Découvrir, étudier et mettre en valeur la culture matérielle : dialectique entre cultures populaire et savante, l'exemple québécois au 20e siècle

Popular culture and academic culture are mutually supportive. The discussion of the concerns and motivations of the academic community to uncover one's heritage, to study it and raise its profile, provides an opportunity to examine, from an ethnological point of view, the meaning of objects in popular and academic culture along with the dynamics between them. In search of local, regional and national distinctive characteristics, some supporters of culture, intellectuals for the most part, met inhabitants of particular regions to discover their habits and customs. Academic circles and governments draw up inventories, and develop and promote cultural and socio-economic characteristics. In this way, they return to the people what they had yielded up, and in so doing, help them rediscover certain facets of their culture. Résumé La culture populaire et la culture savante se nourrissent. L'évocation des préoccupations et des motivations des chercheurs à la découverte du patrimoine, à son étude et à sa mise en valeur donne l'occasion d'aborder, dans une perspective ethnologique, la signification des objets dans les cultures populaire et savante ainsi que la dynamique qu'entretiennent l'une et l'autre entre elles. En quête de particularités locales, régionales et nationales, quelques passionnés delà culture, des intellectuels pour la plupart, ont rencontré des gens du terroir pour découvrir leurs us et coutumes, leurs savoirs et leurs pratiques. Les milieux universitaires et les gouvernements réalisent des inventaires, développent et mettent en valeur des caractères culturels et socio-économiques, redonnant ainsi à la population ce qu'elle avait livré, et même plus, en lui faisant redécouvrir certains pans de sa culture

J Reprod Med

OBJECTIVETo assess barriers to and quality of care received by diabetic pregnant women from obstetrician-gynecologists.STUDY DESIGNA questionnaire was mailed to 1,000 representative practicing Fellows of the American College of Obstetricians and Gynecologists; 74 did not treat pregnant patients and 510 (55.1%) returned completed surveys. Respondents were divided into 3 groups: maternal-fetal medicine specialists, physicians with high minority/low insurance patient populations, and physicians with low minority/high insurance patient populations.RESULTSReported preconception and prenatal care was generally consistent with guidelines. Regarding gestational diabetes mellitus patients the 3 physician groups differed in assessing postpartum glycemic status, counseling about lifestyle changes, and counseling patients to consult a doctor before their next pregnancy. Patient demographics and perceived barriers to care were similar between maternal-fetal medicine specialists and physicians with high minority/low insurance patient populations. These two physician groups were more likely to agree that lack of educational materials, arranging specialist referrals, patient compliance with recommendations, and patients\ue2\u20ac\u2122 ability to afford healthful food were barriers to quality care.CONCLUSIONAccording to physician self-report, pregnant diabetic patients with access to an obstetrician receive quality care regardless of insurance status. Post-partum care is more variable. Physicians with high minority/low insurance patient populations may lack access to resources.CC999999/Intramural CDC HHS/United StatesUA6MC19010/PHS HHS/United States2016-02-26T00:00:00Z23447912PMC476871

Different intensities of glycaemic control for pregnant women with pre-existing diabetes

Background The optimal glycaemic control target in pregnant women with pre-existing diabetes is unclear, although there is a clear link between high glucose concentrations and adverse birth outcomes. Objectives To assess the effects of different intensities of glycaemic control in pregnant women with pre-existing type 1 or type 2 diabetes. Search strategy We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (7 May 2010). Selection criteria We included randomised controlled trials comparing different glycaemic control targets in pregnant women with pre-existing diabetes. Data collection and analysis Two review authors assessed trial eligibility and risk of bias, and extracted data. Main results We included three trials all in women with type 1 diabetes (223 women and babies), and all with a high risk of bias. Two trials compared very tight (3.33 to 5.0 mmol/L fasting blood glucose (FBG)) with tight-moderate (4.45 to 6.38) glycaemic control targets, with one trial of 22 babies reporting no perinatal deaths or serious perinatal morbidity. In the same trial, there were two birth defects in the very tight and none in the tight-moderate group with no significant differences in caesarean section between groups (risk ratio 0.92, 95% confidence interval (CI) 0.49 to 1.73). In these two trials glycaemic control was not significantly different between the very tight and tight-moderate groups by the third trimester, although one trial of 22 women found significantly less maternal hypoglycaemia in the tight-moderate group. In a trial of 60 women and babies comparing tight (≤ 5.6 mmol/L FBG); moderate (5.6 to 6.7); and loose (6.7 to 8.9) glycaemic control targets, there were two neonatal deaths in the loose and none in the tight or moderate groups. There were significantly fewer women with pre-eclampsia, fewer caesareans and fewer birthweights greater than 90th centile in the combined tight-moderate compared with the loose group. Authors' conclusions In a very limited body of evidence, few differences in outcomes were seen between very tight and tight-moderate glycaemic control targets in pregnant women with pre-existing type 1 diabetes, including actual glycaemic control achieved. There is evidence of harm (increased pre-eclampsia, caesareans and birthweights greater than 90th centile) for 'loose' control (FBG above 7 mmol/L). Future trials comparing interventions, rather than glycaemic control targets, may be more feasible particularly for pregnant women with type 2 diabetes.Philippa Middleton, Caroline A Crowther, Lucy Simmonds and Peter Mulle

Different intensities of glycaemic control for pregnant women with pre-existing diabetes

Extent: 58p.Background: The optimal glycaemic control target in pregnant women with pre-existing diabetes is unclear, although there is a clear link between high glucose concentrations and adverse birth outcomes. Objectives: To assess the effects of different intensities of glycaemic control in pregnant women with pre-existing type 1 or type 2 diabetes. Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2012). Selection criteria: We included randomised controlled trials comparing different glycaemic control targets in pregnant women with pre-existing diabetes. Data collection and analysis: Two review authors assessed trial eligibility and risk of bias, and extracted data. Main results: We included three trials all in women with type 1 diabetes (223 women and babies), and all with a high risk of bias. Two trials compared very tight (3.33 to 5.0 mmol/L fasting blood glucose (FBG)) with tight-moderate (4.45 to 6.38) glycaemic control targets, with one trial of 22 babies reporting no perinatal deaths or serious perinatal morbidity. In the same trial, there were two birth defects in the very tight and none in the tight-moderate group with no significant differences in caesarean section between groups (risk ratio 0.92, 95% confidence interval (CI) 0.49 to 1.73). In these two trials glycaemic control was not significantly different between the very tight and tight-moderate groups by the third trimester, although one trial of 22 women found significantly less maternal hypoglycaemia in the tight-moderate group. In a trial of 60 women and babies comparing tight (≤ 5.6 mmol/L FBG); moderate (5.6 to 6.7); and loose (6.7 to 8.9) glycaemic control targets, there were two neonatal deaths in the loose and none in the tight or moderate groups. There were significantly fewer women with pre-eclampsia, fewer caesareans and fewer birthweights greater than 90th centile in the combined tight-moderate compared with the loose group. Authors' conclusions: In a very limited body of evidence, few differences in outcomes were seen between very tight and tight-moderate glycaemic control targets in pregnant women with pre-existing type 1 diabetes, including actual glycaemic control achieved. There is evidence of harm (increased pre-eclampsia, caesareans and birthweights greater than 90th centile) for 'loose' control (FBG above 7 mmol/L). Future trials comparing interventions, rather than glycaemic control targets, may be more feasible particularly for pregnant women with type 2 diabetes.Philippa Middleton, Caroline A Crowther, Lucy Simmond