Perceptions des infirmières et infirmiers du Québec de la prise en compte de l’alimentation durable dans leur pratique clinique : une étude qualitative

Introduction: A sustainable diet is a diet that is respectful of ecosystems, culturally acceptable, accessible and healthy. It is considered as a promising avenue for optimizing health and reducing the impacts of food on the environment. Several nursing associations have demonstrated a growing concern for nurses’ involvement in environmental and climate change issues, including in promoting sustainable diet. However, the literature reveals a lack of data on why and how nurses could address sustainable diet in their clinical practice. Objective: The aim of this study was to explore clinical nurses’ perceptions of their role in the promotion of sustainable diet. Methods: A descriptive qualitative study was conducted based on 6 focus groups involving 20 nurses from 7 regions of the province of Quebec, Canada. Computer-assisted thematic analysis was conducted on verbatim transcripts. Results: The discussions revealed 3 major themes. First, some dimensions of sustainable eating are already implicitly addressed and nurses were theoretically open to make further. However, it was difficult to see how nurses could translate this interest into concrete action due to a lack of time and their other clinical priorities. Lastly, in order to do this, nurses need support from health organizations as well as clear guidelines, training and tools. Discussion and conclusion: Despite experts’ recommendations, many barriers and inadequacies between experts’ recommendations and nurses’ reality prevent the implementation of concrete initiatives toward the promotion of sustainable diet among nurses. Nurses are invited to get involved and contribute to the promotion of sustainable diet with a “bottom-up” approach.Introduction : L’alimentation durable désigne une alimentation saine, solidaire et juste, présentant un faible impact environnemental et contribuant à la souveraineté, à la sécurité et à la santé alimentaires. Plusieurs associations infirmières ont manifesté un intérêt croissant pour favoriser la contribution infirmière en regard des enjeux climatiques, notamment en matière d’alimentation durable. Cependant, peu de données sont disponibles sur les rôles et les actions attendues des infirmières et infirmiers. Objectif : L’objectif de cette étude était d’explorer les perceptions infirmières de la prise en compte de l’alimentation durable dans leur pratique clinique. Méthodes : Une étude qualitative descriptive a été menée auprès de 6 groupes de discussion impliquant 20 infirmières et infirmiers de 7 régions de la province de Québec, au Canada. Les transcriptions intégrales des rencontres ont été analysées selon une analyse thématique assistée par ordinateur. Résultats : Les discussions ont révélé 3 thèmes principaux. Premièrement, les infirmières et infirmiers abordent déjà implicitement certaines dimensions de l’alimentation durable et ont une ouverture « théorique » pour l’intégrer davantage. Deuxièmement, les infirmières et infirmiers perçoivent difficilement comment cet intérêt peut se traduire par des actions concrètes en raison du manque de temps et de leurs autres priorités cliniques. Troisièmement, les infirmières et infirmiers ont besoin de soutien de la part des organisations de santé ainsi que des lignes directrices claires, des formations et des outils. Discussion et conclusion : Plusieurs barrières et inadéquations entre les recommandations émises par les experts et la réalité de la pratique infirmière empêchent la mise en place concrète d’initiatives chez les infirmières et infirmiers qui sont invités à s’engager et à contribuer à la promotion de l’alimentation durable avec une approche dite bottom-up

Контролюючий моніторинг на територіях із забрудненням легкими нафтопродуктами

International audienc

Quebec Nurses’ Perceptions of the Integration of Sustainable Diet Promotion Into Clinical Appointments: A Qualitative Study

Introduction: A sustainable diet is a diet that is respectful of ecosystems, culturally acceptable, accessible and healthy. It is considered as a promising avenue for optimizing health and reducing the impacts of food on the environment. Several nursing associations have demonstrated a growing concern for nurses’ involvement in environmental and climate change issues, including in promoting sustainable diet. However, the literature reveals a lack of data on why and how nurses could address sustainable diet in their clinical practice. Objective: The aim of this study was to explore clinical nurses’ perceptions of their role in the promotion of sustainable diet. Methods: A descriptive qualitative study was conducted based on 6 focus groups involving 20 nurses from 7 regions of the province of Quebec, Canada. Computer-assisted thematic analysis was conducted on verbatim transcripts. Results: The discussions revealed 3 major themes. First, some dimensions of sustainable eating are already implicitly addressed and nurses were theoretically open to make further. However, it was difficult to see how nurses could translate this interest into concrete action due to a lack of time and their other clinical priorities. Lastly, in order to do this, nurses need support from health organizations as well as clear guidelines, training and tools. Discussion and conclusion: Despite experts’ recommendations, many barriers and inadequacies between experts’ recommendations and nurses’ reality prevent the implementation of concrete initiatives toward the promotion of sustainable diet among nurses. Nurses are invited to get involved and contribute to the promotion of sustainable diet with a “bottom-up” approach

Antimicrobial resistance in outpatient Escherichia coli urinary isolates in Dakar, Senegal.

International audienceBACKGROUND: Data regarding the evolution of antimicrobial resistance are needed to suggest appropriate empirical treatment of urinary tract infections (UTI) in developing countries. To assess the antimicrobial susceptibility of Escherichia coli, the predominant pathogen in community-acquired UTI, a prospective multicenter study was carried out in Dakar, Senegal. METHODOLOGY: From February 2004 to October 2006, 1010 non-duplicate E. coli strains were collected from four centres. Antimicrobial susceptibility testing was performed using disk diffusion method according to the recommendations of the CA-SFM (2004). RESULTS: Most of the isolates were resistant to amoxicillin (73.1%), amoxicillin-clavulanic acid (67.5%), cephalothin (55.8%), and trimethoprim/sulfamethoxazole (68.1%). Extended spectrum beta-lactamase was detected in 38 strains. The overall resistance rates to nalidixic acid, norfloxacin and ciprofloxacin were 23.9%, 16.4% and 15.5%, respectively. Most of the strains were susceptible to gentamicin, nitrofurantoin and fosfomycin (respective susceptibility rates, 93.8%, 89.9%, and 99.3%). During this period, a significant decrease in sensitivity was observed for cephalothin, fluoroquinolones and trimethoprim/sulfamethoxazole (p<0.001). CONCLUSIONS: These data suggest that trimethoprim/sulfamethoxazole may no longer be used as empirical treatment for community-acquired UTI in Dakar. In order to preserve the activity of fluoroquinolones for future years, alternatives such as fosfomycin or nitrofurantoin should be considered

Asymptomatic Carriage of Plasmodium in Urban Dakar: The Risk of Malaria Should Not Be Underestimated

Introduction: The objective of this study was to measure the rate of asymptomatic carriage of plasmodium in the Dakar region two years after the implementation of new strategies in clinical malaria management. Methodology: Between October and December 2008, 2952 households selected in 50 sites of Dakar area, were visited for interviews and blood sampling. Giemsa-stained thick blood smears (TBS) were performed for microscopy in asymptomatic adult women and children aged 2 to 10 years. To ensure the quality of the microscopy, we performed a polymerase chai

IgG responses to the gSG6-P1 salivary peptide for evaluating human exposure to Anopheles bites in urban areas of Dakar region, Sénégal

<p>Abstract</p> <p>Background</p> <p>Urban malaria can be a serious public health problem in Africa. Human-landing catches of mosquitoes, a standard entomological method to assess human exposure to malaria vector bites, can lack sensitivity in areas where exposure is low. A simple and highly sensitive tool could be a complementary indicator for evaluating malaria exposure in such epidemiological contexts. The human antibody response to the specific <it>Anopheles </it>gSG6-P1 salivary peptide have been described as an adequate tool biomarker for a reliable assessment of human exposure level to <it>Anopheles </it>bites. The aim of this study was to use this biomarker to evaluate the human exposure to <it>Anopheles </it>mosquito bites in urban settings of Dakar (Senegal), one of the largest cities in West Africa, where <it>Anopheles </it>biting rates and malaria transmission are supposed to be low.</p> <p>Methods</p> <p>One cross-sectional study concerning 1,010 (505 households) children (n = 505) and adults (n = 505) living in 16 districts of downtown Dakar and its suburbs was performed from October to December 2008. The IgG responses to gSG6-P1 peptide have been assessed and compared to entomological data obtained in or near the same district.</p> <p>Results</p> <p>Considerable individual variations in anti-gSG6-P1 IgG levels were observed between and within districts. In spite of this individual heterogeneity, the median level of specific IgG and the percentage of immune responders differed significantly between districts. A positive and significant association was observed between the exposure levels to <it>Anopheles gambiae </it>bites, estimated by classical entomological methods, and the median IgG levels or the percentage of immune responders measuring the contact between human populations and <it>Anopheles </it>mosquitoes. Interestingly, immunological parameters seemed to better discriminate the exposure level to <it>Anopheles </it>bites between different exposure groups of districts.</p> <p>Conclusions</p> <p>Specific human IgG responses to gSG6-P1 peptide biomarker represent, at the population and individual levels, a credible new alternative tool to assess accurately the heterogeneity of exposure level to <it>Anopheles </it>bites and malaria risk in low urban transmission areas. The development of such biomarker tool would be particularly relevant for mapping and monitoring malaria risk and for measuring the efficiency of vector control strategies in these specific settings.</p

Etude du signal de quorum sensing de la bactérie psychrotrophe Pectobacterium atrosepticum. Application de ces connaissances à la protection de la pomme de terre

Pectobacterium atrosepticum, pathogène majeur de la pomme de terre, cause des symptômes de pourriture molle et de jambe noire. Il occasionne d importantes pertes économiques pour la filière pomme de terre, notamment en France où le Comité Nord occupe une place prépondérante. Les lacunes en matière de lutte et le potentiel d expansion de la maladie justifient l urgence de trouver des solutions de protection efficaces. Les priorités de la politique agricole nous ont mené à affiner nos connaissances sur ce pathogène et sur la flore associée aux racines de pommes de terre, ceci afin de proposer une méthode de lutte originale soucieuse de l environnement. Comme beaucoup d autres bactéries phytopathogènes, la virulence de cette bactérie fait intervenir un système de quorum sensing basé sur les N-Acyl homosérine Lactone (N-Acyl-HSL). Chez la bactérie psychrotrophe P. atrosepticum 6276 la N-3oxo-octanoyl-L-homosérine lactone est la principale N-Acyl-HSL. La seule inactivation du gène responsable de sa synthèse rend la souche non virulente. Située à l interface entre les 2 évènements de la pathogénie (multiplication cellulaire et macération), la production des N-Acyl-HSL intervient au moins de 8 à 28C et est optimale à 24C, comme la croissance bactérienne, suggérant l absence de thermorégulation particulière. Face au rôle clé de ce signal, nous nous proposons de développer une méthode de lutte biologique employant des bactéries dégradant les N-Acyl-HSL. La microflore associée aux racines de pomme de terre et 2 souches modèles de Pseudomonas et de Rhodococcus ont servi de source de protecteurs.Pectobacterium atrosepticum is a major pathogen of Solanum tuberosum that causes tuber soft rot and potato plant blackleg that are responsible for important economic losses. As methods of control are limited to avoidance of contamination and pathogen expansion ability is high, potato industry notably Comité Nord promotes researches that aim at finding efficient control strategies. Concerns about environment preservation in European agricultural policies has incited us to detail our knowledge of this telluric pathogen and of the microflora associated to potato roots in order to develop a new control strategy environmentally respectful. As many other phytopathogens, P. atrosepticum virulence is controlled by a quorum sensing regulation system based on N-Acyl homoserine Lactone (N-Acyl-HSL) signalling molecules. The psychrotrophic bacteria P. atrosepticum 6276 uses N-3-oxo-L-octanoyl-homoserine lactone as major N-Acyl-HSL. Mutation of the unique NAcyl- HSL synthase gene leads to an avirulent phenotype. The N-Acyl-HSL production occurs between 2 key events of pathogenicity which are cellular multiplication and maceration. As bacterial growth, N-Acyl-HSL production is observed at least from 8 to 28C and is optimal production of N-Acyl-HSL is observed at 24C. Considering the importance of N-Acyl-HSL for pathogenicity, we develop a biocontrol method using NAcyl- HSL degrading bacteria. Potato root associated microflora and 2 model strains belonging to Pseudomonas and Rhodococcus genera were used as a source of biocontrol agents.ROUEN-BU Sciences (764512102) / SudocSudocFranceF

La qualité de l'air intérieur et ses déterminants dans 45 crèches et écoles parisiennes (étude de 16 paramètres physico-chimiques et biologiques)

PARIS-BIUP (751062107) / SudocSudocFranceF

The Elaboration of an Intersectoral Partnership to Perform Health Impact Assessment in Urban Planning: The Experience of Quebec City (Canada)

Health impact assessments (HIA) allow evaluation of urban interventions&rsquo; potential effects on health and facilitate decision-making in the urban planning process. However, few municipalities have implemented this method in Canada. This paper presents the approach developed with partners, the process, and the outcomes of HIA implementation after seven years of interinstitutional collaborations in Quebec City (ten HIA). Using direct observation and meeting minutes, information includes: perceived role of each institution taking part in HIA beforehand, how the HIA process was implemented, if it was appreciated, and which outcomes were observed. The intersectoral interactions contributed to the development of a common language, which sped up the HIA process over time and fostered positive collaborations in unrelated projects. It was an effective tool to share concerns and responsibilities among independent institutions. This experience resulted in the creation of an informal group of stakeholders from four different institutions that perform HIA to this day in collaboration with researchers

Perceived malaria in the population of an urban setting: a skipped reality in Dakar, Senegal

Abstract Background Urban malaria remains a public health problem. Dakar is located in a low endemic area. However, anti-malarial drugs consumption is reported to be high despite the decline of malaria announced by health authorities. The objective of the present study was to assess the burden of reported malaria attacks (RMAs) in 2008 and to describe care-seeking behaviours in the population of Dakar, Senegal. Methods In this cross-sectional study, 2,952 households selected from 50 sites were visited. In each household, a women and a child between two and 10 years old were interviewed about a malaria episode that occurred in 2008. The following information was recorded: age, education level, sex (for children), type of care seeking, method of diagnosis, use of anti-malarial treatment, place of medication purchase, bed net use, malaria-related deaths in the family, and perceptions of the frequency of mosquito bites. After a description of the variables in each subsample, a Pearson’s chi-square test was used to compare proportions, and logistic regression was performed to identify the association between RMAs and other covariates. Results Among women, 31.8% reported a malaria attack in 2008; among children, the rate of malaria attacks reported by mothers or caretakers was 39.0%. With regard to care-seeking, 79.5% of women and 81.5% of children with a RMA had visited health facilities (HFs). Younger women and children under five years old were more likely to visit a HF (P Conclusion The frequent perceptions of the occurrence of malaria in the population were confirmed at the HF by the high presumptive diagnosis of health professionals. Despite the decline of malaria that has been announced by health authorities, the population will continue to complain of malaria and seek care directly at private pharmacies. This situation may sustain the circulation of anti-malarial drugs and increase the risk of an emergence of anti-malarial resistance.</p