Facteurs génétiques et environnementaux du développement émotionnel chez le nourrisson : la réactivité chez des jumeaux de 5 mois

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

Revue systématique d’essais comparatifs randomisés d’interventions d’abandon du tabac chez les jeunes

Contexte : Bien que l’usage de la cigarette demeure courant parmi les jeunes, on en sait encore bien peu sur la façon de les aider à cesser de fumer. Seulement quelques revues systématiques d’essais comparatifs randomisés (ECR) ont évalué l’efficacité des interventions d’abandon du tabac chez les jeunes.Objectif : Résumer les connaissances sur l’efficacité des interventions visant à aider les jeunes à cesser de fumer en se basant sur des données probantes provenant d’ECR.Sélection des études et extraction des données : Nous avons retenu tous les ECR publiés qui évaluaient les interventions d’abandon du tabac ciblant les jeunes âgés de 20 ans et moins et qui rapportaient l’abstinence au tabac selon une analyse en intention de traiter. Nous avons relevé les études pertinentes provenant de huit revues de synthèse décrivant des études portant sur des interventions d’abandon du tabac publiées entre 2002 et 2006, ainsi qu’une recherche menée dans les bases de données PubMed et PsycINFO entre 2001 et novembre  2006. Nous rapportons l’abstinence au tabagisme au moment du suivi le plus prolongé. Les auteurs ont sélectionné d’un commun accord les données retenues pour cette revue.Résultats : Nous avons identifié 16 ECR auxquels ont participé 6 623 jeunes ; 11 études évaluant des interventions comportementales qui comprenaient 5 764 participants; quatre examinant des interventions pharmacologiques qui comptaient 529 participants ; et une se penchant sur l’acupuncture au laser qui comportait 330 participants. Trois interventions comportementales menées en milieu scolaire sur quatre et une intervention réalisée en milieu de soins de santé sur quatre ont fait augmenter de façon significative l’abstinence au tabac, quatre semaines à 24 mois suivant les interventions. Parmi les quatre ERC qui évaluaient les interventions pharmacologiques réalisées à l’aide soit de bupropion, de timbres ou de gommes à la nicotine, une étude, où le timbre à la nicotine a été utilisé en combinaison avec un counseling cognitivo-comportemental, a montré une hausse marquée, quoique non significative, de l’abstinence six mois après la date d’abandon.Conclusion : Il existe encore peu de preuves démontrant l’efficacité des interventions d’abandon du tabac chez les jeunes. Quatre programmes en milieu scolaire et une intervention dans un établissement de santé ont mis en évidence une certaine efficacité, tandis que pour la thérapie pharmacologique, les résultats ne sont pas encore concluants.Background: Cigarette use remains common among young people but little is known about how to help adolescent smokers quit. There are few systematic reviews of randomized controlled trials (RCTs) that evaluate the effectiveness of cessation interventions for youth.Objective: To synthesize knowledge on the effectiveness of cessation interventions targeted to youth based on evidence from RCTs.Selection of studies and data extraction: We retained all published RCTs with intention to treat analyses that evaluated cessation interventions targeted to youth aged ≤ 20 years. Relevant studies were identified from eight review articles of smoking cessation intervention studies published between 2002 and 2006, and from a search conducted in PubMed and PsycINFO databases from 2001 to November 2006. The outcome of primary interest was abstinence at the longest reported follow-up. Extraction of data was by consensus of the authors. Results: We identified 16 RCTs with a total of 6623 participants; 11 studies that included 5764 participants evaluated behavioural interventions, four with 529 participants evaluated pharmacological interventions, and one with 330 participants evaluated a laser acupuncture intervention. Three of four behavioural interventions conducted in school settings, and one of four conducted in a health care setting significantly increased abstinence four weeks to 24 months after the interventions. Of four RCTs that evaluated pharmacological interventions using either bupropion or nicotine patch or gum, one study using the nicotine patch coupled with cognitive-behavioural counselling showed a marked albeit non-significant increase in abstinence six months after quit date.Conclusion: There is still limited evidence demonstrating the efficacy of smoking cessation interventions in youth. Four school-based programs and one intervention in a health care setting have shown efficacy, while results for pharmacological therapy are inconsistent across studies.Contexto: si bien el tabaco sigue siendo de uso corriente entre los jóvenes, todavía no se sabe mucho sobre cómo ayudarlos a dejar de fumar. Solamente algunas revisiones sistemáticas de ensayos comparativos aleatorizados han evaluado la eficacia de las intervenciones dirigidas a lograr el abandono del tabaco entre los jóvenes.Objetivo: resumir los conocimientos sobre la eficacia de las intervenciones destinadas a ayudar a jóvenes a dejar de fumar sobre la base de los datos probados de los ensayos comparativos aleatorizados.Selección de estudios y extracción de datos: hemos retenido todos los ensayos comparativos aleatorizados publicados, que evalúan las intervenciones de abandono del tabaco en los jóvenes de 20 años y menos, y que informan sobre la abstinencia de tabaco, según un análisis que tiene la intención de tratar. Hemos seleccionado los trabajos pertinentes provenientes de ocho revistas de síntesis, que describen estudios referidos a intervenciones de abandono del tabaco publicados entre 2002 y 2006, así como una investigación llevada a cabo en las bases de datos PubMed et PsycINFO, realizada entre 2001 y noviembre de 2006. Informamos sobre la abstinencia del tabaquismo en el momento de seguimiento más prolongado. Los autores han seleccionado de común acuerdo los datos retenidos por esta revista.Resultados: hemos identificado dieciséis estudios comparativos aleatorizados en los que participaron 6.623 jóvenes; once estudios que evalúan las intervenciones comportamentales, con 5.764 participantes; cuatro que examinan las intervenciones farmacológicas en las que intervienen 529 participantes y uno que se centra en la acupuntura al láser, con 330 participantes. Tres intervenciones comportamentales realizadas en medio escolar de cada cuatro y una intervención realizada en el medio de la atención sanitaria de cada cuatro, aumentaron de manera significativa la abstinencia al tabaco, cuatro semanas a 24 meses después de las intervenciones. Entre los cuatro estudios comparativos aleatorizados que evaluaban las intervenciones farmacológicas, realizadas ya sea con ayuda de bupropion, de parches o de gomas de mascar a la nicotina, uno de ellos, en el que se utilizó un parche de nicotina en combinación con orientación psicológica cognitivo-comportamental, indicó un aumento marcado, aunque no significativo, de la abstinencia, seis meses después de la fecha de abandono.Conclusión: existen todavía pocas pruebas que demuestren la eficacia de las intervenciones de abandono del tabaco entre los jóvenes. Cuatro programas en medio escolar y una intervención en un establecimiento de salud evidenciaron una cierta eficacia, mientras que los resultados no son todavía concluyentes en lo que se refiere a la terapia farmacológica

Genetic variants and early cigarette smoking and nicotine dependence phenotypes in adolescents

Background: While the heritability of cigarette smoking and nicotine dependence (ND) is well-documented, the contribution of specific genetic variants to specific phenotypes has not been closely examined. The objectives of this study were to test the associations between 321 tagging single-nucleotide polymorphisms (SNPs) that capture common genetic variation in 24 genes, and early smoking and ND phenotypes in novice adolescent smokers, and to assess if genetic predictors differ across these phenotypes. Methods: In a prospective study of 1294 adolescents aged 12–13 years recruited from ten Montreal-area secondary schools, 544 participants who had smoked at least once during the 7–8 year follow-up provided DNA. 321 single-nucleotide polymorphisms (SNPs) in 24 candidate genes were tested for an association with number of cigarettes smoked in the past 3 months, and with five ND phenotypes (a modified version of the Fagerstrom Tolerance Questionnaire, the ICD-10 and three clusters of ND symptoms representing withdrawal symptoms, use of nicotine for self-medication, and a general ND/craving symptom indicator). Results: The pattern of SNP-gene associations differed across phenotypes. Sixteen SNPs in seven genes (ANKK1, CHRNA7, DDC, DRD2, COMT, OPRM1, SLC6A3 (also known as DAT1)) were associated with at least one phenotype with a p-value ,0.01 using linear mixed models. After permutation and FDR adjustment, none of the associations remained statistically significant, although the p-values for the association between rs557748 in OPRM1 and the ND/craving and selfmedication phenotypes were both 0.076. Conclusions: Because the genetic predictors differ, specific cigarette smoking and ND phenotypes should be distinguished in genetic studies in adolescents. Fifteen of the 16 top-ranked SNPs identified in this study were from loci involved in dopaminergic pathways (ANKK1/DRD2, DDC, COMT, OPRM1, and SLC6A3). Impact: Dopaminergic pathways may be salient during early smoking and the development of ND

A prognostic tool to identify adolescents at high risk of becoming daily smokers

<p>Abstract</p> <p>Background</p> <p>The American Academy of Pediatrics advocates that pediatricians should be involved in tobacco counseling and has developed guidelines for counseling. We present a prognostic tool for use by health care practitioners in both clinical and non-clinical settings, to identify adolescents at risk of becoming daily smokers.</p> <p>Methods</p> <p>Data were drawn from the Nicotine Dependence in Teens (NDIT) Study, a prospective investigation of 1293 adolescents, initially aged 12-13 years, recruited in 10 secondary schools in Montreal, Canada in 1999. Questionnaires were administered every three months for five years. The prognostic tool was developed using estimated coefficients from multivariable logistic models. Model overfitting was corrected using bootstrap cross-validation. Goodness-of-fit and predictive ability of the models were assessed by R², the c-statistic, and the Hosmer-Lemeshow test.</p> <p>Results</p> <p>The 1-year and 2-year probability of initiating daily smoking was a joint function of seven individual characteristics: age; ever smoked; ever felt like you needed a cigarette; parent(s) smoke; sibling(s) smoke; friend(s) smoke; and ever drank alcohol. The models were characterized by reasonably good fit and predictive ability. They were transformed into user-friendly tables such that the risk of daily smoking can be easily computed by summing points for responses to each item. The prognostic tool is also available on-line at <url>http://episerve.chumontreal.qc.ca/calculation_risk/daily-risk/daily_smokingadd.php</url>.</p> <p>Conclusions</p> <p>The prognostic tool to identify youth at high risk of daily smoking may eventually be an important component of a comprehensive tobacco control system.</p

Mimosoid legume plastome evolution: IR expansion, tandem repeat expansions, and accelerated rate of evolution in clpP

The Leguminosae has emerged as a model for studying angiosperm plastome evolution because of its striking diversity of structural rearrangements and sequence variation. However, most of what is known about legume plastomes comes from few genera representing a subset of lineages in subfamily Papilionoideae. We investigate plastome evolution in subfamily Mimosoideae based on two newly sequenced plastomes (Inga and Leucaena) and two recently published plastomes (Acacia and Prosopis), and discuss the results in the context of other legume and rosid plastid genomes. Mimosoid plastomes have a typical angiosperm gene content and general organization as well as a generally slow rate of protein coding gene evolution, but they are the largest known among legumes. The increased length results from tandem repeat expansions and an unusual 13 kb IR-SSC boundary shift in Acacia and Inga. Mimosoid plastomes harbor additional interesting features, including loss of clpP intron1 in Inga, accelerated rates of evolution in clpP for Acacia and Inga, and dN/dS ratios consistent with neutral and positive selection for several genes. These new plastomes and results provide important resources for legume comparative genomics, plant breeding, and plastid genetic engineering, while shedding further light on the complexity of plastome evolution in legumes and angiosperms.This is the publisher’s final pdf. The published article is copyrighted by the author(s) and published by the Nature Publishing Group. The published article can be found at: http://www.nature.com/articles/srep1695

Gender differences in reasons to quit smoking among adolescents

It is well established that many adolescents who smoke want to quit, but little is known about why adolescents want to quit and if reasons to quit differ across gender. The objective of this study was to determine if reasons to quit smoking differ in boys and girls. Data on the Adolescent Reasons for Quitting (ARFQ) scale were collected in mailed self-report questionnaires in 2010–2011 from 113 female and 83 male smokers aged 14–19 years participating in AdoQuest, a longitudinal cohort study of the natural course of the co-occurrence of health-compromising behaviors in children. Overall, the findings indicate that reasons to quit in boys and girls appear to be generally similar, although this finding may relate to a lack of gender-oriented items in the ARFQ scale. There is a need for continued research to develop and test reasons to quit scales for adolescents that include gender-oriented items

The association between parental history of diagnosed mood/anxiety disorders and psychiatric symptoms and disorders in young adult offspring

Abstract Background Parental history of mood or anxiety disorders is one of the strongest and most consistent risk factors for the development of these disorders in offspring. Gaps remain however in our knowledge of whether maternal or paternal disorders are more strongly associated with offspring disorders, and whether the association exists in non-clinical samples. This study uses a large population-based sample to test if maternal or paternal history of mood and/or anxiety disorders increases the risk of mood and/or anxiety disorders, or symptoms of specific anxiety disorders, in offspring. Methods Data were drawn from the Nicotine Dependence in Teens Study, a prospective cohort investigation of 1293 grade 7 students. Data on mental health outcomes were collected in mailed self-report questionnaires when participants were aged 20.4 (0.7) years on average. Parental data were collected in mailed self-report questionnaires. This current analysis pertains to 564 participants with maternal and/or paternal data. The association between maternal and paternal history and each of diagnosed anxiety disorder, diagnosed mood disorder, and symptoms of specific anxiety disorders in offspring was studied in multivariate logistic regression. Results A higher proportion of mothers than fathers had a diagnosed mood/anxiety disorder (23% versus 12%). Similarly, 14% of female offspring had a diagnosed mood/anxiety disorder, compared to 6% of male offspring. The adjusted odds ratio (95% confidence interval) for maternal history was 2.2 (1.1, 4.5) for diagnosed mood disorders, 4.0 (2.1, 7.8) for diagnosed anxiety disorders, and 2.2 (1.2, 4.0) for social phobia symptoms. Paternal history was not associated with any of the mental health outcomes in offspring. Conclusion Maternal, but not paternal mood/anxiety disorders were associated with diagnosed psychiatric disorders, as well as symptoms of specific anxiety disorders, in offspring. Efforts to detect mood and anxiety disorders in offspring with a maternal history should be encouraged.</p

Revue systématique d’essais comparatifs randomisés d’interventions d’abandon du tabac chez les jeunes

Contexte : Bien que l’usage de la cigarette demeure courant parmi les jeunes, on en sait encore bien peu sur la façon de les aider à cesser de fumer. Seulement quelques revues systématiques d’essais comparatifs randomisés (ECR) ont évalué l’efficacité des interventions d’abandon du tabac chez les jeunes.Objectif : Résumer les connaissances sur l’efficacité des interventions visant à aider les jeunes à cesser de fumer en se basant sur des données probantes provenant d’ECR.Sélection des études et extraction des données : Nous avons retenu tous les ECR publiés qui évaluaient les interventions d’abandon du tabac ciblant les jeunes âgés de 20 ans et moins et qui rapportaient l’abstinence au tabac selon une analyse en intention de traiter. Nous avons relevé les études pertinentes provenant de huit revues de synthèse décrivant des études portant sur des interventions d’abandon du tabac publiées entre 2002 et 2006, ainsi qu’une recherche menée dans les bases de données PubMed et PsycINFO entre 2001 et novembre  2006. Nous rapportons l’abstinence au tabagisme au moment du suivi le plus prolongé. Les auteurs ont sélectionné d’un commun accord les données retenues pour cette revue.Résultats : Nous avons identifié 16 ECR auxquels ont participé 6 623 jeunes ; 11 études évaluant des interventions comportementales qui comprenaient 5 764 participants; quatre examinant des interventions pharmacologiques qui comptaient 529 participants ; et une se penchant sur l’acupuncture au laser qui comportait 330 participants. Trois interventions comportementales menées en milieu scolaire sur quatre et une intervention réalisée en milieu de soins de santé sur quatre ont fait augmenter de façon significative l’abstinence au tabac, quatre semaines à 24 mois suivant les interventions. Parmi les quatre ERC qui évaluaient les interventions pharmacologiques réalisées à l’aide soit de bupropion, de timbres ou de gommes à la nicotine, une étude, où le timbre à la nicotine a été utilisé en combinaison avec un counseling cognitivo-comportemental, a montré une hausse marquée, quoique non significative, de l’abstinence six mois après la date d’abandon.Conclusion : Il existe encore peu de preuves démontrant l’efficacité des interventions d’abandon du tabac chez les jeunes. Quatre programmes en milieu scolaire et une intervention dans un établissement de santé ont mis en évidence une certaine efficacité, tandis que pour la thérapie pharmacologique, les résultats ne sont pas encore concluants.Background: Cigarette use remains common among young people but little is known about how to help adolescent smokers quit. There are few systematic reviews of randomized controlled trials (RCTs) that evaluate the effectiveness of cessation interventions for youth.Objective: To synthesize knowledge on the effectiveness of cessation interventions targeted to youth based on evidence from RCTs.Selection of studies and data extraction: We retained all published RCTs with intention to treat analyses that evaluated cessation interventions targeted to youth aged ≤ 20 years. Relevant studies were identified from eight review articles of smoking cessation intervention studies published between 2002 and 2006, and from a search conducted in PubMed and PsycINFO databases from 2001 to November 2006. The outcome of primary interest was abstinence at the longest reported follow-up. Extraction of data was by consensus of the authors. Results: We identified 16 RCTs with a total of 6623 participants; 11 studies that included 5764 participants evaluated behavioural interventions, four with 529 participants evaluated pharmacological interventions, and one with 330 participants evaluated a laser acupuncture intervention. Three of four behavioural interventions conducted in school settings, and one of four conducted in a health care setting significantly increased abstinence four weeks to 24 months after the interventions. Of four RCTs that evaluated pharmacological interventions using either bupropion or nicotine patch or gum, one study using the nicotine patch coupled with cognitive-behavioural counselling showed a marked albeit non-significant increase in abstinence six months after quit date.Conclusion: There is still limited evidence demonstrating the efficacy of smoking cessation interventions in youth. Four school-based programs and one intervention in a health care setting have shown efficacy, while results for pharmacological therapy are inconsistent across studies.Contexto: si bien el tabaco sigue siendo de uso corriente entre los jóvenes, todavía no se sabe mucho sobre cómo ayudarlos a dejar de fumar. Solamente algunas revisiones sistemáticas de ensayos comparativos aleatorizados han evaluado la eficacia de las intervenciones dirigidas a lograr el abandono del tabaco entre los jóvenes.Objetivo: resumir los conocimientos sobre la eficacia de las intervenciones destinadas a ayudar a jóvenes a dejar de fumar sobre la base de los datos probados de los ensayos comparativos aleatorizados.Selección de estudios y extracción de datos: hemos retenido todos los ensayos comparativos aleatorizados publicados, que evalúan las intervenciones de abandono del tabaco en los jóvenes de 20 años y menos, y que informan sobre la abstinencia de tabaco, según un análisis que tiene la intención de tratar. Hemos seleccionado los trabajos pertinentes provenientes de ocho revistas de síntesis, que describen estudios referidos a intervenciones de abandono del tabaco publicados entre 2002 y 2006, así como una investigación llevada a cabo en las bases de datos PubMed et PsycINFO, realizada entre 2001 y noviembre de 2006. Informamos sobre la abstinencia del tabaquismo en el momento de seguimiento más prolongado. Los autores han seleccionado de común acuerdo los datos retenidos por esta revista.Resultados: hemos identificado dieciséis estudios comparativos aleatorizados en los que participaron 6.623 jóvenes; once estudios que evalúan las intervenciones comportamentales, con 5.764 participantes; cuatro que examinan las intervenciones farmacológicas en las que intervienen 529 participantes y uno que se centra en la acupuntura al láser, con 330 participantes. Tres intervenciones comportamentales realizadas en medio escolar de cada cuatro y una intervención realizada en el medio de la atención sanitaria de cada cuatro, aumentaron de manera significativa la abstinencia al tabaco, cuatro semanas a 24 meses después de las intervenciones. Entre los cuatro estudios comparativos aleatorizados que evaluaban las intervenciones farmacológicas, realizadas ya sea con ayuda de bupropion, de parches o de gomas de mascar a la nicotina, uno de ellos, en el que se utilizó un parche de nicotina en combinación con orientación psicológica cognitivo-comportamental, indicó un aumento marcado, aunque no significativo, de la abstinencia, seis meses después de la fecha de abandono.Conclusión: existen todavía pocas pruebas que demuestren la eficacia de las intervenciones de abandono del tabaco entre los jóvenes. Cuatro programas en medio escolar y una intervención en un establecimiento de salud evidenciaron una cierta eficacia, mientras que los resultados no son todavía concluyentes en lo que se refiere a la terapia farmacológica

Table_1_Assessing healthcare capacity crisis preparedness: development of an evaluation tool by a Canadian health authority.docx

IntroductionThe COVID-19 pandemic presented health systems across the globe with unparalleled socio-political, ethical, scientific, and economic challenges. Despite the necessity for a unified, innovative, and effective response, many jurisdictions were unprepared to such a profound health crisis. This study aims to outline the creation of an evaluative tool designed to measure and evaluate the Vitalité Health Network’s (New Brunswick, Canada) ability to manage health crises.MethodsThe methodology of this work was carried out in four stages: (1) construction of an evaluative framework; (2) validation of the framework; (3) construction of the evaluative tool for the Health Authority; and (4) evaluation of the capacity to manage a health crisis.ResultsThe resulting evaluative tool incorporated 8 dimensions, 74 strategies, and 109 observable elements. The dimensions included: (1) clinical care management; (2) infection prevention and control; (3) governance and leadership; (4) human and logistic resources; (5) communication and technologies; (6) health research; (7) ethics and values; and (8) training. A Canadian Health Authority implemented the tool to support its future preparedness.ConclusionThis study introduces a methodological strategy adopted by a Canadian health authority to evaluate its capacity in managing health crises. Notably, this study marks the first instance where a Canadian health authority has created a tool for emergency healthcare management, informed by literature in the field and their direct experience from handling the SARS-CoV-2 pandemic.</p

Reasons to quit smoking by social status in adolescents

Background: Recent studies report social disparities in reasons to quit smoking among adults, but it is unclear if this observation also pertains to adolescents who smoke. The objective of this study was to describe social disparities in reasons to quit smoking in adolescents. Method: Data on indicators of social status, cigarette smoking and the Adolescent Reasons For Quitting (ARFQ) scale were collected in mailed self-report questionnaires completed by 1,242 grade u students in 2010-11. The associations between each of ten social status indicators and two of the ARFQ subscales were investigated among current adolescents who smoke (n=190; 45% male; mean (sd) age =16.8(0.5)) in logistic regression analyses controlling for age, sex and number of years since first puff. Results: Sixty-three percent of adolescents who smoke rated health as an extremely or very important reason to quit smoking; only 28% endorsed social disapproval. None of the indicators of social status were associated with health as a reason to quit. Participants whose mothers were employed were less likely to endorse social disapproval as a reason to quit smoking (OR (95% CI) = 0.38 (0.15-0.96)). Conclusions: Adolescents who smoke, regardless of social status, endorse health as an important reason to quit smoking, but fewer thought that social disapproval was important. There are few social disparities in reasons to quit in adolescents