiated the deployment of a vast groundwater pressures monitoring network in postglacial marine clays to document their variations in time and improve our understanding of the relationship between failure initiation and climate in clay slopes. This project aims at evaluating the impacts of climate change on clay-slope stability and how it can be integrated in landslide risk management to improve public safety. Hydrogeological data will be acquired at sites located throughout the Québec Province’s post-glacial clay deposits to create a public georeferenced index of typical hydrogeological conditions. The project goes beyond the characterization of groundwater pressures and their variations in clay slopes. Indeed, slope deformation will be measured at several sites. Also, two sites in flat terrain will be instrumented in order to evaluate mechanical properties of clay layers in simple 1-D conditions and groundwater recharge. The unsaturated clay crust in slopes susceptible to superficial landslides will be characterized and instrumented. The current lifetime of the monitoring project has been set to a period of 25 years.