Dialectique de la limite et de la non-adhésion / transgression : une étude exploratoire auprès de patients en restriction sodique atteints d'insuffisance cardiaque

Les patients atteints d'insuffisance cardiaque consultent à répétitions pour des complications dues à l'autogestion inefficace de la maladie. Le contrôle de l'insuffisance cardiaque s'effectue par l'observance de recommandations dont l'une des plus difficiles à respecter est la restriction sodique. Cette difficulté persiste chez la majorité de ces patients. La non-adhésion à la restriction sodique combine des processus conscients et inconscients dictés, en partie, par le plaisir associé aux interdits. Le plaisir, souvent exclu du discours en santé, a soulevé une piste d'exploration favorisant une vision holistique de la non-adhésion à la restriction sodique. Au regard de la théorie de la transgression, l'étude de la non-adhésion à la restriction sodique s'est réalisée par la dialectique de la limite et de la transgression d'un interdit. Cette théorie propose une réflexion sur l'attrait de l'humain pour la limite et l'interdit. Le but de cette étude est d'explorer la relation entre la limite et la nonadhésion/transgression chez des patients insuffisants cardiaques non-adhérents à la restriction sodique. La collecte des données s'est effectuée par un questionnaire sociodémographique, deux autres sur la consommation de sel et des entrevues individuelles semi-structurées. Six patients insuffisants cardiaques nonadhérents à la restriction sodique ont partagé leur expérience face à la maladie chronique et la restriction sodique. Les résultats ont mené à un profil type pour cette clientèle. Les participants ont démontré une prise de conscience des processus sous-jacents à la non-adhésion à la restriction sodique, notamment, la dépendance au sel. Les résultats de l'étude ont également apporté un éclairage sur la contradiction fondamentale de l'homme dans sa pulsion de vivre, qui va à l'encontre de la non-adhésion à la restriction sodique, engendrant des effets délétères reconnus. D'autres résultats ont permis de rappeler la persistance du non-respect des droits des patients et du partage de pouvoir inégalitaire entre soignant et soignéPatients with heart failure repeatedly consult for complications due to poor disease self-management. Control of heart failure is achieved by adherence to many recommendations. One of the most difficult recommendations to respect is the sodium restriction. This difficulty with sodium restriction persists in the majority of these patients. Non-adherence to sodium restriction combines conscious and unconscious processes dictated, in part, by the pleasure related to the forbidden. Pleasure, which is often excluded from the health discourse, has raised a path of exploration that fosters a holistic vision of non-adherence to sodium restriction. According to the theory of transgression, the study of non-adherence to the sodium restriction has been carried out through the dialectic of the limit and the ban transgression. This theory proposes a reflection on the human being attraction for the limit and the forbidden. The aim of this study is to explore the relationship between the limit and nonadherence/transgression in heart failure patients who do not adhere to sodium restriction. Data collection was carried out through a sociodemographic questionnaire, two salt intake questionnaires and also semi-structured individual interviews. Six patients with heart failure, who were not adherent to sodium restriction, shared their experiences with chronic disease and sodium restriction. The results led to a non-adherent to sodium restriction hearth failure patient typical profile. Participants demonstrated an awareness of the processes underlying nonadherence to sodium restriction, including salt addiction. The results of the study also shed light on the fundamental contradiction in the human's urge to live, which runs counter to the non-adherence to sodium restriction, resulting in acknowledged deleterious effects. Other results have served as a reminder of the persistence of the non-respect of patients' rights and the unequal power sharing between caregiver and patient

An essential function of the mitogen‐activated protein kinase Erk2 in mouse trophoblast development

The closely related mitogen-activated protein kinase isoforms extracellular signal-regulated kinase 1 (ERK1) and ERK2 have been implicated in the control of cell proliferation, differentiation and survival. However, the specific in vivo functions of the two ERK isoforms remain to be analysed. Here, we show that disruption of the Erk2 locus leads to embryonic lethality early in mouse development after the implantation stage. Erk2 mutant embryos fail to form the ectoplacental cone and extra-embryonic ectoderm, which give rise to mature trophoblast derivatives in the fetus. Analysis of chimeric embryos showed that Erk2 functions in a cell-autonomous manner during the development of extra-embryonic cell lineages. We also found that both Erk2 and Erk1 are widely expressed throughout early-stage embryos. The inability of Erk1 to compensate for Erk2 function suggests a specific function for Erk2 in normal trophoblast development in the mouse, probably in regulating the proliferation of polar trophectoderm cells

Epitope Density Influences CD8+ Memory T Cell Differentiation

The generation of long-lived memory T cells is critical for successful vaccination but the factors controlling their differentiation are still poorly defined. We tested the hypothesis that the strength of T cell receptor (TCR) signaling contributed to memory CD8(+) T cell generation.We manipulated the density of antigenic epitope presented by dendritic cells to mouse naïve CD8(+) T cells, without varying TCR affinity. Our results show that a two-fold decrease in antigen dose selectively affects memory CD8(+) T cell generation without influencing T cell expansion and acquisition of effector functions. Moreover, we show that low antigen dose alters the duration of the interaction between T cells and dendritic cells and finely tunes the expression level of the transcription factors Eomes and Bcl6. Furthermore, we demonstrate that priming with higher epitope density results in a 2-fold decrease in the expression of Neuron-derived orphan nuclear receptor 1 (Nor-1) and this correlates with a lower level of conversion of Bcl-2 into a pro-apoptotic molecule and an increased number of memory T cells.Our results show that the amount of antigen encountered by naïve CD8(+) T cells following immunization with dendritic cells does not influence the generation of functional effector CD8(+) T cells but rather the number of CD8(+) memory T cells that persist in the host. Our data support a model where antigenic epitope density sensed by CD8(+) T cells at priming influences memory generation by modulating Bcl6, Eomes and Nor-1 expression

Implementasi Program Pemberdayaan Ekonomi Rakyat Melalui Program Mamangun Tuntang Mahaga Lewu (Pm2l) (Studi Kasus Di Dua Desa Tertinggal Di Kalimantan Tengah)

This study aims to determine the implementation of the program of economic empowerment of the people through the program mamangun Tuntang mahaga Lewu (PM2L). Writing method used is qualitative. This method was chosen because it examines the phenomenon of something in more depth, and more able to understand the phenomenon that until now has not been known. Through this study were obtained in the implementation of key information that PM2L are several stages to go through the stage of coordination, socialization, implementation of the action, coaching, monitoring and evaluation. In general, the stages through which it has not been optimal program implementation in practice, especially in terms of stages of development

CD40-Activated B Cells Can Efficiently Prime Antigen-Specific Naïve CD8+ T Cells to Generate Effector but Not Memory T cells

Background: The identification of the signals that should be provided by antigen-presenting cells (APCs) to induce a CD8 + T cell response in vivo is essential to improve vaccination strategies using antigen-loaded APCs. Although dendritic cells have been extensively studied, the ability of other APC types, such as B cells, to induce a CD8 + T cell response have not been thoroughly evaluated. Methodology/Principal Findings: In this manuscript, we have characterized the ability of CD40-activated B cells, stimulated or not with Toll-like receptor (TLR) agonists (CpG or lipopolysaccharide) to induce the response of mouse naïve CD8 + T cells in vivo. Our results show that CD40-activated B cells can directly present antigen to naïve CD8 + T cells to induce the generation of potent effectors able to secrete cytokines, kill target cells and control a Listeria monocytogenes infection. However, CD40-activated B cell immunization did not lead to the proper formation of CD8 + memory T cells and further maturation of CD40-activated B cells with TLR agonists did not promote the development of CD8 + memory T cells. Our results also suggest that inefficient generation of CD8 + memory T cells with CD40-activated B cell immunization is a consequence of reduced Bcl-6 expression by effectors and enhanced contraction of the CD8 + T cell response. Conclusions: Understanding why CD40-activated B cell immunization is defective for the generation of memory T cells and gaining new insights about signals that should be provided by APCs are key steps before translating the use of CD40-B cel

La complexité de l'apprentissage de l'écriture au début du primaire

Morin Marie-France, Lavoie Nathalie, Labrecque Anne-Marie. La complexité de l'apprentissage de l'écriture au début du primaire. In: La Lettre de l'AIRDF, n°52, 2012. pp. 41-45