Les stratégies déployées par les individus atteints de schizophrénie expérimentant le phénomène d'audition des voix

Le présent mémoire représente le troisième volet d’une étude dirigée par Myreille St-Onge, financée par le CRSH, qui a pour objectif de mieux comprendre les facteurs qui entrent en jeu dans le phénomène des hallucinations auditives chez des personnes atteintes de schizophrénie, selon des variables personnelles et environnementales. Plus précisément, il s’intéresse aux stratégies déployées par les entendeurs de voix relativement à leurs perceptions auditives et vise à décrire les stratégies et autres facteurs qui semblent favoriser l’adaptation aux voix. Pour ce faire, deux groupes de discussions ont été tenus auprès de huit participants. Les résultats obtenus révèlent notamment que plusieurs caractéristiques communes sont présentes chez les participants qui composent plus efficacement avec leurs voix. De la même façon, nous observons que plusieurs stratégies apparaissent comme plus efficaces en ce qui a trait à l'adaptation aux voix et qu’il est prometteur d'intervenir sur certaines variables relatives aux croyances.This research is part of a larger study led by Myreille St-Onge and funded by the SSRHRC, which aims to better understand the personal and environmental factors who are linked tho the hearing voices phenomenon. More specifically, this present masters’thesis focuses on the strategies deployed by individuals to cope with disturbing voices. In fact, the aim of this research is to describe the strategies and others factors who seem to yield to effective results. Two focus groups were held with eight participants. A double perspective analysis was realized to respond to our objectives. First, a comparison between participants who show a greater capacity to cope (group A) and those experiencing difficulties to cope (group B) with their voices was done. Secondly, this analysis focusses on the cognitive ABC model. The results suggest that participants of group A have several characteristics in common. We also observe that certain strategies appear to lead to more effective results. In addition, the analysis based on ABC model reveals that it is promising to intervene on the beliefs’system of people hearing voices. A presentation of participants recomands intended to other voices hearers, relatives and professionals working with them as well as social mesures suggestions end this descriptive study

Sexual and relationship intimacy among women with provoked vestibulodynia and their partners : associations with sexual satisfaction, sexual function, and pain self-efficacy

Introduction Provoked vestibulodynia (PVD) is the most frequent subtype of vulvodynia. Women report negative consequences of PVD on their sexual and romantic relationships. Researchers have recently highlighted the importance of examining interpersonal factors such as intimacy, and of including both women and their partners in study designs. Aim The aim of this study was to investigate sexual and relationship intimacy as defined by the Interpersonal Process Model of Intimacy and their associations with sexual satisfaction, sexual function, pain self-efficacy, and pain intensity among women with PVD and their partners. Methods Ninety-one heterosexual women (M age = 27.38, SD = 6.04) diagnosed with PVD and their partners (M age = 29.37, SD = 7.79) completed measures of sexual and relationship intimacy, sexual satisfaction, sexual function, pain self-efficacy, and pain intensity. Main Outcome Measures Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; (iii) Painful Intercourse Self-Efficacy Scale; and (iv) visual analog scale of pain intensity during intercourse. Results After controlling for women's age, women's greater sexual intimacy (β = 0.49, P < 0.001) was associated with women's greater sexual satisfaction and higher pain self-efficacy (β = 0.39, P = 0.001), beyond the effects of partners’ sexual intimacy. Also, women's greater sexual intimacy (β = 0.24, P = 0.05) and women's greater relationship intimacy (β = 0.54, P = 0.003) were associated with greater women's sexual function, beyond the effects of partners’ sexual and relationship intimacy. Conclusions Women's self-reported sexual and relationship intimacy in the couple relationship may promote higher sexual satisfaction, sexual function, and pain self-efficacy, as well as possibly foster greater sexual well-being among women with PVD. The authors discuss implications for the inclusion of emotional and interpersonal aspects of the couple's dynamic in clinical interventions and future research in PVD

Association between interpersonal continuity of care and medication adherence in type 2 diabetes : an observational cohort study

Background: Prior studies have shown that, compared to patients with a low level of interpersonal continuity of care, patients with a high level of continuity of care have a lower likelihood of hospital admission and emergency department visits, and a higher likelihood of patient satisfaction. We sought to determine whether higher levels of continuity of care are associated with medication persistence and compliance among new users of oral antidiabetic treatment. Methods: We conducted a medicoadministrative cohort study of new users of oral antidiabetics aged 18 years or more among people covered by the Quebec public drug plan. We excluded people with fewer than 730 days of treatment and those who had been in hospital for 275 days or more in the first or second year after initiation of antidiabetic treatment. We categorized continuity of care observed in the first year after treatment initiation as low, intermediate or high. The association between continuity of care and medication persistence and compliance was assessed using generalized linear models. Results: In this cohort of 60 924 new users of oral antidiabetic treatment, compared to patients with a high level of continuity of care, those with an intermediate and a low level of continuity of care were less likely to be persistent (adjusted prevalence ratio 0.97 [95% confidence interval (CI) 0.96-0.98] and 0.96 [95% CI 0.95-0.97], respectively) and compliant (adjusted prevalence ratio 0.98 [95% CI 0.97-0.99] and 0.95 [0.94-0.97], respectively) with their antidiabetic treatment. Interpretation: A higher level of interpersonal continuity of care was associated with a higher likelihood of drug persistence and compliance. Since the strength of this association was weak, further research is required to determine whether continuity of care plays a role in medication adherence

Patients’ beliefs about adherence to oral antidiabetic treatment : a qualitative study

Purpose: The purpose of this study was to elicit patients’ beliefs about taking their oral antidiabetic drugs (OADs) as prescribed to inform the development of sound adherence-enhancing interventions. Methods: A qualitative study was performed. Adults with type 2 diabetes who had been taking an OAD for >3 months were solicited to participate in one of six focus groups. Discussions were facilitated using a structured guide designed to gather beliefs related to important constructs of the theory of planned behavior. Four coders using this theory as the theoretical framework analyzed the videotaped discussions. Results: Forty-five adults participated. The most frequently mentioned advantages for OAD-taking as prescribed were to avoid long-term complications and to control glycemia. Family members were perceived as positively influential. Carrying the OAD at all times, having the OAD in sight, and having a routine were important facilitating factors. Being away from home, not accepting the disease, and not having confidence in the physician’s prescription were major barriers to OAD-taking. Conclusion: This study elicited several beliefs regarding OAD-taking behavior. Awareness of these beliefs may help clinicians adjust their interventions in view of their patients’ beliefs. Moreover, this knowledge is crucial to the planning, development, and evaluation of interventions that aim to improve medication adherence

Revisiting the internal consistency and factorial validity of the 8-item Morisky Medication Adherence Scale

Objective: To assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment.Study Design and Setting: In a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach’s alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses.Results: A total of 901 individuals completed the survey. Cronbach’s alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before). The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item.Conclusion: Cronbach’s alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor) and unintentional (second factor) non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scale

Tunable distributed sensing performance in Ca-based nanoparticle-doped optical fibers

Rayleigh scattering enhanced nanoparticle-doped optical fibers is a technology very promising for distributed sensing applications, however, it remains largely unexplored. This work demonstrates for the first time the possibility of tuning Rayleigh scattering and optical losses in Ca-based nanoparticle-doped silica optical fibers by controlling the kinetics of the re-nucleation process that nanoparticles undergo during fiber drawing by controlling preform feed, drawing speed and temperature. A 3D study by SEM, FIB-SEM and optical backscatter reflectometry (OBR) reveals an early-time kinetics at 1870 °C, with tunable Rayleigh scattering enhancement 43.2–47.4 dB, regarding a long-haul single mode fiber, SMF-28, and associated sensing lengths of 3–5.5 m. At 2065 °C, kinetics is slower and nanoparticle dissolution is favored. Consequently, enhanced scattering values of 24.9–26.9 dB/m and sensing lengths of 135–250 m are attained. Finally, thermal stability above 500 °C and tunable distributed temperature sensitivity are proved, from 18.6 pm/°C to 23.9 pm/°C, ∼1.9–2.4 times larger than in a SMF-28. These results show the promising future of Rayleigh scattering enhanced nanoparticle-doped optical fibers for distributed sensing

Nouvelles données sur l’assemblage lithique de la couche L2/3 de La Micoque (Les Eyzies-de-Tayac, Dordogne, France)

Le gisement de La Micoque (Les Eyzies-de-Tayac, Dordogne), s’il est surtout connu comme éponyme des techno-complexes micoquiens et tayaciens, a également livré des niveaux attribuables aux premières phases du Paléolithique moyen en Périgord. Au sein de cette riche séquence, la couche L2/3, corrélée au MIS 10 et caractérisée par F. Bordes comme de l’Acheuléen méridional, livre une industrie orientée quasi exclusivement vers la production d’éclats. D’après l’étude technologique, plusieurs chaînes opératoires de production d’éclats ont ainsi pu être identifiées, simples ou ramifiées. Une production originale de supports allongés à dos et à tranchants linéaires coexiste avec des productions diversifiées issues de débitages sur éclat et de débitages Levallois. Le façonnage est très peu utilisé avec une seule pièce bifaciale. Les produits retouchés montrent une recherche de tranchants linéaires à l’instar de la production brute dominante, tandis que les contacts punctiformes sont rares.L’assemblage lithique de la couche L2/3 nous permet ainsi de renseigner une autre facette de la variabilité inhérente à ces sites du Paléolithique moyen ancien.The site of La Micoque (Les Eyzies-de-Tayac, Dordogne), is known as the Micoquian and the Tayacien techno-complexes’s type site. The site also yielded levels from the early Middle Palaeolithic in the Perigord. In this rich sequence, the layer L2/3, correlated to MIS 10 and described by F. Bordes as a Southern Acheulean, yielded an industry almost exclusively turned towards the production of flakes.Following the technological analysis, several reduction strategies of productions of flakes have been identified among the core technology processes, unique of ramified. An original production of elongated backed blanks and products with linear cutting edges coexists with diversified core technologies such as cores on flakes or Levallois cores. The shaping is rare with only one bifacial tool. A search of linear edges is highlighted by the study of retouched flakes, as in the main production. The point-like edges are rare. The lithic assemblage of the layer L2/3 allows us describing another aspect of the inherent variability the early Middle Paleolithic in Western Europe

Nouvelles données sur l’assemblage lithique de la couche L2/3 de la Micoque (Les Eyzies-de-Tayac, Dordogne). PALEO Revue d'archéologie préhistorique

International audienc

Patient perspectives on the role of community pharmacists for antidepressant treatment : a qualitative study

Objectives : Patients prescribed antidepressant drug treatment (ADT) for major depression report several needs in relation to their treatment, and a large proportion of these patients will end ADT prematurely. Community pharmacists may play an important role in monitoring ADT and supporting these patients. However, little is known about patient experiences of the services provided in community pharmacies. The objectives of this study were to 1) explore patients’ experiences with the services community pharmacists provide for ADT and 2) identify potential avenues for improvement of pharmacists’ services within the context of ADT. Methods : A qualitative descriptive exploratory study was conducted among individuals diagnosed with major depression who had initiated ADT at some point in the 12 months prior to their participation in the study. A total of 14 persons recruited in a local health centre and a community-based organization participated in individual interviews. A thematic analysis of the interview transcripts was conducted. Results : Pharmacists tend to concentrate their involvement in treatment at initiation and at the first refill when questions, uncertainties and side effects are major issues. Patients felt that the pharmacists’ contributions consisted of providing information and reassurance; in these respects, their needs were met. Participants had few ideas as to what additional services pharmacists could implement to improve patients’ experience with ADT. Patients’ sole expectations were that pharmacists extend this information role to the whole length of the treatment and enhance the confidentiality of discussions in pharmacy. Conclusion : Pharmacists should provide counselling throughout the entire treatment rather than passively waiting for patients to ask their questions. However, facilitation of open discussions may not be achieved unless confidentiality at pharmacies is secured

Predicting noninsulin antidiabetic drug adherence using a theoretical framework based on the theory of planned behavior in adults with type 2 Diabetes a prospective study

Understanding the process behind noninsulin antidiabetic drug (NIAD) nonadherence is necessary for designing effective interventions to resolve this problem. This study aimed to explore the ability of the theory of planned behavior (TPB), which is known as a good predictor of behaviors, to predict the future NIAD adherence in adults with type 2 diabetes. We conducted a prospective study of adults with type 2 diabetes. They completed a questionnaire on TPB variables and external variables. Linear regression was used to explore the TPB's ability to predict future NIAD adherence, which was prospectively measured as the proportion of days covered by at least 1 NIAD using pharmacy claims data. The interaction between past NIAD adherence and intention was tested. The sample included 340 people. There was an interaction between past NIAD adherence and intention to adhere to the NIAD (P = 0.032). Intention did not predict future NIAD adherence in the past adherers and nonadherers groups, but its association measure was high among past nonadherers (β = 5.686, 95% confidence interval [CI] -10.174, 21.546). In contrast, intention was mainly predicted by perceived behavioral control both in the past adherers (β = 0.900, 95% CI 0.796, 1.004) and nonadherers groups (β = 0.760, 95% CI 0.555, 0.966). The present study suggests that TPB is a good tool to predict intention to adhere and future NIAD adherence. However, there was a gap between intention to adhere and actual adherence to the NIAD, which is partly explained by the past adherence level in adults with type 2 diabetes