Evaluation of an evidence-based medicine educational intervention in a regional medical campus

Background: Enhanced educational activities were developed by a regional medical campus (RMC) in order to incorporate evidence-based medicine (EBM) practice in the learning process of medical students. This study aimed to measure the effectiveness of these activities.Methods: The experimental group was made up of third-year students from the RMC. The comparison group included students from the main campus of the medical school and another of its RMCs. The experimental group received additional training on EBM: one additional hour in class, plus skills development exercises throughout the semester. During the regular academic sessions, clinical questions requiring EBM literature searching skills were incorporated in the curriculum. Tests on knowledge and self-assessment of competencies were administered to all participants at the beginning and at the end of the semester. Data were analyzed using repeated measures analysis of variance and post hoc tests for within and between groups comparison.Results: The Friedman test demonstrated a statistically significant effect of the intervention on knowledge (p <0.0001). The score of the knowledge test was significantly higher for the experimental group, when compared with baseline testing and with the comparison group (p <0.0001). Repeated measures analysis of variance demonstrated a statistically significant effect of the intervention on the score of the self-assessment of competencies (p=0.032). The score for the self-assessment of competencies was significantly higher for the experimental group when compared to baseline score (p <0.0001), but not with respect to the comparison group.Conclusion: Our study demonstrated the effectiveness of additional training and longitudinal integrated skills development leading to an increase in medical student knowledge and self-perception of competencies in EBM practice.

Inventaire territorial et analyse cartographique de trois régions québécoises : Bas-Saint-Laurent, Gaspésie-Îles-de-la-Madeleine, Côte-Nord et du Golfe du Saint-Laurent : dans le cadre de l'évaluation environnementale stratégique des hydrocarbures au Québec et du plan d'acquisition global des connaissances chantier société (GSOC-01)

L’objectif de la recherche est de réaliser un inventaire territorial et une analyse cartographique décrivant le territoire, le plus finement possible, à un moment donné de son évolution, en matière d’aménagement et d’usages du sol afin de déterminer des aires de sensibilité du territoire à l’étude concerné par l’exploitation des hydrocarbures et gazière. [...] Ce territoire regroupe 173 municipalités et 8 réserves autochtones pour une superficie totale de 316 223 km2 dont 43 % est constitué par le milieu marin. Un peu plus de 336 000 personnes l’habitent. L`hypothèse de base de cette recherche est que les diverses composantes territoriales (32) et d’usage du sol, formant des aires plus ou moins sensibles selon une méthodologie éprouvée, pourraient être affectées, à différents niveaux, selon leur localisation, à la suite d’activités d’exploration et d’exploitation des hydrocarbures et gazières. [...] Cette étude n’est qu’une petite partie d’un tout. En effet, elle s’intègrera, avec une soixantaine d’autres, dans deux évaluations environnementales stratégiques (filière des hydrocarbures et Anticosti), initiées par le Gouvernement du Québec en mai 2014, et qui comprennent deux grandes phases: 1) la synthèse des connaissances actuelles et l’identification des lacunes; 2) l’acquisition de nouvelles connaissances. Elle s’intègre plus particulièrement dans un des cinq chantiers des ÉES, soit celui du chantier société (GSOC-01) qui coordonne trois autres recherches universitaires

Prise de notes numériques au secondaire : comparaison de la qualité des notes numériques avec celle des notes manuscrites

La prise de notes est une activité complexe, mais très importante pour l’apprentissage. C’est la raison pour laquelle cette activité occupe une très grande place dans la classe : elle est utilisée presque tous les jours et dans plusieurs cours. La plus grande accessibilité des technologies, comme l’iPad, offre maintenant aux élèves une nouvelle possibilité : prendre des notes numériques. Comment organiser la prise de notes avec une tablette ? Quels sont les effets de la tablette sur la prise de notes ? Dans la présente recherche, la comparaison de notes manuscrites et de notes numériques d’élèves de troisième secondaire d’une école où l’intégration du iPad s’étend à toutes les classes depuis 2014 a révélé certaines similitudes et différences. Ces dernières ont trait à l’organisation et au contenu des notes, à la qualité de la langue et à l’utilisation de procédés linguistiques de réduction

Anticipating human error before it happens: Towards a psychophysiological model for online prediction of mental workload

Mental workload is a key factor influencing the occurrence of human error; specifically in remotely-operated vehicle operations. Both low and high mental workload has been found to disrupt performance in a nonlinear fashion at a given task; however, research that has attempted to predict individual mental workload has met with little success. The objective of the present study is to investigate the potential of the dual-task paradigm and prefrontal cortex oxygenation as online measures of mental workload. Subjects performed a computerized object tracking task in which they had to follow a dynamic target with their aircraft. Task difficulty was manipulated in terms of processing load and difficulty of control: two critical sources of workload associated with remotely operating a vehicle. Mental workload was assessed by a secondary concurrent time production task and a functional near infrared spectrometer. Results show that the effects of task difficulty differ across measures of mental workload. This pattern of behavioural and neurophysiologic results suggests that the empirically-based selection of an appropriate secondary task for the measure of mental workload is critical as its sensitivity may vary considerably depending on task factors

Participation sociale de jeunes adultes ayant un trouble de l’acquisition de la coordination (TAC) et exploration de leurs besoins en termes de ressources d’information

Problématique : Le trouble de l'acquisition de la coordination (TAC) affecte la réalisation de nombreuses habitudes de vie, autant chez l'enfant que chez l’adulte. Toutefois, peu d’études ont décrit les défis vécus par les jeunes adultes et aucune n’a examiné leurs besoins en termes de ressources d’information. Cette étude exploratoire vise à identifier les principaux défis liés à la participation sociale des jeunes adultes ayant un TAC ainsi que les ressources d’information pouvant les aider. Méthodologie : Des jeunes adultes, âgés entre 18 et 25 ans et ayant un TAC, ainsi que des parents de jeunes adultes correspondant à ces critères ont été recrutés. Un questionnaire inspiré de la Mesure des habitudes de vie (MHAVIE) abrégée a été élaboré en collaboration avec l'Association Québécoise pour les Enfants Dyspraxiques (AQED). Les données obtenues ont été interprétées à l'aide de médianes et d’étendues, et d’une analyse thématique. Résultat : Trois jeunes adultes et trois parents ont participé à cette étude. Le travail est ressorti dans les habitudes de vie les plus atteintes, tant chez les jeunes adultes que chez les parents. Les habitudes de vie les moins satisfaisantes étaient les déplacements selon les jeunes adultes, et le travail et l’habitation selon les parents. Concernant les ressources d'information, les conséquences possibles du TAC sur la santé mentale et les stratégies pour faciliter l'intégration aux études et au travail ont été priorisées par les jeunes adultes et les parents. Le site Internet était la modalité préférée par les jeunes adultes, tandis que les parents privilégiaient le groupe de discussion. Discussion : Malgré le petit échantillon, cette étude a permis d’explorer, pour une première fois au Québec, la participation sociale de jeunes adultes ayant un TAC et leurs besoins en termes de ressources d’information. Ces connaissances permettront de développer une ressource d’information mieux adaptée à cette étape de vie, en collaboration avec l’AQED.Abstract : Problematic: Developmental Coordination Disorder (DCD) affects the realization of many life habits, both with children and adults. However, few studies have described the challenges faced by young adults and none have examined their needs in terms of information resources. The purpose of this exploratory study is to identify the main challenges related to the social participation of young adults with a DCD as well as the information resources that can help them. Methodology: Young adults, aged between 18 and 25 with a DCD, and parents of young adults meeting these criteria were recruited. A survey inspired by the Assessment of Life Habits (LIFE-H) was developed in collaboration with the Quebec Association for Dyspraxic Children. The data obtained was interpreted using medians and scopes, and a thematic analysis. Results: Three young adults and three parents participated in this study. Work came up in the most affected life habits of both young adults and parents. The least satisfactory life habits were travel by young adults, and work and housing by parents. Concerning information resources, young adults and parents prioritize the potential consequences of DCD on mental health and strategies to facilitate integration into school and work. The website was the preferred modality for young adults, while the parents favoured the focus group. Discussion: Despite the small sample, this study explored, for the first time in Quebec, the social participation of young adults with a DCD and their needs in terms of information resources. In collaboration with the Quebec Association for Dyspraxic Children, this knowledge will allow to develop an information resource better adapted to this stage of life

Mapping features to source code in dynamically configured avionics software

Mapping software features to the code that implements them is an important activity for program comprehension and software reengineering. In this paper, we present a novel automated approach to locate features in source code based on static analysis and model checking. This approach focuses on dynamically configured software in which the activation of specific features is controlled by configuration variables. The main advantages of a static approach to feature location are its affordability and applicability to large systems containing hundreds of features. Our methodology is applied to an industrial Flight Management System from the avionics industry. Results show that a static approach to feature mapping is feasible and can locate complex features whose implementation is spread across multiple files and functions

Which trunk inclination directions best predict multidirectional-seated limits of stability among individuals with spinal cord injury?

Objective: To determine which trunk inclination directions most accurately predict multidirectional-seated limits of stability among individuals with spinal cord injury (SCI). Design: Predictive study using cross-sectional data. Setting: Pathokinesiology Laboratory. Participants: Twenty-one individuals with complete or incomplete sensorimotor SCI affecting various vertebral levels participated in this study. Interventions: Participants were instructed to lean their trunk as far as possible in eight directions, separated by 45°intervals, while seated on an instrumented chair with their feet positioned on force plates. Outcomes measures: Eight direction-specific stability indices (DSIs) were used to define an overall stability index (OSI) (limits of stability). Results: All DSIs significantly correlated with the OSI (r = 0.816-0.925). A protocol that only tests the anterior, left postero-lateral, and right lateral trunk inclinations accurately predicts multidirectional-seated postural stability (R 2 = 0.98; P < 0.001). Conclusion: Multidirectional-seated postural stability can be predicted almost perfectly by evaluating trunk inclinations performed toward the anterior, left postero-lateral, and right lateral directions

Oxygen supplementation facilitating successful prosthetic fitting and rehabilitation of a patient with severe chronic obstructive pulmonary disease following trans-tibial amputation: a case report

Abstract Introduction Dysvascular amputations are increasingly performed in patients with underlying cardiac and pulmonary disorders. A limb prosthesis is rarely offered to patients with severe chronic obstructive pulmonary disease because of their inability to achieve the high energy expenditure required for prosthetic ambulation. We describe a case of successful prosthetic fitting and rehabilitation of a patient with severe chronic obstructive pulmonary disease with the aid of oxygen supplementation. Case presentation A 67-year-old aboriginal woman with severe chronic obstructive pulmonary disease and hypercapnic respiratory failure underwent right trans-tibial (below the knee) amputation for severe foot gangrene. An aggressive rehabilitation program of conditioning exercises and gait training utilizing oxygen therapy was initiated. She was custom-fitted with a right trans-tibial prosthesis. A rehabilitation program improved her strength, endurance and stump contracture, and she was able to walk for short distances with the prosthesis. The motion analysis studies showed a cadence of 73.5 steps per minute, a velocity of 0.29 meters per second and no difference in right and left step time and step length. Conclusion This case report illustrates that patients with significant severe chronic obstructive pulmonary disease can be successfully fitted with limb prostheses and undergo rehabilitation using supplemental oxygen along with optimization of their underlying comorbidities. Despite the paucity of published information in this area, prosthesis fitting and rehabilitation should be considered in patients who have undergone amputation and have severe chronic obstructive disease.</p

Becoming a research participant : decision-making needs of individuals with neuromuscular diseases

BACKGROUND: Research has shown that some people with neuromuscular diseases may have a lower level of education due to lower socioeconomic status and possibly compromised health literacy. In view of these data, it appears important to document their decision-making needs to ensure better support when faced with the decision to participate or not in research projects. OBJECTIVES: 1) To document the decision-making needs of individuals with neuromuscular diseases to participate in research; 2) To explore their preferences regarding the format of knowledge translation tools related to research participation. METHODS: This qualitative study is based on the Ottawa Decision Support Framework. A two-step descriptive study was conducted to capture the decision-making needs of people with neuromuscular diseases related to research participation: 1) Individual semi-directed interviews (with people with neuromuscular diseases) and focus groups (with healthcare professionals); 2) Synthesis of the literature. RESULTS: The semi-directed interviews (n = 11), the two focus groups (n = 11) and the literature synthesis (n = 50 articles) identified information needs such as learning about ongoing research projects, scientific advances and research results, the potential benefits and risks associated with different types of research projects, and identified values surrounding research participation: helping other generations, trust, obtaining better clinical follow-up, and socialization. CONCLUSION: This paper provides useful recommendations to support researchers and clinicians in developing material to inform individuals with neuromuscular diseases about research participation

Dependence of the magnetic resonance signal on the magnetic susceptibility of blood studied with models based on real microvascular networks

PURPOSE: The primary goal of this study was to estimate the value of beta , the exponent in the power law relating changes of the transverse relaxation rate and intra-extravascular local magnetic susceptibility differences as Delta R 2 * proportional, variant ( Delta chi ) beta. The secondary objective was to evaluate any differences that might exist in the value of beta obtained using a deoxyhemoglobin-weighted Delta chi distribution versus a constant Delta chi distribution assumed in earlier computations. The third objective was to estimate the value of beta that is relevant for methods based on susceptibility contrast agents with a concentration of Delta chi higher than that used for BOLD fMRI calculations. METHODS: Our recently developed model of real microvascular anatomical networks is used to extend the original simplified Monte-Carlo simulations to compute beta from the first principles. RESULTS: Our results show that beta = 1 for most BOLD fMRI measurements of real vascular networks, as opposed to earlier predictions of beta = 1 .5 using uniform Delta chi distributions. For perfusion or fMRI methods based on contrast agents, which generate larger values for Delta chi , beta = 1 for B 0 </= 9.4 T, whereas at 14 T beta can drop below 1 and the variation across subjects is large, indicating that a lower concentration of contrast agent with a lower value of Delta chi is desired for experiments at high B0. CONCLUSION: These results improve our understanding of the relationship between R2 (*) and the underlying microvascular properties. The findings will help to infer the cerebral metabolic rate of oxygen and cerebral blood volume from BOLD and perfusion MRI, respectively.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435380/Accepted manuscrip