Facteurs associés à l’implantation d’un programme de formation interprofessionnelle au sein d’un Centre de santé et de services sociaux au Québec

INTRODUCTION: La collaboration interprofessionnelle a émergé comme étant l’un des aspects essentiels à consolider pour améliorer l’organisation de la première ligne de soins et assurer un accès adéquat aux ressources disponibles. Pour favoriser l’accroissement de la collaboration interprofessionnelle, il est suggéré que les professionnels des sciences de la santé soient formés en interdisciplinarité, particulièrement à l’occasion des stages cliniques. OBJECTIFS: Ce projet vise à mesurer le degré d’implantation du programme de formation interprofessionnelle (PFI) du Centre de santé et de services sociaux (CSSS) à l’étude comparativement au modèle proposé initialement. De plus, ce projet vise à comprendre comment les facteurs systémiques, les facteurs organisationnels et les caractéristiques du programme de formation mis en place influencent l’implantation du PFI. MÉTHODOLOGIE : Il s’agit d’une étude de cas unique effectuée au sein d’un CSSS situé dans la grande région de Montréal au Québec, Canada. Les données ont été recueillies à l’aide de 11 entrevues semi-dirigées qui ont été réalisées auprès de professionnels et administrateurs responsables de l’implantation du PFI et d’un étudiant en stage ayant participé au PFI. Une analyse des documents administratifs et cliniques écrits concernant l’implantation du PFI a également été effectuée. RÉSULTATS : L’implantation du PFI est toujours en évolution comme le traduit la présence des différentes composantes définissant la mise en œuvre du PFI qui est de moyenne à élevée et l’intensité des différentes composantes qui est généralement faible. Les facteurs systémiques, les facteurs organisationnels et les caractéristiques du programme de formation mis en place influencent l’implantation du PFI en milieu clinique et il existe des interrelations entre ces différents facteurs. L’analyse des facteurs influençant l’implantation d’un PFI en milieu clinique doit également s'attarder aux différents facteurs influençant le développement des pratiques collaboratives dans ce milieu.INTRODUCTION: Interprofessional collaboration emerged as one of the key aspects that have to be consolidated to improve the organization of primary care and to ensure an appropriate access to available resources. In order to increase interprofessional collaboration, it has been suggested that health sciences professionals should be trained in an interdisciplinary fashion, especially during clinical training. OBJECTIVES: The aim of this research is to measure the degree of implementation of an initiative in interprofessional education (IPE) which takes place in the Health and social service centre (HSSC) studied, as compared to the initially proposed model. Furthermore, the objective of this research is to understand how systemic factors, organizational factors and the training program’s attributes influence the IPE initiative’s implementation. METHODS: This is a case study based on an HSSC located in the greater Montreal region in Quebec, Canada. Data was collected through 11 semi-structured interviews performed with professionals and administrators responsible for the IPE initiative’s implementation, together with one student who participated in the IPE initiative during his clinical training. An analysis of administrative and clinical documents regarding the IPE initiative’s implementation was also performed. RESULTS: The implementation of the IPE initiative is still an ongoing process as it is showed by the medium-high presence of the different elements which define the IPE implementation and the generally low intensity of these elements. Systemic factors, organizational factors and the training program’s attributes influence the implementation of the IPE initiative in a clinical setting and there is an interaction between all of these factors. An analysis of the different factors influencing the implementation of an IPE initiative in a clinical setting should also consider the different factors influencing the development of collaborative practice in this environment

Investigation into the mechanisms behind the differential inhibition of Listeria monocytogenes in soft-ripened cheeses

Soft-ripened cheeses (e.g., Camembert; SRC) are at risk for the growth of the Listeria monocytogenes due to favourable moisture and pH compared to other cheeses; however, the L. monocytogenes growth is not uniform across all SRC. The cheese microbiome, which is influenced by the farm and processing environments, may affect L. monocytogenes growth. Therefore, the purpose of this thesis was to investigate how the taxonomic and functional profiles of SRC microbiomes may affect the growth of L. monocytogenes. Forty-three SRC were inoculated with L. monocytogenes, and pathogen growth was monitored over 12 days at 8°C by select plating. Cheeses were produced from both raw (n=12) and pasteurized (n=31) milk. The taxonomic and functional profiles of the cheeses microbiomes was investigated using 16S rRNA targeted amplicon sequencing, shotgun metagenomic sequencing of 39 and 15 cheeses, respectively. L. monocytogenes growth differed significantly between cheeses (ANOVA; p < 0.001), with increases ranging from 0 to 5.4 log CFU (mean of 2.5 ± 1.2 log CFU) over the incubation period. Raw milk cheeses showed significantly lower L. monocytogenes growth than pasteurized milk cheeses (t-test; p = 0.008), possibly due to an increase in microbial richness. L. monocytogenes growth in cheeses was positively correlated with the relative abundance of Streptococcus thermophilus (Spearman correlation; p < 0.0001), and negatively correlated with the relative abundances of Brevibacterium aurantiacucm (Spearman correlation; p = 0.0002) and two Lactococcus spp. (Spearman correlation; p < 0.01). The inclusion of S. thermophilus as a starter culture is more common in industrialize SRC production, suggesting that industrial production of SRC may increase the risk of L. monocytogenes growth. L. monocytogenes growth was negatively correlated with the relative abundance of two metabolic pathways related to formaldehyde oxidation and β-D-glucuronosides degradation. No mechanism was identified for the antilisterial effects of these pathways, but it may involve the depletion of micronutrients. The presence of bacteriocin-encoding genes did not affect the growth of L. monocytogenes in the cheeses. These results further our understanding of the cheese microbiome’s affect on L. monocytogenes growth, hopefully leading to the development of SRC starter/ripening cultures that can prevent L. monocytogenes growth.Land and Food Systems, Faculty ofGraduat

Occurrence and potential predictors of verotoxigenic Escherichia coli (VTEC), Salmonella, and Listeria monocytogenes in surface water used for produce irrigation in the Lower Mainland of British Columbia, Canada

Foodborne pathogens such as verotoxigenic Escherichia coli (VTEC), Salmonella, and Listeria monocytogenes may be present in surface waters, thus having the potential to contaminate fresh produce during crop irrigation. The objectives of this study were to determine the occurrence of VTEC, Salmonella, and L. monocytogenes in surface waters used for produce irrigation in the Lower Mainland of British Columbia, and to investigate potential predictors of their presence. Water samples (n = 223) were collected from three and four irrigation ditches in both the Serpentine and Sumas watersheds, respectively, between February 2015 and August 2016. VTEC colonies on water filters were detected using a verotoxin colony immunoblot developed for the detection of all VTEC serotypes, and isolates were confirmed via multiplex PCR for virulence genes vt1 and vt2. Detection of Salmonella and L. monocytogenes was completed using Health Canada Methods MFHPB-20 and MFHPB-30, respectively. Generic E. coli (EC) and fecal coliforms (FC) were enumerated using 3M™ Petrifilm™ Count Plates, and by membrane filtration with growth on m-FC agar with 0.01% rosalic acid; this was followed by transfer to nutrient agar containing 4-methylumbelliferyl-β-D-glucuronide. Meteorological data were collected from Environment Canada records, and agricultural data were collected from the British Columbia Agricultural Land Use Inventories. The most commonly occurring pathogen was L. monocytogenes (11.2%), followed by VTEC (4.93%), and Salmonella (2.68%). Pathogen recovery was more common in the Serpentine watershed (p < 0.05), especially during the winter and fall seasons (p < 0.05). Pathogen occurrence in these locations was correlated with FC (r = 0.431) and EC (r = 0.408), but only by using the membrane filtration method. Pathogens were still recovered when indicator concentrations were low. Pathogen occurrence was also correlated with the proximity to upstream livestock (rs = -0.886) and the level of precipitation the day before sample collection (r = 0.203). In conclusion, VTEC, Salmonella, and L. monocytogenes are present in surface waters used for irrigation in the Lower Mainland of British Columbia. There is potential to predict their presence, but further research is required to confirm factors affecting pathogen occurrence, which entail longer sampling times and increased sampling locations.Land and Food Systems, Faculty ofGraduat

Occurrence, characterization, and potential predictors of verotoxigenic Escherichia coli, Listeria monocytogenes, and Salmonella in surface water used for produce irrigation in the Lower Mainland of British Columbia, Canada.

Produce has become a major source of foodborne illness, and may become contaminated through surface water irrigation. The objectives of this study were to (i) determine the frequency of verotoxigenic E. coli (VTEC), Listeria monocytogenes, and Salmonella in surface waters used for irrigation in the Lower Mainland of British Columbia, (ii) assess the suitability of fecal coliforms and generic E. coli as hygiene indicators, and (iii) investigate the correlations of environmental factors with pathogen occurrence. Water samples were collected semi-monthly for 18 months from seven irrigation ditches across the Serpentine and Sumas watersheds. VTEC colonies on water filters were detected using a verotoxin colony immunoblot, and the presence of virulence genes vt1 and vt2 was ascertained via multiplex PCR. Detection of L. monocytogenes and Salmonella was completed using standard, Health Canada Compendium of Analytical Methods. Fecal coliforms and generic E. coli were enumerated by 3M™ Petrifilm™ and filtration methods, and meteorological and geographic data were collected from government records. VTEC, L. monocytogenes, and Salmonella were detected in 4.93%, 10.3%, and 2.69% of 223 samples, respectively. L. monocytogenes occurrence was greatest in the Serpentine watershed (χ2; p < 0.05), and was most common during the winter and fall (Fisher exact test; p < 0.05). Site dependence of VTEC and Salmonella occurrence was observed within watersheds (Fisher's exact test; p < 0.10). Pathogen occurrence correlated with fecal coliform counts (r = 0.448), while VTEC occurrence also correlated with precipitation over the five days before sampling (r = 0.239). The density of upstream livestock correlated with VTEC (rs = 0.812), and L. monocytogenes (rs = 0.841) detection. These data show that foodborne pathogens are present in the waters used for irrigation in the Lower Mainland of British Columbia, but their frequency may depend on spatial and temporal factors

Cellular lipid composition affects sensitivity of plant pathogens to fengycin, an antifungal compound produced by Bacillus subtilis strain CU12

Fengycin is an antimicrobial cyclic lipopeptide produced by various Bacillus subtilis strains, including strain CU12. Direct effects of fengycin include membrane pore formation and efflux of cellular contents leading to cell death in sensitive microorganisms. In this study, four plant pathogens were studied in order to elucidate the role of membrane lipids in their relative sensitivity to fengycin. Inhibition of mycelial growth in these pathogens varied considerably. Analysis of membrane lipids in these microorganisms indicated that sensitivity correlated with low ergosterol content and shorter phospholipid fatty acyl chains. Sensitivity to fengycin also correlated with a lower anionic/zwitterionic phospholipid ratio. Our data suggest that decreased fluidity buffering capacity, as a result of low ergosterol content, and higher intrinsic fluidity afforded by short fatty acyl chain length may increase the sensitivity of microbial membranes to fengycin. Our results also suggest that lower content in anionic phospholipids may increase fengycin insertion into the membrane through reduced electrostatic repulsion with the negatively charged fengycin. The intrinsic membrane lipid composition may contribute, in part, to the observed level of antimicrobial activity of fengycin in various plant pathogens

Listeria serotypes collected from irrigation water at three sites each in the Sumas and Serpentine watersheds of the Lower Mainland of British Columbia.

<p>Listeria serotypes collected from irrigation water at three sites each in the Sumas and Serpentine watersheds of the Lower Mainland of British Columbia.</p

Sequences of primers used for confirmation and virulence characterization of verotoxigenic <i>E</i>. <i>coli</i> isolates.

<p>Sequences of primers used for confirmation and virulence characterization of verotoxigenic <i>E</i>. <i>coli</i> isolates.</p

Occurrence, characterization, and potential predictors of verotoxigenic <i>Escherichia coli</i>, <i>Listeria monocytogenes</i>, and <i>Salmonella</i> in surface water used for produce irrigation in the Lower Mainland of British Columbia, Canada

<div><p>Produce has become a major source of foodborne illness, and may become contaminated through surface water irrigation. The objectives of this study were to (i) determine the frequency of verotoxigenic <i>E</i>. <i>coli</i> (VTEC), <i>Listeria monocytogenes</i>, and <i>Salmonella</i> in surface waters used for irrigation in the Lower Mainland of British Columbia, (ii) assess the suitability of fecal coliforms and generic <i>E</i>. <i>coli</i> as hygiene indicators, and (iii) investigate the correlations of environmental factors with pathogen occurrence. Water samples were collected semi-monthly for 18 months from seven irrigation ditches across the Serpentine and Sumas watersheds. VTEC colonies on water filters were detected using a verotoxin colony immunoblot, and the presence of virulence genes <i>vt1</i> and <i>vt2</i> was ascertained via multiplex PCR. Detection of <i>L</i>. <i>monocytogenes</i> and <i>Salmonella</i> was completed using standard, Health Canada Compendium of Analytical Methods. Fecal coliforms and generic <i>E</i>. <i>coli</i> were enumerated by 3M™ Petrifilm™ and filtration methods, and meteorological and geographic data were collected from government records. VTEC, <i>L</i>. <i>monocytogenes</i>, and <i>Salmonella</i> were detected in 4.93%, 10.3%, and 2.69% of 223 samples, respectively. <i>L</i>. <i>monocytogenes</i> occurrence was greatest in the Serpentine watershed (χ²; p < 0.05), and was most common during the winter and fall (Fisher exact test; p < 0.05). Site dependence of VTEC and <i>Salmonella</i> occurrence was observed within watersheds (Fisher’s exact test; p < 0.10). Pathogen occurrence correlated with fecal coliform counts (r = 0.448), while VTEC occurrence also correlated with precipitation over the five days before sampling (r = 0.239). The density of upstream livestock correlated with VTEC (r_s = 0.812), and <i>L</i>. <i>monocytogenes</i> (r_s = 0.841) detection. These data show that foodborne pathogens are present in the waters used for irrigation in the Lower Mainland of British Columbia, but their frequency may depend on spatial and temporal factors.</p></div

Seasonal occurrence of verotoxigenic <i>E</i>. <i>coli</i> (VTEC), <i>L</i>. <i>monocytogenes</i>, <i>Salmonella</i>, or any of the three in the Sumas and/or Serpentine watersheds.

<p>Seasonal occurrence of verotoxigenic <i>E</i>. <i>coli</i> (VTEC), <i>L</i>. <i>monocytogenes</i>, <i>Salmonella</i>, or any of the three in the Sumas and/or Serpentine watersheds.</p