Interventions visant à améliorer l'engagement ludique dans les interactions sociales des enfants d'âge préscolaire présentant un Trouble du Spectre Autistique (TSA) : une "scoping study"

Les enfants d'âge préscolaire présentant d'un Trouble du Spectre Autistique (TSA) éprouvent des difficultés importantes dans le jeu. L’engagement ludique dans les interactions sociales est un objectif important pour les ergothérapeutes, car il est considéré comme la fondation au jeu social. Toutefois, les interventions permettant d’améliorer cette compétence ne sont pas encore bien connues. Ce mémoire présente les résultats d'un exercice de clarification conceptuelle dans lequel plusieurs comportements clés associés au construit d’engagement ludique chez les enfants d'âge préscolaire atteints de TSA ont été identifiés, ainsi que les résultats d'une étude exploratoire de type scoping study qui a révélé un nombre considérable de stratégies et d’approches d'intervention cohérentes avec la promotion de l'engagement ludique. Ces résultats fournissent des orientations spécifiques aux ergothérapeutes et aux parents pour favoriser les interactions sociales significatives en bas âge de ces enfants au quotidien. Plusieurs pistes de recherche sont également présentées.Preschool-aged children with Autism Spectrum Disorder (ASD) experience significant difficulties engaging in meaningful play. Enabling their playful engagement in social interactions, the foundation of social play, is an important objective for occupational therapists. However, little is known about which interventions promote this competency. This thesis presents the results of a conceptual clarification exercise in which several key behaviors associated with the construct of playful engagement in preschool-aged children with ASD were identified, plus the results of a scoping study which revealed a considerable number and variety of strategies as well as intervention approaches that are coherent with the promotion of playful engagement. These results provide specific guidance to occupational therapists about how to promote the meaningful social interactions of young children with ASD and provide different strategies that may be embedded by parents in their daily interactions with their children. Several directions for future research are presented

Convulsed in desperate living : ghetto criminality and the economy of survival in the Harlem narratives of Chester Himes, Claude Brown and Louise Meriwether

In the 1960s and early 1970s, the radicalism of African-American leaders such as Malcolm X, George Jackson and Eldridge Cleaver found expression in polemical writings that targeted, in their critique of established white power structures, the American judicial and penal system. Drawing their rhetorical power from the authors' direct experience of ghetto criminality, and from their encounters with the machinery of "criminal justice," the protest writings of outspoken activists and prisoners have shaped critical perceptions of African-American narrative discourse of this period. While critics have expected to find, in African-American novels of the 1960s and 1970s, a deep current of radicalism, and a clear commitment to identifiable models of resistance, the Harlem narratives of Chester Himes, Claude Brown and Louise Meriwether temper such assumptions by engaging in representations of the ghetto and the criminalized subject that do not posit an empowering movement from "desperate living" to political astuteness and radical action. Instead, Himes's Blind Man With a Pistol (1969), Brown's Manchild in the Promised Land (1965) and Meriwether's Daddy Was a Number Runner (1970) complicate an understanding of African-American critiques of racial politics by participating in a discourse that refuses to perform the gestures of enlightened protest. These texts point to the conditions of survival in a space governed by the predatory economy of widespread criminality--conditions that deny the relevance of a rhetoric of resistance and compel ghetto-dwellers to resign themselves to a numbing, unalterable state of affairs

Low-Income, Single-Parent Francophone Mothers and the Educational Achievement of Their Children

This phenomenological study focused on single-parent, low-income francophonemothers’ relationships with the educational and cultural achievement of their children attending French-speaking schools in Anglo-dominant settings in New Brunswick (Canada). We conducted individual (N = 8) semi-structured interviews to solicit information about the participants’ lived world through their articulated voices and experiences. Qualitative data were analyzed using Giorgi’s descriptive phenomenological approach. Four themes emerged: parenting and financial difficulties; mother’s level of education and their involvement in their children’s education; relationship with their children’s school; and parental role in enhancing language acquisition and building cultural identity. Findings revealed that single-parent, low-income francophone mothers need help with parenting skills as they pertain to improving their children’s education achievements. We concluded that the New Brunswick government needs to (a) respect its mandate to ensure that the education system teaches and provides opportunities for building a francophone identity, and (b) respect its pledge to make certain that every child arrives at kindergarten ready to learn, particularly to single-parent women living in poverty, who have limited financial resources

L'apport de Prudence Heward, Lilias Torrance Newton et Jori Smith à l'élaboration de la modernité picturale canadienne : 1920-1948

Dans la continuité des ouvrages publiés durant les dernières années sur l'art moderne et sur les femmes artistes, le présent mémoire s'attarde sur la participation de Prudence Heward, de Lilias Torrance Newton et de Jori Smith au développement de la modernité picturale canadienne. C'est plus précisément l'étude des portraits de femmes et d'enfants peints de 1920 à 1948 qui nous intéresse puisque la figure humaine, en plus de caractériser les productions de ces trois peintres, est l'un des thèmes privilégiés de la modernité canadienne naissante. C'est ainsi que nous tentons de démontrer que ces artistes, en plus d'intégrer les principes esthétiques modernes tels que les définit notamment l'historienne de l'art Esther Trépanier, expriment une vision à la fois intime et personnelle de la femme et de l'enfant. En premier lieu, il importe de définir ce qu'est la modernité picturale au Canada durant la période de l'entre-deux-guerres. En nous appuyant sur les recherches de Trépanier, nous différencions, tout comme la chercheuse, les modernités européenne et canadienne. Les approches historiographiques et historiques occupent donc une place importante dans la constitution de notre pensée. Toutefois, c'est l'analyse formelle qui permet de mesurer de manière adéquate la participation de Heward, de Torrance Newton et de Smith à l'élaboration de la modernité picturale. Ces analyses nous aident à comprendre, par exemple, l'influence cézannienne dans l'art des trois peintres, mais aussi de constater l'usage de teintes flamboyantes, de grands aplats de couleur et de la ligne contour, bref autant de caractéristiques des esthétiques modernes en vigueur au pays durant ces quelque vingt années. De même, nous observons que le trio d'artistes a posé un regard moderne sur le corps de la femme, entre autres en peignant à plusieurs reprises une personne confiante en elle-même et au caractère bien défini. Cependant, c'est principalement grâce au nu que Heward, Torrance Newton et Smith ont pu remettre en question la représentation de la femme en tant que sujet peint puisque les nombreuses figures dénudées qu'elles ont peintes défient souvent les conventions qui régissent le genre au Canada durant les années 1920 à 1940. Les trois peintres ne se sont toutefois pas limitées à peindre des femmes possédant un fort caractère. En effet, plusieurs de leurs portraits présentent aussi une femme ou un enfant témoignant d'une grande vulnérabilité ou d'une tristesse apparente. Autrement dit, les trois peintres présentent des portraits dits \ud « psychologiques » en usant de l'image de la femme et de l'enfant pour exprimer l'intime et le subjectif, deux notions importantes à la base même de la définition de l'art moderne canadien. ______________________________________________________________________________ MOTS-CLÉS DE L’AUTEUR : Modernité picturale, Figure humaine, Prudence Heward, Lilias Torrance Newton, Jori Smith

Validity and reliability of a brief selfreported questionnaire assessing fruit and vegetable consumption among pregnant women

Background: Short instruments measuring frequency of specific foods, such as fruit and vegetable (FV), are increasingly used in interventions. The objective of the study was to verify the validity and test-retest reliability of such an instrument among pregnant women. Methods: Pregnant women from the region of Quebec City, Quebec, Canada, were recruited through e-mails sent to female students and employees of the local university from October 2014 to April 2015. To assess the validity of the fruit and vegetable questionnaire (FVQ) developed by Godin et al. (Can J Public Health 99: 494-498, 2008), pregnant women were asked in a first mailing to complete the FVQ assessing FV intake over the past 7 days and a 3-day estimated food record. A subsample (n¿=¿33) also gave a fasting blood sample and completed a validated semi-quantitative FFQ administered by a trained registered dietitian during a visit at the research center. FV intakes for all instruments were calculated in terms of servings of FV based on Canada’s Food Guide definition of a serving of fruit or vegetable. In order to assess its test-retest reliability, respondents were asked to complete the FVQ 14 days later in a second mailing. Results: Forty-eight pregnant women from all three trimesters completed the questionnaires in the first mailing. FV intake assessed using the FVQ was correlated to FV consumption measured using the food record (r¿=¿0.34, p¿=¿0.0180) and the FFQ (r¿=¿0.61, p¿=¿0.0002). Results were similar when controlling for energy intake and the experience of nausea in the past month. Only ß-cryptoxanthin was significantly correlated to FV intake assessed by the FFQ when adjusted for the presence of nausea (r¿=¿0.35, p¿=¿0.0471). Data on the test-retest reliability was available for 44 women and the intra-class coefficient for the FVQ was 0.72 at a mean 28-day interval. Conclusions: The FVQ has acceptable validity and test-retest reliability values, but seems to underestimate FV servings in pregnant women. It represents an interesting alternative for researchers or clinicians interested in estimating quickly FV intake among pregnant women, such as in large trials or during prenatal visits. The FVQ should however be coupled with other self-reported measures, such as a food record, for assessing precise individual FV intake

La part de l’ironie et de la satire dans la promotion d’un artiste

À la fin des années 1940, Robert Roussil (1925-2013) est un artiste en début de carrière, peu connu du grand public. Cette situation change dès le 10 novembre 1949, lorsque La Famille (fig. 1), une sculpture de 318 cm de hauteur, taillée dans un pin et enduite de cire rouge, est saisie par des policiers après avoir été retrouvée de manière inusitée sur le terrain attenant au musée des Beaux-Arts de Montréal. L’institution n’avait pas commandé l’œuvre et ignorait qu’elle y serait livrée. La sc..

Anticipated regret to increase uptake of colorectal cancer screening (ARTICS):a randomised controlled trial

Objective. Screening is key to early detection of colorectal cancer. Our aim was to determine whether a simple anticipated regret (AR) intervention could increase colorectal cancer screening uptake. Methods. We conducted a randomised controlled trial of a simple, questionnaire-based AR intervention, delivered alongside existing pre-notification letters. 60,000 adults aged 50-74 from the Scottish National Screening programme were randomised to: 1) no questionnaire (control), 2) Health Locus of Control questionnaire (HLOC) or 3) HLOC plus anticipated regret questionnaire (AR). Primary outcome was guaiac Faecal Occult Blood Test (FOBT) return. Secondary outcomes included intention to return test kit and perceived disgust (ICK). Results. 59,366 people were analysed as allocated (Intentionto- treat (ITT)); there were no overall differences between treatment groups on FOBT uptake (control: 57.3%, HLOC: 56.9%, AR: 57.4%). 13,645 (34.2%) people returned questionnaires. Analysis of the secondary questionnaire measures showed that AR had an indirect effect on FOBT uptake via intention, whilst ICK had a direct effect on FOBT uptake over and above intention. The effect of AR on FOBT uptake was also moderated by intention strength: for less than strong intenders only, uptake was 4.2% higher in the AR (84.6%) versus the HLOC group (80.4%) (95% CI for difference (2.0, 6.5)). Conclusion. The findings show that psychological concepts including anticipated regret and perceived disgust (ICK) are important factors in determining FOBT uptake. However, there was no simple effect of the AR intervention in the ITT. We conclude that exposure to AR in those with low intentions may be required to increase FOBT uptake. Current controlled trials: www.controlledtrials. com number: ISRCTN74986452

Anticipated regret to increase uptake of colorectal cancer screening in Scotland (ARTICS): Study protocol for a randomised controlled trial

Background: Colorectal cancer is the second leading cause of cancer deaths in the UK. Screening is key to early detection. The Scottish programme of colorectal cancer screening is running successfully, and involves all adults aged between 50 and 74 years being invited to post back a faecal sample for testing every 2 years. However, screening uptake is sub-optimal: for example rates for the period November 2009 to October 2011 ranged from just 39% for males living in the most deprived areas to 67% for least deprived females. Recent research has shown that asking people to consider the emotional consequences of not participating in screening (anticipated regret) can lead to a significant increase in screening uptake. Methods/Design: We will test a simple anticipated regret manipulation, in a large randomised controlled trial with 60,000 members of the general public. They will be randomly allocated to one of 3 arms, no questionnaire, control questionnaire or anticipated regret questionnaire. The primary outcome will be screening test kit return. Results will also be examined by demographic variables (age, gender, deprivation) as these are currently related to screening kit return. Discussion: If this anticipated regret intervention leads to a significant increase in colorectal cancer screening kit returns, this would represent a rare example of a theoretically-driven, simple intervention that could result in earlier detection of colorectal cancer and many more lives saved. Trial registration: Current Controlled trials: ISRCTN7498645

Bcl-2–Modifying Factor Induces Renal Proximal Tubular Cell Apoptosis in Diabetic Mice

This study investigated the mechanisms underlying tubular apoptosis in diabetes by identifying proapoptotic genes that are differentially upregulated by reactive oxygen species in renal proximal tubular cells (RPTCs) in models of diabetes. Total RNAs isolated from renal proximal tubules (RPTs) of 20-week-old heterozygous db/m+, db/db, and db/db catalase (CAT)-transgenic (Tg) mice were used for DNA chip microarray analysis. Real-time quantitative PCR assays, immunohistochemistry, and mice rendered diabetic with streptozotocin were used to validate the proapoptotic gene expression in RPTs. Cultured rat RPTCs were used to confirm the apoptotic activity and regulation of proapoptotic gene expression. Additionally, studies in kidney tissues from patients with and without diabetes were used to confirm enhanced proapoptotic gene expression in RPTs. Bcl-2–modifying factor (Bmf) was differentially upregulated (P < 0.01) in RPTs of db/db mice compared with db/m+ and db/db CAT-Tg mice and in RPTs of streptozotocin-induced diabetic mice in which insulin reversed this finding. In vitro, Bmf cDNA overexpression in rat RPTCs coimmunoprecipated with Bcl-2, enhanced caspase-3 activity, and promoted apoptosis. High glucose (25 mmol/L) induced Bmf mRNA expression in RPTCs, whereas rotenone, catalase, diphenylene iodinium, and apocynin decreased it. Knockdown of Bmf with small interfering RNA reduced high glucose–induced apoptosis in RPTCs. More important, enhanced Bmf expression was detected in RPTs of kidneys from patients with diabetes. These data demonstrate differential upregulation of Bmf in diabetic RPTs and suggest a potential role for Bmf in regulating RPTC apoptosis and tubular atrophy in diabetes

Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science

Abstract Background Many interventions found to be effective in health services research studies fail to translate into meaningful patient care outcomes across multiple contexts. Health services researchers recognize the need to evaluate not only summative outcomes but also formative outcomes to assess the extent to which implementation is effective in a specific setting, prolongs sustainability, and promotes dissemination into other settings. Many implementation theories have been published to help promote effective implementation. However, they overlap considerably in the constructs included in individual theories, and a comparison of theories reveals that each is missing important constructs included in other theories. In addition, terminology and definitions are not consistent across theories. We describe the Consolidated Framework For Implementation Research (CFIR) that offers an overarching typology to promote implementation theory development and verification about what works where and why across multiple contexts. Methods We used a snowball sampling approach to identify published theories that were evaluated to identify constructs based on strength of conceptual or empirical support for influence on implementation, consistency in definitions, alignment with our own findings, and potential for measurement. We combined constructs across published theories that had different labels but were redundant or overlapping in definition, and we parsed apart constructs that conflated underlying concepts. Results The CFIR is composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Eight constructs were identified related to the intervention (e.g., evidence strength and quality), four constructs were identified related to outer setting (e.g., patient needs and resources), 12 constructs were identified related to inner setting (e.g., culture, leadership engagement), five constructs were identified related to individual characteristics, and eight constructs were identified related to process (e.g., plan, evaluate, and reflect). We present explicit definitions for each construct. Conclusion The CFIR provides a pragmatic structure for approaching complex, interacting, multi-level, and transient states of constructs in the real world by embracing, consolidating, and unifying key constructs from published implementation theories. It can be used to guide formative evaluations and build the implementation knowledge base across multiple studies and settings.http://deepblue.lib.umich.edu/bitstream/2027.42/78272/1/1748-5908-4-50.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/2/1748-5908-4-50-S1.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/3/1748-5908-4-50-S3.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/4/1748-5908-4-50-S4.PDFhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/5/1748-5908-4-50.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78272/6/1748-5908-4-50-S2.PDFPeer Reviewe