The Transfer of Problem-Based Learning Skills to Clinical Practice

The purpose of this article is to present and discuss the reported impact of a fully problem-based learning (PBL) master’s program on the way graduates worked with patients and colleagues in Ireland. These graduates had completed a sixteen-month fully PBL master’s in sonography while concurrently working in clinical practice. Semi-structured telephone interviews were used to collect qualitative data from graduates of the PBL program. PBL graduates reported four notable changes in their approach to clinical practice following the PBL MSc ultrasound program: (1) thinking more before, during, and after clinical practice; (2) more effective communication with patients; (3) improved communication with colleagues; and (4) an increase in proactivity in clinical practice. The transfer of skills developed during the PBL program, as reported by sonography graduates, led to the development of more patient-centered, evidence-based, proactive clinical practice

La promotion de la santé mentale des pères durant la période périnatale: travail de Bachelor

Introduction: Depuis 2015, l’Organisation mondiale de la santé [OMS] appelle les Sages-femmes* à inclure les pères dans les services de périnatalité pour améliorer la santé des mères et des enfants. Cependant, selon les recherches récentes près d’un père sur dix souffrirait de dépression périnatale [DPN] avec des répercussions négatives sur toute la famille notamment le développement des enfants. Objectif : Explorer les facteurs protecteurs de la santé mentale des pères et le rôle que pourraient avoir les sages-femmes auprès des pères. Méthode : Ce travail est une revue de la littérature scientifique limitée à 5 articles recueillis dans les bases de données Medline, PsycINFO, CINAHL, MIDIRS et le moteur de recherche Google Scholar grâce à des mots6clés tels que « fathers », « mental health » et « midwives » avec un filtre incluant les publications du 1.01.2004 au 15.01.2018. Résultats : Selon les études, les pères ont besoin de soutien émotionnel et informatif pour assurer leur bien6être psychique durant la période périnatale. Le bien-être de la partenaire, la satisfaction dans le couple, le sentiment de cohérence familiale et le sentiment d’auto6efficacité parentale seraient des facteurs protecteurs de la DPN. Les pères expriment un sentiment d’exclusion des services de périnatalité et un manque de reconnaissance dans leur rôle de coparent. Ils questionnent leur légitimité à y être inclus craignant le regard de la société et d’ôter des ressources à la mère et l’enfant. Les sages6femmes ont besoin de formations complémentaires et ne semblent pas être l’interlocuteur privilégié, cependant elles peuvent avoir un impact favorable. Les pères se disent intéressés par de l’information sur différents supports et des services de périnatalité plus flexibles. Limites : La santé mentale des pères est un objet de recherche récent et les publications peu nombreuses limitent la comparaison des résultats. De plus, la paternité évoluant rapidement socialement, cette revue de la littérature devrait être mise à jour régulièrement. Conclusion : Ces résultats invitent les sages-femmes à réfléchir à la place accordée aux pères dans les services de périnatalité, la formation des sages6 femmes et les programmes à destination des parents. Des interventions favorisant le bien être des partenaires, la qualité de la relation de couple, le sentiment de cohérence familial et le sentiment d’auto-efficacité parentale des pères pourraient être mises en place. *Bien qu'il s'entende aussi au masculin, le terme sage-femme est employé au féminin par mesure de simplification

Burden of Self-reported Acute Gastrointestinal Illness in Cuba

Acute gastrointestinal illness is an important public-health issue worldwide. Burden-of-illness studies have not previously been conducted in Cuba. The objective of the study was to determine the magnitude, distribution, and burden of self-reported acute gastrointestinal illness in Cuba. A retrospective, cross-sectional survey was conducted in three sentinel sites during June-July 2005 (rainy season) and during November 2005–January 2006 (dry season). Households were randomly selected from a list maintained by the medical offices in each site. One individual per household was selected to complete a questionnaire in a face-to-face interview. The case definition was three or more bouts of loose stools in a 24-hour period within the last 30 days. In total, 97.3% of 6,576 interviews were completed. The overall prevalence of acute gastrointestinal illness was 10.6%. The risk of acute gastrointestinal illness was higher during the rainy season (odds ratio [OR]=3.85, 95% confidence interval [CI] 3.18-4.66) in children (OR=3.12, 95% CI 2.24-4.36) and teens (OR=2.27, 95% CI 1.51-3.41) compared to people aged 25-54 years, in males (OR=1.24, 95% CI 1.04-1.47), and in the municipality of Santiago de Cuba (OR=1.33, 95% CI 1.11-1.61). Of 680 cases, 17.1-38.1% visited a physician, depending on sentinel site. Of the cases who visited a physician, 33.3-53.9% were requested to submit a stool sample, and of those, 72.7-100.0% complied. Of the cases who sought medical care, 16.7- 61.5% and 0-31.6% were treated with antidiarrhoeals and antibiotics respectively. Acute gastrointestinal illness represented a substantial burden of health compared to developed countries. Targeting the identified risk factors when allocating resources for education, food safety, and infrastructure might lower the morbidity associated with acute gastrointestinal illness

Test de la vraisemblance entre deux motifs de points

Test de la vraisemblance entre deux motifs de point

Prevalence of SOS-mediated control of integron integrase expression as an adaptive trait of chromosomal and mobile integrons

Background: Integrons are found in hundreds of environmental bacterial species, but are mainly known as the agents responsible for the capture and spread of antibiotic-resistance determinants between Gram-negative pathogens. The SOS response is a regulatory network under control of the repressor protein LexA targeted at addressing DNA damage, thus promoting genetic variation in times of stress. We recently reported a direct link between the SOS response and the expression of integron integrases in Vibrio cholerae and a plasmid-borne class 1 mobile integron. SOS regulation enhances cassette swapping and capture in stressful conditions, while freezing the integron in steady environments. We conducted a systematic study of available integron integrase promoter sequences to analyze the extent of this relationship across the Bacteria domain. Results: Our results showed that LexA controls the expression of a large fraction of integron integrases by binding to Escherichia coli-like LexA binding sites. In addition, the results provide experimental validation of LexA control of the integrase gene for another Vibrio chromosomal integron and for a multiresistance plasmid harboring two integrons. There was a significant correlation between lack of LexA control and predicted inactivation of integrase genes, even though experimental evidence also indicates that LexA regulation may be lost to enhance expression of integron cassettes. Conclusions: Ancestral-state reconstruction on an integron integrase phylogeny led us to conclude that the ancestral integron was already regulated by LexA. The data also indicated that SOS regulation has been actively preserved in mobile integrons and large chromosomal integrons, suggesting that unregulated integrase activity is selected against. Nonetheless, additional adaptations have probably arisen to cope with unregulated integrase activity. Identifying them may be fundamental in deciphering the uneven distribution of integrons in the Bacteria domain

The SOS response controls integron recombination

Integrons are found in the genome of hundreds of environmental bacteria but are mainly known for their role in the capture and spread of antibiotic resistance determinants among Gram-negative pathogens. We report a direct link between this system and the ubiquitous SOS response. We found that LexA controlled expression of most integron integrases and consequently regulated cassette recombination. This regulatory coupling enhanced the potential for cassette swapping and capture in cells under stress, while minimizing cassette rearrangements or loss in constant environments. This finding exposes integrons as integrated adaptive systems and has implications for antibiotic treatment policie

Late vaccination reinforcement during a measles epidemic in Niamey, Niger (2003-2004).

Low measles vaccination coverage (VC) leads to recurrent epidemics in many African countries. We describe VC before and after late reinforcement of vaccination activities during a measles epidemic in Niamey, Niger (2003-2004) assessed by Lot Quality Assurance Sampling (LQAS). Neighborhoods of Niamey were grouped into 46 lots based on geographic proximity and population homogeneity. Before reinforcement activities, 96% of lots had a VC below 70%. After reinforcement, this proportion fell to 78%. During the intervention 50% of children who had no previous record of measles vaccination received their first dose (vaccination card or parental recall). Our results highlight the benefits and limitations of vaccine reinforcement activities performed late in the epidemic

Assessing Antimalarial Efficacy in a Time of Change to Artemisinin-Based Combination Therapies: The Role of Médecins Sans Frontières

Jean-Paul Guthmann and colleagues describe the output of MSF's work in antimalarial efficacy assessment during the last decade

European collaborative efforts to achieve effective, safe, and cost-controlled dismantling of nuclear facilities

This paper aims to give an overview of very recent European coordinate efforts to implement technologies of the “4.0 Industry” in the nuclear deconstruction sector. This objective aims to benefit from the lever of efficiency and reliability represented by innovative technologies on all the value chain of the dismantling, from early characterization to the dismantling operations themselves through engineering studies, waste management, project management and coordination of multiple stakeholders of each project. The outcomes of five projects (INNO4GRAPH, LD-SAFE, PLEIADES, CLEANDEM and INSIDER) are summarized here. They result in a unique data and knowledge common base, as well as in a significant sharing of experience based on dismantling projects already carried out or to come. They also result in designing new tools or methods natively taking into account the needs of a maximum of dismantling operators, as well as new test facilities. This will allow the undertaken joint work and collaboration to be continued. All of this paves the way to further collaborative projects and developments, in order to continue to implement reliable new technologies and processes in European dismantling projects to make future dismantling operations more efficient, safer and more cost-effective