Participation in leisure and physical activity among children and adolescents with juvenile idiopathic arthritis

Contexte: L’arthrite juvénile idiopathique (AJI) est l’une des maladies chroniques auto-immune les plus répandues chez les enfants et est caractérisée par des enflures articulaires (maladie active), de la douleur, de la fatigue et des raideurs matinales pouvant restreindre leur niveau de participation aux activités quotidiennes (par exemple: les loisirs, l’activité physique, la mobilité et les soins personnels) à la maison comme à l’école. Participer aux activités de loisirs et à l’activité physique a des bienfaits au niveau de la santé et du développement de tous les enfants et démontrent aussi des effets positifs qui réduisent les symptômes des maladies chroniques telle l’AJI. Malgré ces bienfaits la participation aux loisirs chez les jeunes avec l’AJI demeure largement sous-étudiée. Objectifs: Cette étude vise à évaluer le niveau de participation aux loisirs et à l’activité physique chez les enfants et les adolescents atteints d’AJI, ainsi qu’à identifier les facteurs liés à la maladie, la personne et l’environnement. Méthodes : L’évaluation du niveau de participation et l’exploration des facteurs associés aux loisirs et à l’activité physique ont été complétés par l’entremise d’une revue systématique de la littérature, l’analyse de données d’un échantillon national représentatif d’enfants canadiens atteints d’arthrite âgés entre 5 et 14 ans (npondéré = 4350), ainsi que l’analyse standardisée du niveau de participation aux loisirs à l’aide du Children’s Assessment of Participation and Enjoyment (n=107) et la mesure objective de l’activité physique par accéléromètre (n=76) auprès d’un échantillon d’enfants (âgés entre 8 et 11 ans ) et d’adolescents (âgés entre 12 et 17 ans) suivis en clinique de rhumatologie à l’hôpital de Montréal pour enfants, Centre Universitaire de Santé McGill. Les résultats cliniques ont été comparés à des données normatives, ainsi qu’à un groupe contrôle sans AJI. Nous avons exploré les facteurs associés avec le niveau de participation aux loisirs et à l’activité physique en utilisant les modèles de régression linéaire multiple et l’analyse hiérarchique. Résultats : Les enfants et les adolescents atteints d’AJI participent à une multitude d’activités de loisirs; cependant ils sont moins souvent impliqués dans des activités physiques et de raffinement en comparaison aux autres types d’activités de loisirs. Ceux avec l’AJI étaient en général moins actifs que leurs pairs sans arthrite et la plupart n’atteignaient pas les recommandations nationales d’activité physique. Les garçons avec l’AJI participent plus souvent à des activités physiques et moins aux activités sociales, de raffinement et de développement de soi en comparaison avec les filles ayant l’AJI. En général, être un garçon, être plus âgé, avoir une meilleure motivation pour participer aux activités de motricité globale, avoir un statut socio-économique plus élevé et être d’origine culturelle canadienne sont associés à un niveau de participation plus élevé aux activités physiques. La préférence pour les activités de raffinement, un niveau d’éducation maternelle plus élevé et être une fille étaient associés à un niveau de participation plus élevé aux activités de raffinement. Conclusion: La participation aux loisirs et à l’activité physique en AJI est un concept complexe et semble surtout être expliqué par des facteurs personnels et environnementaux. L’identification des facteurs associés aux loisirs et à l’activité physique est très importante en AJI puisqu’elle peut permettre aux professionnels de la santé de développer des interventions significatives basées sur les activités préférées des enfants, améliorer l’observance au traitement et promouvoir des habitudes de vie saine.Background: Juvenile idiopathic arthritis (JIA), one of the most common chronic childhood autoimmune diseases, is a heterogeneous inflammatory condition characterised by joint inflammation (i.e. active disease), chronic pain, fatigue and morning stiffness, which may interfere with age-appropriate daily activities (i.e. leisure and physical activity, mobility and self-care), both at home and at school. Involvement in leisure and physical activity is beneficial to the health and development of all children and adolescents, and has also shown to help mitigate the effects of disease among those with chronic conditions such as JIA. Despite the benefits of leisure participation this subject remains vastly understudied in JIA. Objective: The aim of this thesis was to assess participation in leisure and physical activity among children and adolescents with JIA, as well as identify associated disease-related, personal and environmental factors. Methods: The assessment of patterns and exploration of potential predictors of participation in leisure and physical activity in children and adolescents with JIA was completed through a systematic review of the literature, analysis of survey data from a nationally representative sample of Canadian children with arthritis (age range = 5 to 14 years, nweighted = 4350), as well as the standardized assessment of leisure with the Children’s Assessment of Participation and Enjoyment (n=107) and the objective measurement of physical activity with accelerometer (n=76) among a clinical sample of children (age range = 8 to 11 years) and adolescents (age range = 12 to 17 years) with JIA followed at the Rheumatology clinic at the Montreal Children’s Hospital, McGill University Health Center. Clinical data were also compared to normative data and children and adolescents without JIA. We explored factors associated with participation in leisure and physical activity using multiple linear regression models and hierarchical analysis. Results: Children and adolescents with JIA participated in an array of leisure activities; however involvement was least frequent in active physical and skill-based leisure activities compared to other types of activity. Those with JIA were generally less physically active than healthy peers without JIA, and most with JIA did not meet national recommendations for physical activity. Boys with JIA were more likely to engage in physical activities, and less likely to take part in social, skill-based and self-improvement activities than girls with JIA. In general, being a boy, older age, greater mastery motivation for gross motor skills, higher socio-economic status and being of Canadian cultural background were associated with increased participation in more physical activities. Preference for skill-based activities, higher maternal education and being a girl were associated with increased participation in skill-based activities. Conclusion: Participation in leisure and physical activity in JIA is a complex concept and is mostly explained by personal and environmental factors. The identification of factors associated with leisure participation and physical activity is of utmost importance in JIA as it may aid health care professionals to tailor meaningful intervention plans based on preferred activities, improve adherence to treatment and help promote healthier lifestyles

The impact of child's functional severity on parental coping in two cohorts : children with juvenile idiopathic arthritis and children with physical disabilities

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

VOCs Measurements in Residential Buildings: Quantification via Thermal Desorption and Assessment of Indoor Concentrations in a Case-Study

Volatile organic compounds (VOCs) represent one of the most important categories of pollutants, influencing the air quality and human health and well-being in indoor environments. In the present study, 12 selected VOCs were sampled using Tenax TA tubes and analyzed by thermal desorption combined with gas chromatography and a flame ionization detector (TD-GC-FID). The TD-GC-FID method was optimized to obtain the separation of all the analytical peaks (including m- and p-xylene) and a satisfactory sensitivity, with low detection (between 0.14 and 0.31 ng) and quantification (between 0.47 and 1.02 ng) limits. The whole procedure was firstly assessed with the analysis of four co-located tubes exposed at an outdoor monitoring site, with results that revealed a very low inter-tubes variability (relative standard deviations of parallel measurements <5%). Then, the measurement protocol was used to quantify the indoor concentrations of the target VOCs in nine different homes during the dishwasher washing cycle. The most abundant detected VOC in all dwellings was d-limonene (mean: 231 µg/m3; maximum: 611 µg/m3). All the other compounds were monitored at concentration levels one or two orders of magnitude lower than d-limonene, and were generally comparable with those found in the scientific literature. In terms of health concerns, the measured concentrations were always well below the safe levels established for the protection of the general population in living environments

Monitor and sensors 2.0 for exposure assessment to airborne pollutants

In recent years, the issue of exposure assessment to airborne pollutants has become increasingly popular, both in the occupational and environmental fields. The increasingly stringent national and international air quality standards and exposure limit values both for indoor environments and occupational exposure limit values have been developed with the aim of protecting the health of the general population and workers. On the other hand, this requires a considerable and continuous development of the technologies used to monitor the concentrations of the pollutants to ensure the reliability of the exposure assessment studies. In this regard, one of the most interesting aspects is certainly the development of “new generation” instrumentation for monitoring airborne pollutants (“Next Generation Monitors and Sensors” – NGMS). The main purpose of this work is to analyze the state of the art regarding the afore-mentioned instrumentation, to be able to investigate any practical applications within exposure assessment studies. In this regard, a systematic review of the scientific literature was carried out using three different databases (Scopus, PubMed and Web of Knowledge) and the results were analyzed in terms of the objectives set out above. What emerged is the fact that the use of NGMSs is increasingly growing within the scientific community for exposure assessment studies applied to the occupational and environmental context. The investigated studies have emphasized that NGMSs cannot be considered, in terms of the reliability of the results, to be equal to the reference measurement tools and techniques (i.e., those defined in recognized methods used for regulatory purposes), but they can certainly be integrated into the internal exposure assessment studies to improve their spatial-temporal resolution. These tools have the potential to be easily adapted to different types of studies, are characterized by a small size, which allows them to be worn comfortably without affecting the normal activities of workers or citizens, and by a relatively low cost. Despite this, there is certainly a gap with respect to the reference instrumentation, regarding the measurement performance and quality of the data provided; the objective to be set, however, is not to replace the traditional instrumentation with NGMSs but to integrate and combine the two typologies of instruments to benefit from the strengths of both, therefore, the desirable future developments in this sense has been discussed in this work

Smart-working VS office work: how does personal exposure to different air pollutants change?

The COVID-19 pandemic is raging all over the world, with possible structural effects on the work: the smart-working (WFH -Working From Home) role is therefore emphasized by the fact that it could become a traditional way of working in many work sectors. Several scientific papers have recently analyzed the WFH phenomenon under different aspects, but scientific studies have not yet been conducted considering the differences between WFH and WFO (Working From Office), in terms of evaluation of personal exposure assessment to selected airborne pollutants. This study, therefore, aims to evaluate, using portable monitors, the differences in terms of personal exposure to selected airborne pollutants, during different working conditions (WFO vs WFH), over long periods of time (from days to weeks), extending the results to even longer periods (years), to adhere to the approach proposed by the concept of the exposome. The preliminary results of this study refer to three separate phases of the work (i) re-analyses of literature data via Monte Carlo simulation, and assessment of personal exposure to different air pollutants during different working conditions, during (ii) “long term” campaign and (iii) a “short term” monitoring campaign. During the two different measurement campaigns, portable instrumentation was used, because of the ability of these kinds of instruments to obtain data characterized by a high spatial and temperature resolution. The re-elaborations of the data obtained from the literature show how, under different conditions, the exposure concentrations to different PM fractions are statistically lower in WFH working conditions, compared to WFO conditions. These results are in contrast with the preliminary results obtained from exploratory monitoring (both for the “long term” and for the “short term” campaigns). The results obtained from these exploratory monitoring show that the WFH condition has a greater impact on the daily exposure of the monitored subjects, compared to the WFO condition

An In-Field Assessment of the P.ALP Device in Four Different Real Working Conditions: A Performance Evaluation in Particulate Matter Monitoring

This study aimed to assess the performance, in terms of precision and accuracy, of a prototype (called “P.ALP”—Ph.D. Air Quality Low-cost Project) developed for monitoring PM2.5 concentration levels. Four prototypes were co-located with reference instrumentation in four different microenvironments simulating real-world and working conditions, namely (i) office, (ii) home, (iii) outdoor, and (iv) occupational environments. The devices were evaluated for a total of 20 monitoring days (approximately 168 h) under a wide range of PM2.5 concentrations. The performances of the prototypes (based on the light-scattering working principle) were tested through different statistical methods. After the data acquisition and data cleaning processes, a linear regression analysis was performed to assess the precision (by comparing all possible pairs of devices) and the accuracy (by comparing the prototypes against the reference instrumentation) of the P.ALP. Moreover, the United States Environmental Protection Agency (US EPA) criteria were applied to assess the possible usage of this instrumentation, and to evaluate the eventual error trends of the P.ALP in the data storage process, Bland–Altman plots were also adopted. The outcomes of this study underlined that the P.ALP performed differently depending on the microenvironment in which it was tested and, consequently, on the PM2.5 concentrations. The device can monitor PM2.5 variations with acceptable results, but the performance cannot be considered satisfactory at extremely low and remarkably high PM2.5 concentrations. Thanks to modular components and open-source software, the tested device has the potential to be customized and adapted to better fit specific study design needs, but it must be implemented with ad hoc calibration factors depending on the application before being used in field

Studies on Air Pollution and Air Quality in Rural and Agricultural Environments: A Systematic Review

Studies on air quality in rural environments are fundamental to obtain first-hand data for the determination of base emissions of air pollutants, to assess the impact of rural-specific airborne pollutants, to model pollutant dispersion, and to develop proper pollution mitigation technologies. The literature lacks a systematic review based on the evaluation of the techniques and methods used for the sampling/monitoring (S/M) of atmospheric pollutants in rural and agricultural settings, which highlights the shortcomings in this field and the need for future studies. This work aims to review the study design applied for on-field monitoring campaigns of airborne pollutants in rural environments and discuss the possible needs and future developments in this field. The results of this literature review, based on the revision of 23 scientific papers, allowed us to determine (i) the basic characteristics related to the study design that should always be reported; (ii) the main techniques and analyses used in exposure assessment studies conducted in this type of setting; and (iii) contextual parameters and descriptors of the S/M site that should be considered to best support the results obtained from the different studies. Future studies carried out to monitor the airborne pollution in rural/agriculture areas should (i) include the use of multiparametric monitors for the contextual measurement of different atmospheric pollutants (as well as meteorological parameters) and (ii) consider the most important boundary information, to better characterize the S/M site

mass concentration and size distribution of atmospheric particulate matter in an urban environment

To investigate the ambient mass concentration, size-distribution and temporal variability of atmospheric particulate matter (PM), a long-term monitoring campaign was undertaken at an urban background site in Como, Northern Italy, from May 2015 to March 2016. A 13-stage Low Pressure Impactor (DLPI) was used for the collection of size-segregated particulates in the 0.028-10 μm size range. The results revealed a good level of agreement between DLPI and a co-located Harvard-type PM_(2.5) Impactor, allowing them to be classified as comparable and characterized by a reciprocal predictability. The PM concentration levels varied greatly between the different 5-days monitoring sessions, with higher mean mass concentrations during the heating season. Appreciable seasonal differences were found for particles between 0.15 and 1.60 μm that, on average, registered concentration levels 3.5 times higher during the heating season (mean: 28.2 μg m^(-3); median: 24.4 μg m^(-3)) compared to the non-heating season (mean: 8.3 μg m^(-3); median: 7.6 μg m^(-3)). No relevant and significant differences were detected for the coarser ranges (> 1.60 μm). Temporal variabilities were influenced by typical PM urban sources (e.g., household heating, traffic), that significantly affected fine and submicrometer particles, and were related to meteorological factors. Ambient air particles exhibited a trimodal distribution: a first and sharp peak more pronounced during the heating season was identified between 0.3 and 0.5 μm and two other slight peaks in the coarse mode were centered on approximately 3 and 8 μm. No relevant differences were found in the shape of the size-distribution between the two investigated seasons. The mean PM_(2.5) (22.4 μg m^(-3)) and PM_(10) (27.7 μg m^(-3)) concentrations monitored in the study area exceeded the annual Air Quality Guideline Values (respectively equal to 10 μg m^(-3) and 20 μg m^(-3)) established by the World Health Organization

Aberrant MET activation impairs perinuclear actin cap organization with YAP1 cytosolic relocation

: Little is known about the signaling network responsible for the organization of the perinuclear actin cap, a recently identified structure holding unique roles in the regulation of nuclear shape and cell directionality. In cancer cells expressing a constitutively active MET, we show a rearrangement of the actin cap filaments, which crash into perinuclear patches associated with spherical nuclei, meandering cell motility and inactivation of the mechano-transducer YAP1. MET ablation is sufficient to reactivate YAP1 and restore the cap, leading to enhanced directionality and flattened nuclei. Consistently, the introduction of a hyperactive MET in normal epithelial cells, enhances nuclear height and alters the cap organization, as also confirmed by TEM analysis. Finally, the constitutively active YAP1 mutant YAP5SA is able to overcome the effects of oncogenic MET. Overall, our work describes a signaling axis empowering MET-mediated YAP1 dampening and actin cap misalignment, with implications for nuclear shape and cell motility

Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations. View Full-Tex