Utilisation des services par les personnes fréquentant les ressources pour personnes itinérantes de Montréal et de Québec, et atteintes de troubles concomitants de santé mentale et de toxicomanie

Contexte : Depuis les années 1990, le Québec vit une vague de désinstitutionnalisation et crée des ressources plus intégrées pour les personnes ayant des troubles concomitants de santé mentale et de toxicomanie. Or, aucune étude au Québec n’a précisé l’utilisation des services par les personnes itinérantes atteintes de troubles concomitants, qui éprouvent plusieurs difficultés à recevoir des services. Objectif : Décrire l’utilisation de services en santé mentale et en toxicomanie de personnes fréquentant les ressources pour personnes itinérantes. Méthode : Les troubles de santé mentale, ceux liés aux substances et les troubles concomitants, et l’utilisation des services relativement à ces problèmes sont décrits à partir des données d’une enquête effectuée auprès de la clientèle utilisant des ressources pour personnes itinérantes de Montréal et de Québec (n=757). Résultats : Vingt-deux pour cent de la population qui utilise des ressources a éprouvé des troubles concomitants au cours d’une année. Ces personnes n’utilisent pas plus les services de santé mentale ou ceux liés à la toxicomanie que les personnes n’ayant que le type de problème en question, et ces taux d’utilisation de services sont très bas. Conclusion : Des pistes de solutions (logements supervisés, programmes PACT) sont suggérées et les efforts d’intégration doivent se continuer afin d’améliorer l’accessibilité aux soins de cette clientèle.Context: Since the 90’s, the province of Quebec pass through a deinstitutionalization process and integrated resources for people having concurrent mental health and drug related disorders were created. In Quebec, no study specified the utilization of services by homeless people with concurrent disorders, a population who face difficulties in receiving services. Objective: To describe utilization of mental health and substance related disorders services of clientele using resources intended for homeless people. Methods: This study uses data from a survey conducted on the clientele of resources for homeless persons in Montreal and Quebec city (n=757). Mental health problems, substance use disorders and concurrent disorders, as well as utilization of services related to these problems by clientele from resources for homeless people are presented. Results: Twenty-two percent of this population had concurrent disorders during a one-year period. They don’t use more mental health and substance related disorders services than those with a single problem and their utilization of these services is very low. Conclusion: Some suggestions are brought (supportive housing, PACT programs) and it is proposed to continue working on integration of services in order to improve accessibility for this clientele.Contexto: desde la década del 90 se produce en Quebec una ola de desinstitucionalización, acompañada por la creación de recursos más integrados para quienes padecen problemas concomitantes de salud mental y toxicomanía. Sin embargo, ningún estudio llevado a cabo en Quebec a precisado la utilización de los servicios por parte de los itinerantes que padecen problemas concomitantes y que experimentan diversas dificultades para recibir dichos servicios. Objetivo: describir el uso de los servicios de salud mental y toxicomanía por parte de quienes frecuentan los recursos para itinerantes. Método: los problemas de salud mental, aquéllos ligados al consumo de sustancias psicotrópicas y problemas concomitantes y la utilización de los servicios relacionados con estos problemas se describen a partir de datos de una investigación realizada con la clientela que utiliza los recursos para itinerantes en Montreal y en Quebec (n=757). Resultados: el veintidós por ciento de la población que utiliza estos recursos ha experimentado problemas concomitantes durante el curso de un año. Estas personas no utilizan los servicios de salud mental o relacionados con la toxicomanía más que las personas que tienen sólo el tipo de problema en cuestión, y el porcentaje de utilización de estos servicios es muy bajo. Conclusión: se sugieren soluciones posibles (departamentos en alquiler supervisados, programas PACT) y se señala que los esfuerzos de integración deben continuar con el objetivo de mejorar el acceso a los servicios por parte de esta clientela

Meilleures pratiques et formation dans le contexte du continuum des services en santé mentale et en toxicomanie : le programme de formation croisée du sud-ouest de Montréal

Cet article présente le programme de formation croisée du sud-ouest de Montréal. Les auteurs estiment que le contexte post-désinstitutionalisation et d’intégration des services en santé mentale impose de nouveaux rôles aux intervenants oeuvrant dans les différents réseaux de services. La formation croisée apparaît donc comme un modèle particulièrement adapté à leurs besoins afin d’optimiser leurs interventions. Le modèle est présenté à partir des études les plus récentes et est illustré par le programme de formation croisée, développé pour les réseaux de la santé mentale et de la toxicomanie dans le sud-ouest de Montréal. Ses applications sont explorées pour d’autres réseaux.This article presents the cross training program in Montreal’s south-west. The authors underline that the context of post-deinstitutionalization and mental health service integration impose new roles to professionals who work within these different networks of services. Cross training thus appears as a model that is particularly adapted to their needs in order to optimize their interventions. The model is presented with a review of the most recent studies and is illustrated with the cross training program, a model developed by the networks of mental health care and addiction treatment in Montreal’s south-west. The program’s applications are examined for other networks of care and services.Este artículo presenta el programa de formación cruzada del suroeste de Montreal. Los autores estiman que el contexto de posdesinstitucionalización e integración de los servicios de salud mental impone roles nuevos a los interventores que laboran en las diversas redes de servicios. La formación cruzada parece por consiguiente un modelo particularmente adaptado a sus necesidades para optimizar sus intervenciones. El modelo es presentado a partir de los estudios más recientes y es ilustrado por medio del programa de formación cruzada, un modelo desarrollado para las redes de salud mental y toxicomanía en el suroeste de Montreal. Se exploran sus aplicaciones para otras redes.Este artigo apresenta o programa de formação cruzada do sudoeste de Montreal. Os autores acreditam que o contexto de pós-desinstitucionalização e de integração dos serviços em saúde mental impõe novos papéis aos intervenientes que trabalham nas diferentes redes de serviços. A formação cruzada demonstra ser, então, um modelo especialmente adaptado a suas necessidades a fim de otimizar suas intervenções. O modelo é apresentado a partir dos estudos mais recentes e é ilustrado pelo programa de formação cruzada, um modelo desenvolvido para as redes da saúde mental e da toxicomania no sudoeste de Montreal. Suas aplicações são exploradas para outras redes

Nucleozymes

Nucleozymes containing ribonucleotides and deoxyribonucleotides or nucleic acid analogues are described herein. The nucleozymes have catalytic activity and are significantly more resistant to degradation than their all-RNA ribozyme counterparts. Also described are methods for preparing the nucleozymes along with methods of using nucleozymes, e.g., as therapeutic agents

RNA G-quadruplexes and their potential regulatory roles in translation

Abstract: DNA guanine (G)-rich 4-stranded helical nucleic acid structures called G-quadruplexes (G4), have been extensively studied during the last decades. However, emerging evidence reveals that 50- and 30-untranslated regions (50- and 30-UTRs) as well as open reading frames (ORFs) contain putative RNA G-quadruplexes. These stable secondary structures play key roles in telomere homeostasis and RNA metabolism including pre-mRNA splicing, polyadenylation, mRNA targeting and translation. Interestingly, multiple RNA binding proteins such as nucleolin, FMRP, DHX36, and Aven were identified to bind RNA G-quadruplexes. Moreover, accumulating reports suggest that RNA G-quadruplexes regulate translation in cap-dependent and -independent manner. Herein, we discuss potential roles of RNA G-quadruplexes and associated trans-acting factors in the regulation of mRNA translation

Exploring mRNA 3'-UTR G-quadruplexes: evidence of roles in both alternative polyadenylation and mRNA shortening

Abstract: Guanine-rich RNA sequences can fold into noncanonical, four stranded helical structures called G-quadruplexes that have been shown to be widely distributed within the mammalian transcriptome, as well as being key regulatory elements in various biological mechanisms. That said, their role within the 30-untranslated region (UTR) of mRNA remains to be elucidated and appreciated. A bioinformatic analysis of the 30-UTRs of mRNAs revealed enrichment in G-quadruplexes. To shed light on the role(s) of these structures, those found in the LRP5 and FXR1 genes were characterized both in vitro and in cellulo. The 30- UTR G-quadruplexes were found to increase the efficiencies of alternative polyadenylation sites, leading to the expression of shorter transcripts and to possess the ability to interfere with the miRNA regulatory network of a specific mRNA. Clearly, G-quadruplexes located in the 30-UTRs of mRNAs are cis-regulatory elements that have a significant impact on gene expression

A conserved target site in HIV-1 Gag RNA is accessible to inhibition by both an HDV ribozyme and a short hairpin RNA

Abstract: Antisense-based molecules targeting HIV-1 RNA have the potential to be used as part of gene or drug therapy to treat HIV-1 infection. In this study, HIV-1 RNA was screened to identify more conserved and accessible target sites for ribozymes based on the hepatitis delta virus motif. Using a quantitative screen for effects on HIV-1 production, we identified a ribozyme targeting a highly conserved site in the Gag coding sequence with improved inhibitory potential compared to our previously described candidates targeting the overlapping Tat/Rev coding sequence. We also demonstrate that this target site is highly accessible to short hairpin directed RNA interference, suggesting that it may be available for the binding of antisense RNAs with different modes of action. We provide evidence that this target site is structurally conserved in diverse viral strains and that it is sufficiently different from the human transcriptome to limit off-target effects from antisense therapies. We also show that the modified hepatitis delta virus ribozyme is more sensitive to a mismatch in its target site compared to the short hairpin RNA. Overall, our results validate the potential of a new target site in HIV-1 RNA to be used for the development of antisense therapies

Unbiased in vitro selection reveals the unique character of the self-cleaving antigenomic HDV RNA sequence

In order to revisit the architecture of the catalytic center of the antigenomic hepatitis delta virus (HDV) ribozyme we developed an unbiased in vitro selection procedure that efficiently selected novel variants from a relatively small set of sequences. Using this procedure we examined all possible variants from a pool of HDV ribozymes that had been randomized at 25 positions (4(25)). The isolated set of sequences shows more variability than do the natural variants. Nucleotide variations were found at all randomized positions, even at positions when the general belief was that the specific base was absolutely required for catalytic activity. Covariation analysis supports the presence of several base pairs, although it failed to propose any new tertiary contacts. HDV ribozyme appears to possess a greater number of constraints, in terms of sequences capable of supporting the catalysed cleavage, than do other catalytic RNAs. This supports the idea that the appearance of this catalytic RNA structure has a low probability (i.e. is a rare event), which may explain why to date it has been found in nature only in the HDV. These contrasts with the hammerhead self-cleaving motif that is proposed to have multiple origins, and that is widespread among different organisms. Thus, just because a self-cleaving RNA motif is small does not imply that it occurs easily

Structurexplor : a platform for the exploration of structural features of RNA secondary structures

Abstract : Summary: Discovering function-related structural features, such as the cloverleaf shape of transfer RNA secondary structures, is essential to understand RNA function. With this aim, we have developed a platform, named Structurexplor, to facilitate the exploration of structural features in populations of RNA secondary structures. It has been designed and developed to help biologists interactively search for, evaluate and select interesting structural features that can potentially explain RNA functions

The super-n-motifs model : a novel alignment-free approach for representing and comparing RNA secondary structures

Abstract : Motivation: Comparing ribonucleic acid (RNA) secondary structures of arbitrary size uncovers structural patterns that can provide a better understanding of RNA functions. However, performing fast and accurate secondary structure comparisons is challenging when we take into account the RNA configuration (i.e. linear or circular), the presence of pseudoknot and G-quadruplex (G4) motifs and the increasing number of secondary structures generated by high-throughput probing techniques. To address this challenge, we propose the super-n-motifs model based on a latent analysis of enhanced motifs comprising not only basic motifs but also adjacency relations. The super-n-motifs model computes a vector representation of secondary structures as linear combinations of these motifs. Results: We demonstrate the accuracy of our model for comparison of secondary structures from linear and circular RNA while also considering pseudoknot and G4 motifs. We show that the supern- motifs representation effectively captures the most important structural features of secondary structures, as compared to other representations such as ordered tree, arc-annotated and string representations. Finally, we demonstrate the time efficiency of our model, which is alignment free and capable of performing large-scale comparisons of 10 000 secondary structures with an efficiency up to 4 orders of magnitude faster than existing approaches