29 research outputs found
Des scandales Ă la vertu : gouvernance interne et reddition de comptes des OBNL Ă Laval
Le scandale de la corruption dans lâoctroi de contrats publics qui a menĂ© Ă lâarrestation de lâex-maire Gilles Vaillancourt en 2013 a conduit la Ville de Laval Ă rĂ©former en profondeur ses mĂ©canismes de gouvernance. Pourquoi et comment sâest effectuĂ© ce virage? Cette table ronde vise Ă prĂ©senter les multiples facettes de la mise en oeuvre des bonnes pratiques en matiĂšre de gouvernance selon deux volets, soit la gouvernance des instances consultatives internes et la reddition de comptes des organismes Ă but non lucratif (OBNL) recevant un appui financier direct ou indirect de la Ville
Profiles of Parental Burnout Around the Globe: Similarities and Differences Across 36 Countries
Parental burnout (PB) is a pervasive phenomenon. Parenting is embedded in cultural values, and previous research has shown the role of individualism in PB. In this paper, we reanalyze previously collected data to identify profiles based on the four dimensions of PB, and explore whether these profiles vary across countriesâ levels of collectivistic-individualistic (COL-IND) values. Our sample comprised 16,885 individuals from 36 countries (73% women; 27% men), and we used a latent profile approach to uncover PB profiles. The findings showed five profiles: Fulfilled, Not in PB, Low risk of PB, High risk of PB and Burned out. The profiles pointed to climbing levels of PB in the total sample and in each of the three country groups (High COL/Low IND, Medium COL-IND, Low COL/High IND). Exploratory analyses revealed that distinct dimensions of PB had the most prominent roles in the climbing pattern, depending on the countriesâ levels of COL/IND. In particular, we found contrast to be a hallmark dimension and an indicator of severe burnout for individualistic countries. Contrary to our predictions, emotional distance and saturation did not allow a clear differentiation across collectivistic countries. Our findings support several research avenues regarding PB measurement and intervention
SerĂĄ que esse remĂ©dio vai valer a pena mesmo? Estudo antropolĂłgico sobre a adesĂŁo Ă s terapias antirretrovirais entre grupos de mĂștua ajuda de pessoas vivendo com HIV/aids
Unusual presentation of pheochromocytoma: thirteen years of anxiety requiring psychiatric treatment
Pheochromocytoma is a rare tumor of the adrenal gland. It often presents with the classic triad of headache, palpitations and generalized sweating. Although not described as a typical symptom of pheochromocytoma, anxiety is the fourth most common symptom reported by patients suffering of pheochromocytoma. We report the case of a 64 year old man who had severe anxiety and panic disorder as presenting symptoms of pheochromocytoma. After 13Â years of psychiatric follow-up, the patient was diagnosed with malignant pheochromocytoma. After surgical resection of his pheochromocytoma and his hepatic metastases, the major panic attacks completely disappeared, the anxiety symptoms improved significantly and the psychiatric medications were stopped except for a very low maintenance dose of venlafaxine. We found in our cohort of 160 patients with pheochromocytoma 2 others cases of apparently benign tumors with severe anxiety that resolved after pheochromocytoma resection. These cases highlight that pheochromocytoma should be included in the differential diagnosis of refractory anxiety disorder
Opposed Left and Right Brain Hemisphere Contributions to Sexual Drive: A Multiple Lesion Case Analysis
Brain topographical studies of normal men have have shown that sexual excitation is asymmetric in the brain hemispheres. Group studies of patients with unilateral epileptic foci and other studies of patients with unilateral brain lesions have come to the same conclusion. The present study reviewed previously published single case reports of patients with frank hypo or hypersexuality subsequent to a unilateral brain lesion. Hyposexual patients tended to have left hemisphere lesions (primarily of the temporal lobe), and hypersexual patients tended to have right hemisphere lesions (primarily of the temporal lobe) (p < 0.05). We interpret this double dissociation as part of a more general phenomenon of psychic tone similarly dissociated with regard to hemispheric control, including mood, psychomotor baseline, speech rate, and even immunity. The behavioral significance of this psychic tone is to modulate approach versus avoidance behavior
Step-by-step Strategies for an Integrated Patient-Oriented Research: Lessons Learned from a Multicentered Study
Introduction: The literature on Patient-Oriented Research (POR) and, more specifically, on the collaborative experience between research teams and patient partners (PPs), varies in the way it reports experiences. In Canada, since a few years, POR has been upgraded and literature now provides several guidelines and tools to support effective engagement of PPs in research. However, scientific literature most often presents elements from the researchersâ or from the PPsâ perspective, but rarely from both simultaneously. Objective: This paper objective is to enhance the current literature and provide examples of day-to-day pre, per, and post POR activities. Methods: Based on the 4 guiding principles of the Strategy for POR of the Canadian Institutes of Health Research, we present a step-by-step description of our POR strategies used during our research project. We also give concrete examples and tips shared by PPs and researchers. Discussion and conclusion: We favored 3 steps to engage positively our team in a POR approach. These steps led us to 3 main lessons. First, there is a necessity to adapt training on POR. Second, researchers must demonstrate open-mindedness and humility throughout the collaboration. Third, PPsâ recognition needs to be emphasized including a normalization of financial aspect. The reflections made in this article will help, hopefully, research teams to begin their patient-centered research process by building on the previous experiences of other teams, such as ours.Introduction : La littĂ©rature sur la recherche axĂ©e sur le patient (RAP), particuliĂšrement celle relatant lâexpĂ©rience collaborative entre les patients partenaires et les Ă©quipes de recherche, varie dans la façon dont lâexpĂ©rience est rapportĂ©e. Au Canada, depuis quelques annĂ©es, la littĂ©rature concernant la RAP Ă©merge et fournit davantage de recommandations sur les façons efficaces dâengager les patients dans la recherche. Cependant, celle-ci rapporte le plus souvent lâexpĂ©rience soit des chercheurs ou des patients partenaires, mais rarement celles des deux perspectives mises en commun. Objectif : Cet article a pour objectif dâenrichir la littĂ©rature sur la RAP et de fournir des exemples dâactivitĂ©s quotidiennes avant, pendant et aprĂšs la RAP. MĂ©thodes : En nous basant sur les 4 principes de la RAP des Instituts de recherche en santĂ© du Canada, nous prĂ©sentons les stratĂ©gies « pas Ă pas » utilisĂ©es pendant notre projet de recherche. Nous fournissons Ă©galement des exemples et des astuces partagĂ©es par les patients partenaires et les chercheurs. Discussion et conclusion : Afin dâengager positivement notre Ă©quipe dans une dĂ©marche de RAP, nous avons retenu 3 Ă©tapes qui nous ont permis de dĂ©gager 3 leçons de cette expĂ©rience. PremiĂšrement, il est nĂ©cessaire dâadapter les formations portant sur la RAP selon les publics concernĂ©s dans le projet de recherche. Ensuite, les chercheurs doivent faire preuve dâhumilitĂ© et dâouverture dâesprit pour reconnaitre les expĂ©riences variĂ©es. Puis, la contribution des patients partenaires doit ĂȘtre reconnue incluant la normalisation dâune rĂ©tribution financiĂšre pour leur travail effectuĂ©. Les rĂ©flexions apportĂ©es dans cet article aideront, nous lâespĂ©rons, des Ă©quipes de recherche Ă construire leur RAP en bĂ©nĂ©ficiant des expĂ©riences comme celle que nous rapportons
Traduction et adaptation en langue française du Lasater Clinical Judgment Rubric: Une étude multicentrique
Résumé
Contexte : Les infirmiÚres nouvellement diplÎmées ont souvent un niveau insuffisant de jugement clinique pour le contexte de soins aigus et critiques lorsqu\u27elles commencent leur pratique. Faciliter le développement du jugement clinique pendant leur formation est essentiel.
But de lâĂ©tude : Produire un instrument en langue française, fondĂ© sur les rĂ©sultats de la traduction et de la validation dans diffĂ©rentes rĂ©gions de la francophonie dâun instrument existant, permettant dâapprĂ©cier le dĂ©veloppement du jugement clinique.
MĂ©thode : Ătude multicentrique internationale. Traduction et validation transculturelle en cinq Ă©tapes : 1. sĂ©lection dâun instrument valide et fidĂšle en langue anglaise; 2. traduction inversĂ©e; 3. rĂ©vision en comitĂ© de lâinstrument traduit; 4. prĂ©test de l\u27instrument traduit; 5. Ă©tude de fidĂ©litĂ© test-retest.
RĂ©sultats : Le Lasater Clinical Judgment RubricÂź sâest avĂ©rĂ© un instrument pertinent pour rendre compte du dĂ©veloppement du jugement clinique tant grĂące au modĂšle conceptuel sur lequel il sâappuie que par ses qualitĂ©s mĂ©trologiques. Des participantes du QuĂ©bec, de lâOntario, du Manitoba, du Nouveau-Brunswick, de la Suisse, de la France et de la Belgique ont participĂ© au prĂ©test (n = 16) et au test-retest (n = 35). Parmi les termes plus difficiles Ă traduire et Ă adapter culturellement notons expected patterns, patterns in data, being skillful, prompting et commitment. Les coefficients alpha de Cronbach Ă©taient tous au-dessus de α = ,84 et les coefficients de corrĂ©lation intra-classe du test retest Ă©taient tous supĂ©rieurs Ă ,81.
Conclusions : La diversité et la complexité des situations cliniques demandent aux nouvelles infirmiÚres en pratique professionnelle des compétences largement développées. La version française de la grille de jugement clinique élaborée par Lasater (LCJR-VF) définit la trajectoire du développement du jugement clinique et décrit en termes concrets le modÚle de Tanner. Cette grille facilite la communication et la compréhension de ce qui est attendu des étudiantes en termes de performance. La rubrique peut servir de guide au débriefing, à la rétroaction et à la réflexion quand elle est utilisée dans le cadre de la simulation clinique.
Abstract
Background: The clinical judgment of nursing graduates who begin practising is rarely fully adequate in situations requiring acute and critical care. Facilitating their clinical judgment development while they are learning is thus essential.
Study objective: To produce a French-language version of an existing instrument for assessing the development of clinical judgment, based on translation and validation efforts in various French-speaking regions.
Method: International multicentre study. Five-step transcultural translation and validation process: (1) selection of a valid and reliable English-language instrument; (2) reverse translation; (3) committee review of the translated instrument; (4) pre-testing of the translated instrument; and (5) test-retest reliability study.
Results: The Lasater Clinical Judgment RubricÂź has proven to be an apt instrument for reporting on the development of clinical judgment thanks both to its conceptual model and its metrological characteristics. Participants from QuĂ©bec, Ontario, Manitoba, New Brunswick, Switzerland, France, and Belgium took part in the pre-testing (n=16) and test-retest (n=35) phases. The terms that proved most difficult to translate included expected patterns, patterns in data, being skillful, prompting, and commitment. Cronbachâs alpha coefficients were all greater than 0.84. In addition, all test-retest intraclass correlation coefficients were above 0.81.
Conclusions: New nurses in professional practice need to have well-developed capabilities to manage the diversity and complexity of clinical situations. The French-language version of the Lasater Clinical Judgment Rubric defines the trajectory of clinical judgment development and describes the Tanner Model in concrete terms; it also facilitates communication and understanding of expectations for student performance. In clinical simulations, the Rubric may be used as a guide for debriefing, providing feedback, and encouraging reflective practice