Les relations entre les intervenants et les parents d'adultes ayant une déficience intellectuelle en contexte d'hébergement

Dans le domaine de la déficience intellectuelle, des relations de nature partenariale entre les parents et les intervenants sont maintenant souhaitées. D’ailleurs, les avantages d’établir un partenariat dans les relations entre les parents et les intervenants ne sont plus à démontrer. Pourtant, les écrits portant sur ce sujet dressent un portrait où le partenariat est plutôt absent des relations entre les intervenants et les parents. En situation d’hébergement, le partenariat entre les parents et les intervenants est encore plus pertinent puisqu’il constitue un facteur influençant positivement l’implication des parents auprès de leur enfant ayant une déficience intellectuelle. Par contre, le sujet spécifique des relations entre les intervenants et les parents de personnes ayant une déficience intellectuelle en contexte d’hébergement a été peu exploré dans les écrits. Dans le cadre du présent mémoire, une recherche qualitative a été menée afin de connaître la perception de parents d’adultes ayant une déficience intellectuelle de leurs relations avec les intervenants dans un contexte d’hébergement. Dix parents ont donc été rencontrés en entrevue. Les objectifs de cette recherche étaient de qualifier, à partir de la perception de parents, la nature des relations qu’ils entretiennent avec les intervenants et de cibler les facteurs qui influencent leurs relations.In the mental retardation field, partnership relationships between parents and caregivers are now a must. In fact, the advantages of a partnership in the relationships between parents and caregivers no longer need to be validated. Still, written documents on this subject usually depict a picture of a partnership that is somewhat lacking in the relationships between the caregivers and the parents. This partnership between caregivers and parents is even more important in foster homes settings as it strongly influences the parents’ involvement in the life of their child with learning disabilities. However, the actual subject of relationships between caregivers and parents of adult children with mental retardation in foster homes settings has been seldom documented. This thesis required a qualitative research be made to better understand the perception of parents of adult children with mental retardation with respect to their relationship with the caregivers in a foster home setting. Ten parents were interviewed. The purpose of this research was to better qualify, according to the parents’ perception, the type of relationships they have with the caregivers and to identify the factors that influence these relationships. The results showed that most parents are satisfied with their relationships with their adult child’s caregivers. The description they give of their relationships brings us to conclude that there is in fact a partnership. From an ecological analysis, we have grouped these factors according to different systems. The familial systemic model also enabled us to analyze the factors at a deeper level. Amongst the identified factors, some are more important than others. First, there is the factor that caregivers recognize the importance of the parents’ contribution. Then, there is the factor that the parents notice a sense of well-being in their child. Finally, there is the factor that the parents are able to voice their point of view and their expectations

Mediation Analysis Supports a Causal Relationship between Maternal Hyperglycemia and Placental DNA Methylation Variations at the Leptin Gene Locus and Cord Blood Leptin Levels.

Changes in fetal DNA methylation (DNAm) of the leptin (LEP) gene have been associated with exposure to maternal hyperglycemia, but their links with childhood obesity risk are still unclear. We investigated the association between maternal hyperglycemia, placental LEP DNAm (25 5-C-phosphate-G-3 (CpG) sites), neonatal leptinemia, and adiposity (i.e., BMI and skinfold thickness (ST) (subscapular (SS) + triceps (TR) skinfold measures, and the ratio of SS:TR) at 3-years-old, in 259 mother-child dyads, from Gen3G birth cohort. We conducted multivariate linear analyses adjusted for gestational age at birth, sex of the child, age at follow-up, and cellular heterogeneity. We assessed the causal role of DNAm in the association between maternal glycemia and childhood outcomes, using mediation analysis. We found three CpGs associated with neonatal leptinemia (p ≤ 0.002). Of these, cg05136031 and cg15758240 were also associated with BMI (β = -2.69, p = 0.05) and fat distribution (β = -0.581, p = 0.05) at 3-years-old, respectively. Maternal glycemia was associated with DNAm at cg15758240 (β = -0.01, p = 0.04) and neonatal leptinemia (β = 0.19, p = 0.004). DNAm levels at cg15758240 mediates 0.8% of the association between maternal glycemia and neonatal leptinemia (p < 0.001). Our results support that DNAm regulation of the leptin pathway in response to maternal glycemia might be involved in programming adiposity in childhood

Synthesis and biological evaluation of novel N-phenyl ureidobenzenesulfonate derivatives as potential anticancer agents. Part 2. Modulation of the ring B

DNA double strand-breaks (DSBs) are the most deleterious lesions that can affect the genome of living beings and are lethal if not quickly and properly repaired. Recently, we discovered a new family of anticancer agents designated as N-phenyl ureidobenzenesulfonates (PUB-SOs) that are blocking the cells cycle progression in S-phase and inducing DNA DSBs. Previously, we have studied the effect of several modifications on the molecular scaffold of PUB-SOs on their cytocidal properties. However, the effect of the nature and the position of substituents on the aromatic ring B is still poorly studied. In this study, we report the preparation and the biological evaluation of 45 new PUB-SO derivatives substituted by alkyl, alkoxy, halogen and nitro groups at different positions on the aromatic ring B. All PUB-SOs were active in the submicromolar to low micromolar range (0.24–20 μM). The cell cycle progression analysis showed that PUB-SOs substituted at position 2 by alkyl, halogen or nitro groups or substituted at position 4 by a hydroxyl group arrest the cell cycle progression in S-phase. Interestingly, all others PUB-SOs substituted at positions 3 and 4 arrested the cell cycle in G2/M-phase. PUB-SOs arresting the cell cycle progression in S-phase also induced the phosphorylation of H2AX (γH2AX) which is indicating the generation of DNA DSBs. We evidenced that few modifications on the ring B of PUB-SOs scaffold lead to cytocidal derivatives arresting the cell cycle in S-phase and inducing γH2AX and DSBs. In addition, this study shows that these new anticancer agents are promising and could be used as alternative to circumvent some of the biopharmaceutical complications that might be encountered during the development of PUB-SOs

Discovery of a Wide Planetary-mass Companion to the Young M3 Star GU Psc

We present the discovery of a comoving planetary-mass companion ~42" (~2000 AU) from a young M3 star, GU Psc, a likely member of the young AB Doradus Moving Group (ABDMG). The companion was first identified via its distinctively red i − z color (>3.5) through a survey made with Gemini-S/GMOS. Follow-up Canada–France–Hawaii Telescope/WIRCam near-infrared (NIR) imaging, Gemini-N/GNIRS NIR spectroscopy and Wide-field Infrared Survey Explorer photometry indicate a spectral type of T3.5 ± 1 and reveal signs of low gravity which we attribute to youth. Keck/Adaptive Optics NIR observations did not resolve the companion as a binary. A comparison with atmosphere models indicates T_eff = 1000–1100 K and log g = 4.5–5.0. Based on evolution models, this temperature corresponds to a mass of 9–13  M_Jup for the age of ABDMG (70–130 Myr). The relatively well-constrained age of this companion and its very large angular separation to its host star will allow its thorough characterization and will make it a valuable comparison for planetary-mass companions that will be uncovered by forthcoming planet-finder instruments such as Gemini Planet Imager and SPHERE

Exploring dietitians' salient beliefs about shared decision-making behaviors

<p>Abstract</p> <p>Background</p> <p>Shared decision making (SDM), a process by which health professionals and patients go through the decision-making process together to agree on treatment, is a promising strategy for promoting diet-related decisions that are informed and value based and to which patients adhere well. The objective of the present study was to identify dietitians' salient beliefs regarding their exercise of two behaviors during the clinical encounter, both of which have been deemed essential for SDM to take place: (1) presenting patients with all dietary treatment options for a given health condition and (2) helping patients clarify their values and preferences regarding the options.</p> <p>Methods</p> <p>Twenty-one dietitians were allocated to four focus groups. Facilitators conducted the focus groups using a semistructured interview guide based on the Theory of Planned Behavior. Discussions were audiotaped, transcribed verbatim, coded, and analyzed with NVivo8 (QSR International, Cambridge, MA) software.</p> <p>Results</p> <p>Most participants stated that better patient adherence to treatment was an advantage of adopting the two SDM behaviors. Dietitians identified patients, physicians, and the multidisciplinary team as normative referents who would approve or disapprove of their adoption of the SDM behaviors. The most often reported barriers and facilitators for the behaviors concerned patients' characteristics, patients' clinical situation, and time.</p> <p>Conclusions</p> <p>The implementation of SDM in nutrition clinical practice can be guided by addressing dietitians' salient beliefs. Identifying these beliefs also provides the theoretical framework needed for developing a quantitative survey questionnaire to further study the determinants of dietitians' adoption of SDM behaviors.</p

Simultaneous, Multi-Wavelength Variability Characterization of the Free-Floating Planetary Mass Object PSO J318.5-22

We present simultaneous HST WFC3 + Spitzer IRAC variability monitoring for the highly-variable young ($\sim$20 Myr) planetary-mass object PSO J318.5-22. Our simultaneous HST + Spitzer observations covered $\sim$2 rotation periods with Spitzer and most of a rotation period with HST. We derive a period of 8.6$\pm$0.1 hours from the Spitzer lightcurve. Combining this period with the measured $v sin i$ for this object, we find an inclination of 56.2$\pm 8.1^{\circ}$. We measure peak-to-trough variability amplitudes of 3.4$\pm$0.1$\%$ for Spitzer Channel 2 and 4.4 - 5.8$\%$ (typical 68$\%$ confidence errors of $\sim$0.3$\%$) in the near-IR bands (1.07-1.67 $\mu$m) covered by the WFC3 G141 prism -- the mid-IR variability amplitude for PSO J318.5-22 one of the highest variability amplitudes measured in the mid-IR for any brown dwarf or planetary mass object. Additionally, we detect phase offsets ranging from 200--210$^{\circ}$ (typical error of $\sim$4$^{\circ}$) between synthesized near-IR lightcurves and the Spitzer mid-IR lightcurve, likely indicating depth-dependent longitudinal atmospheric structure in this atmosphere. The detection of similar variability amplitudes in wide spectral bands relative to absorption features suggests that the driver of the variability may be inhomogeneous clouds (perhaps a patchy haze layer over thick clouds), as opposed to hot spots or compositional inhomogeneities at the top-of-atmosphere level.Comment: 48 pages, 22 figures, accepted to A

Variation in the psychosocial determinants of the intention to prescribe hormone therapy prior to the release of the Women's Health Initiative trial: a survey of general practitioners and gynaecologists in France and Quebec

BACKGROUND: Theory-based approaches are advocated to improve our understanding of prescription behaviour. This study is an application of the theory of planned behaviour (TPB) with additional variables. It was designed to assess which variables were associated with the intention to prescribe hormone therapy (HT). In addition, variations in the measures across medical specialities (GPs and gynaecologists) and across countries (France and Quebec) were investigated. METHODS: A survey among 2,000 doctors from France and 1,044 doctors from Quebec was conducted. Data were collected by means of a self-administered questionnaire. A clinical vignette was used to elicit doctors' opinions. The following TPB variables were assessed: attitude, subjective norm, perceived behavioural control, attitudinal beliefs, normative beliefs and power of control beliefs. Additional variables (role belief, moral norm and practice pattern-related factors) were also assessed. A stepwise logistic regression was used to assess which variables were associated with the intention to prescribe HT. GPs and gynaecologists were compared to each other within countries and the two countries were compared within the specialties. RESULTS: Overall, 1,085 doctors from France returned their questionnaire and 516 doctors from Quebec (response rate = 54% and 49%, respectively). In the overall regression model, power of control beliefs, moral norm and role belief were significantly associated with intention (all at p < 0.0001). The models by specialty and country were: for GPs in Quebec, power of control beliefs (p < 0.0001), moral norm (p < 0.01) and cytology and hormonal dosage (both at p < 0.05); for GPs in France, power of control beliefs and role belief (both at p < 0.0001) and perception of behavioural control (p < 0.05) and cessation of menses (p < 0.01); for gynaecologists in Quebec, moral norm and power of control beliefs (both at p = 0.01); and for gynaecologists in France, power of control beliefs (p < 0.0001), and moral norm, role belief and lipid profile (all at p < 0.05). CONCLUSION: In both countries, compared with GPs, intention to prescribe HT was higher for gynaecologists. Psychosocial determinants of doctors' intention to prescribe HT varied according to the specialty and the country thus, suggesting an influence of contextual factors on these determinants

Users' perspectives of barriers and facilitators to implementing EHR in Canada: A study protocol

<p>Abstract</p> <p>Background</p> <p>In Canada, federal, provincial, and territorial governments are developing an ambitious project to implement an interoperable electronic health record (EHR). Benefits for patients, healthcare professionals, organizations, and the public in general are expected. However, adoption of an interoperable EHR remains an important issue because many previous EHR projects have failed due to the lack of integration into practices and organizations. Furthermore, perceptions of the EHR vary between end-user groups, adding to the complexity of implementing this technology. Our aim is to produce a comprehensive synthesis of actual knowledge on the barriers and facilitators influencing the adoption of an interoperable EHR among its various users and beneficiaries.</p> <p>Methods</p> <p>First, we will conduct a comprehensive review of the scientific literature and other published documentation on the barriers and facilitators to the implementation of the EHR. Standardized literature search and data extraction methods will be used. Studies' quality and relevance to inform decisions on EHR implementation will be assessed. For each group of EHR users identified, barriers and facilitators will be categorized and compiled using narrative synthesis and meta-analytical techniques. The principal factors identified for each group of EHR users will then be validated for its applicability to various Canadian contexts through a two-round Delphi study, involving representatives from each end-user groups. Continuous exchanges with decision makers and periodic knowledge transfer activities are planned to facilitate the dissemination and utilization of research results in policies regarding the implementation of EHR in the Canadian healthcare system.</p> <p>Discussion</p> <p>Given the imminence of an interoperable EHR in Canada, knowledge and evidence are urgently needed to prepare this major shift in our healthcare system and to oversee the factors that could affect its adoption and integration by all its potential users. This synthesis will be the first to systematically summarize the barriers and facilitators to EHR adoption perceived by different groups and to consider the local contexts in order to ensure the applicability of this knowledge to the particular realities of various Canadian jurisdictions. This comprehensive and rigorous strategy could be replicated in other settings.</p

Défis liés à la culture dans la réponse aux besoins des familles francophones de l’Alberta

Cette étude examine les besoins et les défis en matière de soutien social de répondants francophones albertains, répartis en cinq sous-groupes selon leur lieu d’origine. La langue et l’hétérogénéité culturelle dans un contexte minoritaire sont prises en compte sous l’angle des processus d’acculturation. Une méthode mixte (quantitative et qualitative) a permis de dresser un portrait global des expériences de stress et de soutien en lien avec des événements de vie, des facteurs limitant l’accès aux ressources et des besoins prioritaires des répondants. La discussion met en relief l’importance de concevoir des services culturellement adaptés aux besoins de cette communauté.This study examines the social support needs and challenges of French-speaking Albertans, distinguished in five sub-groups according to their place of origin. The language and cultural heterogeneity are considered from an acculturation perspective. A mixed quantitative and qualitative method was used to draw a global portrait of respondents’ experience of stress and support, in relation to recent life events, the main barriers limiting their access to exiting resources and their perception of the services most urgently needed by their community. The discussion highlights the importance of responding to the needs of this community with culturally adapted services