L’impact de la violence conjugale sur les enfants : quel parent est responsable?

Ce texte est le fruit d’une réflexion axée sur la pratique des auteures en matière d’intervention concernant la violence conjugale auprès de femmes qui en sont victimes et de leurs enfants. Leur but est de démontrer que les droits parentaux évoluent à la faveur des transformations sociales et qu’ils entrent trop souvent aujourd’hui, au Québec, en concurrence avec les droits fondamentaux des victimes d’actes criminels lorsque ceux-ci se produisent au sein de la famille. En d’autres termes, la Politique québécoise en matière de violence conjugale ne pénètre pas la sphère du droit familial où se transigent les droits parentaux des auteurs de cette violence, ce qui amène à reconstruire des rôles parentaux sexués.This article is based on our experience as practitioners in women’s shelters in Québec and in particular with children who have witnessed domestic violence. It addresses how parental rights too often contradict those of the victims of these crimes. In fact, we note very little impact of the governmental policies protecting children against domestic violence on the Family Court system which deals with custody. This seems to render victims rather than aggressors responsible for the consequences of this violence on children

Écoulement d'un cours d'eau aux abords de structures de restauration

La présente recherche porte sur l'étude de l'écoulement de l'eau dans un canal à surface libre aux abords de structures de restauration tels que les épis. Les épis sont utilisés depuis plusieurs décennies pour contrer les problèmes d'érosion de berges et pour réhabiliter les habitats de poissons. Les problèmes d'érosion de berges sont fréquents et la construction d'épis est une bonne alternative aux techniques de stabilisation de berges structurales tel que l'empierrement : il s'agit d'une solution habituellement moins coûteuse et elle a généralement moins d'impact sur l'environnement. Malheureusement, malgré l'utilisation de ces structures de restauration, la connaissance n'est pas encore assez développée pour permettre à tous les projets de restauration avec épis de connaître le succès escompté. Un mauvais choix de géométrie, d'emplacement dans le cours d'eau ou de profondeur peut mener le projet à l'échec. L'écoulement aux abords de structures de restauration est complexe et plusieurs recherches expérimentales et numériques sont présentement en cours à ce sujet. Ce mémoire présente une recherche qui porte sur trois épis rectangulaires avec une orientation différente (135 degrés, 90 degrés, 45 degrés) confrontés à trois débits différents. Les vitesses mesurées en laboratoire avec un profileur de vitesse acoustique Doppler (ADVP) montrent que l'épi perpendiculaire (90°) est plus influent sur le courant et le potentiel de transport de sédiments que les autres épis. Les contraintes de Reynolds calculées suggèrent aussi que l'épi perpendiculaire serait l'épi qui créerait une zone d'affouillement plus importante que les deux autres épis. Le modèle expérimental a ensuite été modélisé numériquement avec le logiciel d'éléments finis bidimensionnel MIKE21 du Danish Hydraulic Institute (DHI) au Danemark. Les résultats du modèle sont fidèles aux résultats expérimentaux. Une validation a aussi été effectuée avec le logiciel par éléments finis River2D de l'Université d'Alberta. Bien que les vitesses soient légèrement inférieures à celles obtenues par MIKE21 ou en laboratoire, River2D représente bien les distributions générales des vitesses et l'ordre de grandeur de celles-ci. Contrairement à l'opinion de certains chercheurs, qui croient que les logiciels à éléments finis tridimensionnels sont des incontournables pour obtenir une bonne modélisation, les résultats de cette recherche suggèrent que les logiciels d'éléments finis bidimensionnels seraient adéquats pour représenter des projets en rivière

Effectiveness of adaptive e-Learning environments on knowledge, competence, and behavior in health professionals and students : protocol for a systematic review and meta-analysis

Background: Adaptive e-learning environments (AEEs) can provide tailored instruction by adapting content, navigation, presentation, multimedia, and tools to each user’s navigation behavior, individual objectives, knowledge, and preferences. AEEs can have various levels of complexity, ranging from systems using a simple adaptive functionality to systems using artificial intelligence. While AEEs are promising, their effectiveness for the education of health professionals and health professions students remains unclear. Objective: The purpose of this systematic review is to assess the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. Methods: We will follow the Cochrane Collaboration and the Effective Practice and Organisation of Care (EPOC) Group guidelines on systematic review methodology. A systematic search of the literature will be conducted in 6 bibliographic databases (CINAHL, EMBASE, ERIC, PsycINFO, PubMed, and Web of Science) using the concepts “adaptive e-learning environments,” “health professionals/students,” and “effects on knowledge/skills/behavior.” We will include randomized and nonrandomized controlled trials, in addition to controlled before-after, interrupted time series, and repeated measures studies published between 2005 and 2017. The title and the abstract of each study followed by a full-text assessment of potentially eligible studies will be independently screened by 2 review authors. Using the EPOC extraction form, 1 review author will conduct data extraction and a second author will validate the data extraction. The methodological quality of included studies will be independently assessed by 2 review authors using the EPOC risk of bias criteria. Included studies will be synthesized by a descriptive analysis. Where appropriate, data will be pooled using meta-analysis by applying the RevMan software version 5.1, considering the heterogeneity of studies. Results: The review is in progress. We plan to submit the results in the beginning of 2018. Conclusions: Providing tailored instruction to health professionals and students is a priority in order to optimize learning and clinical outcomes. This systematic review will synthesize the best available evidence regarding the effectiveness of AEEs in improving knowledge, competence, and behavior in health professionals and students. It will provide guidance to policy makers, hospital managers, and researchers in terms of AEE development, implementation, and evaluation in health care

Efficacy of adaptive e-learning for health professionals and students : a systematic review and meta-analysis

Objective Although adaptive e-learning environments (AEEs) can provide personalised instruction to health professional and students, their efficacy remains unclear. Therefore, this review aimed to identify, appraise and synthesise the evidence regarding the efficacy of AEEs in improving knowledge, skills and clinical behaviour in health professionals and students. Design Systematic review and meta-analysis. Data sources CINAHL, EMBASE, ERIC, PsycINFO, PubMed and Web of Science from the first year of records to February 2019. Eligibility criteria Controlled studies that evaluated the effect of an AEE on knowledge, skills or clinical behaviour in health professionals or students. Screening, data extraction and synthesis Two authors screened studies, extracted data, assessed risk of bias and coded quality of evidence independently. AEEs were reviewed with regard to their topic, theoretical framework and adaptivity process. Studies were included in the meta-analysis if they had a non-adaptive e-learning environment control group and had no missing data. Effect sizes (ES) were pooled using a random effects model. Results From a pool of 10 569 articles, we included 21 eligible studies enrolling 3684 health professionals and students. Clinical topics were mostly related to diagnostic testing, theoretical frameworks were varied and the adaptivity process was characterised by five subdomains: method, goals, timing, factors and types. The pooled ES was 0.70 for knowledge (95% CI −0.08 to 1.49; p.08) and 1.19 for skills (95% CI 0.59 to 1.79; p<0.00001). Risk of bias was generally high. Heterogeneity was large in all analyses. Conclusions AEEs appear particularly effective in improving skills in health professionals and students. The adaptivity process within AEEs may be more beneficial for learning skills rather than factual knowledge, which generates less cognitive load. Future research should report more clearly on the design and adaptivity process of AEEs, and target higher-level outcomes, such as clinical behaviour

Common Variants in the Adiponectin Gene (ADIPOQ) Associated With Plasma Adiponectin Levels, Type 2 Diabetes, and Diabetes-Related Quantitative Traits: The Framingham Offspring Study

OBJECTIVE— Variants in ADIPOQ have been inconsistently associated with adiponectin levels or diabetes. Using comprehensive linkage disequilibrium mapping, we genotyped single nucleotide polymorphisms (SNPs) in ADIPOQ to evaluate the association of common variants with adiponectin levels and risk of diabetes

Multi-Tissue Epigenetic analysis Identifies Distinct associations Underlying insulin Resistance and alzheimer\u27s Disease at Cpt1A Locus

BACKGROUND: Insulin resistance (IR) is a major risk factor for Alzheimer\u27s disease (AD) dementia. The mechanisms by which IR predisposes to AD are not well-understood. Epigenetic studies may help identify molecular signatures of IR associated with AD, thus improving our understanding of the biological and regulatory mechanisms linking IR and AD. METHODS: We conducted an epigenome-wide association study of IR, quantified using the homeostatic model assessment of IR (HOMA-IR) and adjusted for body mass index, in 3,167 participants from the Framingham Heart Study (FHS) without type 2 diabetes at the time of blood draw used for methylation measurement. We identified DNA methylation markers associated with IR at the genome-wide level accounting for multiple testing (P \u3c 1.1 × 10 RESULTS: We confirmed the strong association of blood DNA methylation with IR at three loci (cg17901584-DHCR24, cg17058475-CPT1A, cg00574958-CPT1A, and cg06500161-ABCG1). In FHS, higher levels of blood DNA methylation at cg00574958 and cg17058475 were both associated with lower IR (P = 2.4 × 10 CONCLUSIONS: Our results suggest potentially distinct epigenetic regulatory mechanisms between peripheral blood and dorsolateral prefrontal cortex tissues underlying IR and AD at CPT1A locus

Epigenome-Wide Association Study of Incident Type 2 Diabetes in a British Population: EPIC-Norfolk Study.

Epigenetic changes may contribute substantially to risks of diseases of aging. Previous studies reported seven methylation variable positions (MVPs) robustly associated with incident type 2 diabetes mellitus (T2DM). However, their causal roles in T2DM are unclear. In an incident T2DM case-cohort study nested within the population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk cohort, we used whole blood DNA collected at baseline, up to 11 years before T2DM onset, to investigate the role of methylation in the etiology of T2DM. We identified 15 novel MVPs with robust associations with incident T2DM and robustly confirmed three MVPs identified previously (near to TXNIP, ABCG1, and SREBF1). All 18 MVPs showed directionally consistent associations with incident and prevalent T2DM in independent studies. Further conditional analyses suggested that the identified epigenetic signals appear related to T2DM via glucose and obesity-related pathways acting before the collection of baseline samples. We integrated genome-wide genetic data to identify methylation-associated quantitative trait loci robustly associated with 16 of the 18 MVPs and found one MVP, cg00574958 at CPT1A, with a possible direct causal role in T2DM. None of the implicated genes were previously highlighted by genetic association studies, suggesting that DNA methylation studies may reveal novel biological mechanisms involved in tissue responses to glycemia

Total Zinc Intake May Modify the Glucose-Raising Effect of a Zinc Transporter (SLC30A8) Variant

Objective: Many genetic variants have been associated with glucose homeostasis and type 2 diabetes in genome-wide association studies. Zinc is an essential micronutrient that is important for β-cell function and glucose homeostasis. We tested the hypothesis that zinc intake could influence the glucose-raising effect of specific variants. Research Design and Methods: We conducted a 14-cohort meta-analysis to assess the interaction of 20 genetic variants known to be related to glycemic traits and zinc metabolism with dietary zinc intake (food sources) and a 5-cohort meta-analysis to assess the interaction with total zinc intake (food sources and supplements) on fasting glucose levels among individuals of European ancestry without diabetes. Results: We observed a significant association of total zinc intake with lower fasting glucose levels (β-coefficient ± SE per 1 mg/day of zinc intake: −0.0012 ± 0.0003 mmol/L, summary P value = 0.0003), while the association of dietary zinc intake was not significant. We identified a nominally significant interaction between total zinc intake and the SLC30A8 rs11558471 variant on fasting glucose levels (β-coefficient ± SE per A allele for 1 mg/day of greater total zinc intake: −0.0017 ± 0.0006 mmol/L, summary interaction P value = 0.005); this result suggests a stronger inverse association between total zinc intake and fasting glucose in individuals carrying the glucose-raising A allele compared with individuals who do not carry it. None of the other interaction tests were statistically significant. Conclusions: Our results suggest that higher total zinc intake may attenuate the glucose-raising effect of the rs11558471 SLC30A8 (zinc transporter) variant. Our findings also support evidence for the association of higher total zinc intake with lower fasting glucose levels