Encadrement normatif et contractuel des pratiques de téléconsultation en clinique de première ligne

Jusqu'à la pandémie de la COVID-19, les services de téléconsultation offerts par des médecins omnipraticiens au Québec étaient fortement limités essentiellement parce qu'ils n'étaient pas rémunérés puisque non reconnus comme des actes médicaux assurables. Le décret du 16 mars 2020 , adopté dans le contexte d'urgence sanitaire, permet maintenant cette rémunération au même titre que la rémunération associée à la visite du patient en clinique. De nombreux avantages sont reconnus et associés à la téléconsultation en première ligne si cette téléconsultation est bien encadrée. Le présent projet vise à examiner les bonnes pratiques d'encadrement de la téléconsultation et à proposer des recommandations avant que ne soit négocié la prochaine entente de rémunération avec les médecins omnipraticiens. Nous recommandons notamment une formation obligatoire, une clarification législative quant au droit des assureurs privés de rembourser la téléconsultation et des modalités de rémunération variées en fonction du type de téléconsultation. Il nous appert enfin impératif de rapidement commander une étude détaillée sur les bénéfices et les coûts de la téléconsultation au Québec

A KSR/CNK complex mediated by HYP, a novel SAM domain-containing protein, regulates RAS-dependent RAF activation in Drosophila

RAF is a critical effector of the small GTPase RAS in normal and malignant cells. Despite intense scrutiny, the mechanism regulating RAF activation remains partially understood. Here, we show that the scaffold KSR (kinase suppressor of RAS), a RAF homolog known to assemble RAF/MEK/ERK complexes, induces RAF activation in Drosophila by a mechanism mediated by its kinase-like domain, but which is independent of its scaffolding property or putative kinase activity. Interestingly, we found that KSR is recruited to RAF prior to signal activation by the RAF-binding protein CNK (connector enhancer of KSR) in association with a novel SAM (sterile α motif) domain-containing protein, named Hyphen (HYP). Moreover, our data suggest that the interaction of KSR to CNK/HYP stimulates the RAS-dependent RAF-activating property of KSR. Together, these findings identify a novel protein complex that controls RAF activation and suggest that KSR does not only act as a scaffold for the MAPK (mitogen-activated protein kinase) module, but may also function as a RAF activator. By analogy to catalytically impaired, but conformationally active B-RAF oncogenic mutants, we discuss the possibility that KSR represents a natural allosteric inducer of RAF catalytic function

KSR is a scaffold required for activation of the ERK/MAPK module

Mechanisms that regulate signal propagation through the ERK/MAPK pathway are still poorly understood. Several proteins are suspected to play critical roles in this process. One of these is Kinase Suppressor of Ras (KSR), a component previously identified in RAS-dependent genetic screens in Drosophila and Caenorhabditis elegans. Here, we show that KSR functions upstream of MEK within the ERK/MAPK module. In agreement with this, we found that KSR facilitates the phosphorylation of MEK by RAF. We further show that KSR associates independently with RAF and MEK, and that these interactions lead to the formation of a RAF/MEK complex, thereby positioning RAF in close proximity to its substrate MEK. These findings suggest that KSR functions as a scaffold that assembles the RAF/MEK functional pair

Bimodal regulation of RAF by CNK in Drosophila

Connector enhancer of KSR (CNK) is a multidomain-containing protein previously identified as a positive regulator of the RAS/MAPK pathway in Drosophila. Using transfection experiments and an RNAi-based rescue assay in Drosophila S2 cells, we demonstrate that CNK has antagonistic properties with respect to RAF activity. We show that CNK’s N-terminal region contains two domains (SAM and CRIC) that are essential for RAF function. Unexpectedly, we also report that the C-terminal region of CNK contains a short bipartite element that strongly inhibits RAF catalytic function. Interestingly, CNK’s opposite properties appear to prevent signaling leakage from RAF to MEK in the absence of upstream signals, but then transforms into a potent RAF activator upon signal activation. Together, these findings suggest that CNK not only participates in the elusive RAF activation process, but might also contribute to the switch-like behavior of the MAPK module

Gender and work in ergonomics : recent trends

Since the establishment of the Gender and Work Technical Committee (TC) of the International Ergonomics Association (IEA) in 2006, many researchers have addressed the role of sex and gender in ergonomics, producing a great deal of new information. This special issue aims to present new ways of viewing women's work and gender differences in work-related injury risks in an era of rapidly changing labour market configurations. It offers innovative methods for integrating sex and gender into ergonomic analysis and for designing work environments. It shares reflections on the intersection of vulnerabilities according to certain identity markers. Finally, it contributes to establishing milestones standards of practice so that the consideration of sex and gender can be more systematically modelled in ergonomics research and interventions, for example in training ergonomists or in knowledge transfer initiatives

Integration of sex and gender in interventions by students in ergonomics

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