52 research outputs found
Measuring organizational readiness for knowledge translation in chronic care
<p>Abstract</p> <p>Background</p> <p>Knowledge translation (KT) is an imperative in order to implement research-based and contextualized practices that can answer the numerous challenges of complex health problems. The Chronic Care Model (CCM) provides a conceptual framework to guide the implementation process in chronic care. Yet, organizations aiming to improve chronic care require an adequate level of organizational readiness (OR) for KT. Available instruments on organizational readiness for change (ORC) have shown limited validity, and are not tailored or adapted to specific phases of the knowledge-to-action (KTA) process. We aim to develop an evidence-based, comprehensive, and valid instrument to measure OR for KT in healthcare. The OR for KT instrument will be based on core concepts retrieved from existing literature and validated by a Delphi study. We will specifically test the instrument in chronic care that is of an increasing importance for the health system.</p> <p>Methods</p> <p>Phase one: We will conduct a systematic review of the theories and instruments assessing ORC in healthcare. The retained theoretical information will be synthesized in a conceptual map. A bibliography and database of ORC instruments will be prepared after appraisal of their psychometric properties according to the standards for educational and psychological testing. An online Delphi study will be carried out among decision makers and knowledge users across Canada to assess the importance of these concepts and measures at different steps in the KTA process in chronic care.</p> <p>Phase two: A final OR for KT instrument will be developed and validated both in French and in English and tested in chronic disease management to measure OR for KT regarding the adoption of comprehensive, patient-centered, and system-based CCMs.</p> <p>Discussion</p> <p>This study provides a comprehensive synthesis of current knowledge on explanatory models and instruments assessing OR for KT. Moreover, this project aims to create more consensus on the theoretical underpinnings and the instrumentation of OR for KT in chronic care. The final product--a comprehensive and valid OR for KT instrument--will provide the chronic care settings with an instrument to assess their readiness to implement evidence-based chronic care.</p
Overexpression of Wild-Type Human Alpha-Synuclein Causes Metabolism Abnormalities in Thy1-aSYN Transgenic Mice
Parkinsonâs disease is a progressive neurodegenerative disorder characterized by loss of dopaminergic neurons, pathological accumulation of alpha-synuclein and motor symptoms, but also by non-motor symptoms. Metabolic abnormalities including body weight loss have been reported in patients and could precede by several years the emergence of classical motor manifestations. However, our understanding of the pathophysiological mechanisms underlying body weight loss in PD is limited. The present study investigated the links between alpha-synuclein accumulation and energy metabolism in transgenic mice overexpressing Human wild-type (WT) alpha-synuclein under the Thy1 promoter (Thy1-aSYN mice). Results showed that Thy1-aSYN mice gained less body weight throughout life than WT mice, with significant difference observed from 3 months of age. Body composition analysis of 6-month-old transgenic animals showed that body mass loss was due to lower adiposity. Thy1-aSYN mice displayed lower food consumption, increased spontaneous activity, as well as a reduced energy expenditure compared to control mice. While no significant change in glucose or insulin responses were observed, Thy1-aSYN mice had significantly lower plasmatic levels of insulin and leptin than control animals. Moreover, the pathological accumulation of alpha-synuclein in the hypothalamus of 6-month-old Thy1-aSYN mice was associated with a down-regulation of the phosphorylated active form of the signal transducer and activator of transcription 3 (STAT3) and of Rictor (the mTORC2 signaling pathway), known to couple hormonal signals with the maintenance of metabolic and energy homeostasis. Collectively, our results suggest that (i) metabolic alterations are an important phenotype of alpha-synuclein overexpression in mice and that (ii) impaired STAT3 activation and mTORC2 levels in the hypothalamus may underlie the disruption of feeding regulation and energy metabolism in Thy1-aSYN mice
Transformations agricoles et agroalimentaires
Ă lâheure des robots et du numĂ©rique, la terre (habitat, agriculture, paysage, planĂšte) et la nourriture (du corps et de lâĂąme) sont parmi les prĂ©occupations majeures dans les espaces mĂ©diatiques et politiques. Le pĂ©trole et lâabondance qui lâa accompagnĂ© nous avaient fait oublier quâelles sont au fondement des sociĂ©tĂ©s humaines. La « crise alimentaire » de 2008, qui a secouĂ© plusieurs continents, a rappelĂ© aux gouvernements lâenjeu de la sĂ©curitĂ© alimentaire. AprĂšs des dĂ©cennies dâexcĂ©dents, de baisse du prix des produits agricoles de base, la question de la valeur de la terre et de lâagriculture est de retour. La question de la santĂ© et celle des droits humains prennent une place Ă©largie tant dans les politiques publiques et dans la production de normes alimentaires. Des mouvements sociaux transnationaux sâemparent de la question de lâavenir de lâagriculture et de lâalimentation, et de celle de la « bonne vie ». Pour contribuer Ă cette rĂ©flexion sur lâavenir de la terre et de la nourriture, cet ouvrage Ă©tudie la socialisation de lâagriculture, câest-Ă -dire sa prise en charge tant par les politiques agricoles (essentiellement nationales) que par lâorganisation des marchĂ©s dans un cadre national et international. Il le fait en prenant un large recul et mobilise trois temporalitĂ©s. La premiĂšre est celle de la planĂšte. La seconde, celle des rĂ©gimes mĂ©taboliques, façons dont lâhumanitĂ© Ă diffĂ©rents stades de dĂ©veloppement, mobilise matĂ©riaux et Ă©nergie. La troisiĂšme est celle du capitalisme, avec la succession de systĂšmes hĂ©gĂ©moniques (ce qui nâexclue pas de multiples polaritĂ©s). Cet ouvrage rĂ©unit des recherches rĂ©centes dâĂ©conomistes, de sociologues, dâhistoriens et dâagronomes, de diffĂ©rents pays, recherches qui ont en commun de concerner la place de lâagriculture dans lâĂ©volution des capitalismes
Belo VIII. Le sanctuaire d'Isis
International audienceCe volume prĂ©sente le sanctuaire dâIsis qui, en raison de son Ă©tat de conservation, constitue lâun desmeilleurs exemples dâIseum Ă lâĂ©poque romaine. Construit sous NĂ©ron, Ă cĂŽtĂ© du capitole, il domine la ville et le port de Belo. Sont proposĂ©es une Ă©tude architecturale et stylistique des diffĂ©rentes composantes du sanctuaire ainsi quâune restitution dâensemble. Les sources Ă©pigraphiques, littĂ©raires, figurĂ©es et architecturales permettent dâĂ©clairer les rapports existant entre lâarchitecture du sanctuaire et la liturgie isiaque
Belo VIII. Le sanctuaire d'Isis
International audienceCe volume prĂ©sente le sanctuaire dâIsis qui, en raison de son Ă©tat de conservation, constitue lâun desmeilleurs exemples dâIseum Ă lâĂ©poque romaine. Construit sous NĂ©ron, Ă cĂŽtĂ© du capitole, il domine la ville et le port de Belo. Sont proposĂ©es une Ă©tude architecturale et stylistique des diffĂ©rentes composantes du sanctuaire ainsi quâune restitution dâensemble. Les sources Ă©pigraphiques, littĂ©raires, figurĂ©es et architecturales permettent dâĂ©clairer les rapports existant entre lâarchitecture du sanctuaire et la liturgie isiaque
Water inputs influences on atmospheric CO2 exchanges on a temperate salty meadow revealed through Eddy Covariance flux measurements
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â Le Mali rĂ©unit les conditions pour que les agrocarburants impactent le dĂ©veloppement rural. Une analyse des jeux dâacteurs montre comment ceux-ci conditionnent les trajectoires de dĂ©veloppement des agrocarburants et la durabilitĂ© des filiĂšres. â La notion de bien commun, portĂ©e par la Politique Commune de la PĂȘche (PCP), est analysĂ©e Ă la lumiĂšre des stratĂ©gies des acteurs de la pĂȘche professionnelle, Ă partir dâune grille commune « communautĂ©-territoire-ressource ». â Les agricultures entrepreneuriales s'inscrivent dans des chaĂźnes globales de valeur. Une typologie Ă partir des rĂ©alitĂ©s sud-amĂ©ricaines montre leur grande diversitĂ© et leurs impacts diffĂ©renciĂ©s sur le dĂ©veloppement rural. Faits et chiffres â La rĂ©forme de la carte intercommunale remettait en cause la coexistence des intercommunalitĂ©s et des Pays. Elle a rĂ©duit de 20 % le nombre d'EPCI. Avant la rĂ©forme, les Pays constituaient des espaces de coopĂ©ration entre EPCI. La rĂ©forme ne remet cependant pas en cause les territoires de projet. DĂ©bat â CoopĂ©ratives agricoles : identitĂ©, enjeux et dĂ©fis Note de lecture â En toute saison : le marchĂ© des fruits et lĂ©gumes en Franc
Atmospheric CO2 exchanges measured by eddy covariance over a temperate salt marsh and influence of environmental controlling factors
International audienceWithin the coastal zone, salt marshes are atmospheric CO2 sinks and represent an essential component of biological carbon (C) stored on earth due to a strong primary production. Significant amounts of C are processed within these tidal systems which requires a better understanding of the temporal CO2 flux dynamics, the metabolic processes involved and the controlling factors. Within a temperate salt marsh (French Atlantic coast), continuous CO2 fluxes measurements were performed by the atmospheric eddy covariance technique to assess the net ecosystem exchange (NEE) at diurnal, tidal and seasonal scales as well as the associated relevant biophysical drivers. To study marsh metabolic processes, measured NEE was partitioned into gross primary production (GPP) and ecosystem respiration (Reco) during marsh emersion allowing to estimate NEE at the marshâatmosphere interface (NEEmarshâ=âGPPâââReco). During the year 2020, the net C balance from measured NEE was â483âgâCâmâ2âyrâ1 while GPP and Reco absorbed and emitted 1019 and 533âgâCâmâ2âyrâ1, respectively. The highest CO2 uptake was recorded in spring during the growing season for halophyte plants in relationships with favourable environmental conditions for photosynthesis, whereas in summer, higher temperatures and lower humidity rates increased ecosystem respiration. At the diurnal scale, the salt marsh was a CO2 sink during daytime, mainly driven by light, and a CO2 source during night-time, mainly driven by temperature, irrespective of emersion or immersion periods. However, daytime immersion strongly affected NEE fluxes by reducing marsh CO2 uptake up to 90â%. During night-time immersion, marsh CO2 emissions could be completely suppressed, even causing a change in metabolic status from source to sink under certain situations, especially in winter when Reco rates were lowest. At the annual scale, tidal immersion did not significantly affect the net C uptake of the studied salt marsh since similar annual balances of measured NEE (with tidal immersion) and estimated NEEmarsh (without tidal immersion) were recorded
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â DiffĂ©rentes modalitĂ©s de mise en Ćuvre du programme Leader dans les pays europĂ©ens sont mises en Ă©vidence Ă partir dâanalyses statistique et cartographique, et confrontĂ©es avec les principes fondamentaux du dĂ©veloppement local. â Deux instruments Ă©conomiques de gestion dĂ©centralisĂ©e de la ressource en eau, issus des travaux dâOstrom, sont testĂ©s par une mĂ©thode de prospective participative : un systĂšme de bonus-malus individuels et monĂ©taires, et un systĂšme dâautorĂ©gulation imbriquĂ©e. â Une analyse de la consommation alimentaire Ă domicile de 1995 Ă 2007 montre que la composition de lâeuro alimentaire Ă©volue sous des effets « prix » mais Ă©galement de transformations plus profondes des modes de production et de consommation des produits alimentaires. â Une enquĂȘte statistique, portant sur environ 1 500 jugements rendus durant une annĂ©e en France, rĂ©vĂšle la nature des prĂ©tentions juridiques les plus frĂ©quemment adressĂ©es aux juridictions ainsi que les logiques de ces recours. â Les diffĂ©rents parcours professionnels des salariĂ©s travaillant dans les exploitations agricoles sont caractĂ©risĂ©s Ă partir dâune base de donnĂ©es originale, issue de la MutualitĂ© Sociale Agricole (MSA). Faits et chiffres â Le morcellement des exploitations agricoles françaises Notes de lecture â Organisations et sociĂ©tĂ©s paysannes. Une lecture par la rĂ©ciprocitĂ© â Nicholas Georgescu-Roegen, pour une rĂ©volution bioĂ©conomique. Suivi de "De la science Ă©conomique Ă la bioĂ©conomie
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