Représentation de la vieillesse et formation gérontologique, l’âgisme en question

Les étudiant.e.s de l’enseignement supérieur sont peu enclin.e.s à s’orienter vers des études gérontologiques malgré les défis d’actualité. Un questionnaire abordant les représentations liées au vieillissement a été diffusé auprès de 228 participant.e.s issu.e.s de la faculté de psychologie et des sciences de l’éducation de l’UMONS. L’analyse des résultats quantitatifs démontre une vision nuancée des aîné.e.s. Notre échantillon tend à faiblement recourir à des stéréotypes âgistes, le suivi d’une formation et la poursuite du parcours universitaire influant négativement sur la discrimination. Des perspectives de formation sont donc discutées afin d’adapter les programmes aux besoins des étudiant.e.s et de la société.Higher education students are reluctant to specialise in the field of gerontology, despite current challenges. A survey onthe representations of old age questioned 228 participants from the Faculty of Psychology and Educational Science of UMONS. An analysis of the quantitative results revealed that the students have a nuanced view of older people. Indeed, our sample does not strongly demonstrate recourse to stereotypes linked to age. In this respect, participation in trainingand continuing higher education are identified as a negative influence on discrimination. Therefore, opportunities for training are discussed in order to adapt programmes to the needs of students and society

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Représentations de la vieillesse et orientation professionnelle

The issues of our exploratory study emerge from a pedagogical observation that students enrolled in the Faculty of Psychology and Educational Sciences (UMONS) have little interest in the options addressing the theme of aging, despite the increasing opportunities. Several theories justify this trend and are frequently associated with the principle of ageism, discrimination based on age criteria (Butler, 1969), widespread in our hypermodern societies (Adam, Joubert & Missotten, 2013). Referring to Abric modeling (1976, 1994, 2005), a questionnaire focusing on the representations of students with regard to old age has been distributed to an occasional sample of 228 subjects of the faculty. Qualitative data were analyzed by a methodological triangulation performed with software NVivo 11 (ACT) and IRaMuTteQ (ADS, CDH, AFC and prototypical analysis). Result's analysis showed a nuanced vision of the elderly carried by students. Indeed, the core of the representation refers to a retired, wise and experienced elder. However, the peripheral areas of the representation would show a more negative view of aging, characterized by losses with handicapping socio-economic consequences, which are wild widespread concerns in our societies. In conclusion, the low orientation towards gerontological professions seems therefore not linked to exclusively negative representations of advancing age, but would also refer to a lack of skills, legitimacy perceived by young people looking for landmarks and recognition. The assumptions will be discussed with practical, teaching and research perspectives to promote socio-professional inclusion

Comment les équipes éducatives prennent-elles en compte la situation d’enfants atteints du diabète de type 1 ? Analyse du propos des enseignants en Belgique francophone

Cette étude vise à recueillir le vécu expérientiel de vingt enseignants primaires en Belgique francophone lié à l’accueil d’enfants diabétiques de type 1 ainsi que les stratégies déployées pour promouvoir l’inclusion scolaire de ce public présentant des besoins médicaux spécifiques. L’analyse des entretiens semi-directifs révèle que l’accueil de ces élèves représente une grande responsabilité pouvant générer des difficultés émotionnelles. De plus, deux autres constats majeurs sont observés : d’une part, l’absence quasi-totale d’une connaissance du cadre administrivo-juridique inhérent à l’accompagnement de l’enfant diabétique à l’école et, d’autre part, une potentielle incompatibilité existante entre les aménagements raisonnables mis en place par les enseignants et les cas de figure anticipés par le législateur. Ces résultats soulignent l’importance de promouvoir la formation initiale et continue relative aux cadres et enjeux de l’inclusion scolaire ainsi que l’évolution juridique nécessaire pour permettre une mise en adéquation de la pratique des enseignants aux prescrits légaux.This study aims to collect the experiences of twenty primary teachers in French-speaking Belgium related to the caring of children with type 1 diabetes as well as the strategies deployed in order to promote the school inclusion of this public with specific medical needs. The analysis of the semi-structured interviews reveals that the reception of these pupils represents a great responsibility which can generate emotional difficulties. In addition, two other major observations were made: first, the almost total absence of knowledge of the administrative and legal framework inherent in the support of diabetic children at school and, second, a potential incompatibility between the reasonable arrangements made by teachers and the cases anticipated by the legislator. These results underline the importance to promote initial and ongoing training on the frameworks and issues of school inclusion, as well as the legal changes needed to ensure that teachers' practices are in line with legal requirements

Comment les équipes éducatives prennent-elles en compte la situation d’enfants atteints du diabète de type 1 ? Analyse du propos des enseignants en Belgique francophone

This study aims to collect the experiences of twenty primary teachers in French-speaking Belgium related to the caring of children with type 1 diabetes as well as the strategies deployed in order to promote the school inclusion of this public with specific medical needs. The analysis of the semi-structured interviews reveals that the reception of these pupils represents a great responsibility which can generate emotional difficulties. In addition, two other major observations were made: first, the almost total absence of knowledge of the administrative and legal framework inherent in the support of diabetic children at school and, second, a potential incompatibility between the reasonable arrangements made by teachers and the cases anticipated by the legislator. These results underline the importance to promote initial and ongoing training on the frameworks and issues of school inclusion, as well as the legal changes needed to ensure that teachers' practices are in line with legal requirements

Circulating microRNA-based screening tool for breast cancer

peer reviewedCirculating microRNAs (miRNAs) are increasingly recognized as powerful biomarkers in several pathologies, including breast cancer. Here, their plasmatic levels were measured to be used as an alternative screening procedure to mammography for breast cancer diagnosis. A plasma miRNA profile was determined by RT-qPCR in a cohort of 378 women. A diagnostic model was designed based on the expression of 8 miRNAs measured first in a profiling cohort composed of 41 primary breast cancers and 45 controls, and further validated in diverse cohorts composed of 108 primary breast cancers, 88 controls, 35 breast cancers in remission, 31 metastatic breast cancers and 30 gynecologic tumors. A receiver operating characteristic curve derived from the 8-miRNA random forest based diagnostic tool exhibited an area under the curve of 0.81. The accuracy of the diagnostic tool remained unchanged considering age and tumor stage. The miRNA signature correctly identified patients with metastatic breast cancer. The use of the classification model on cohorts of patients with breast cancers in remission and with gynecologic cancers yielded prediction distributions similar to that of the control group. Using a multivariate supervised learning method and a set of 8 circulating miRNAs, we designed an accurate, minimally invasive screening tool for breast cancer