La « tripe » : trousse de ressources Internet pour les professeurs de chimie du programme Sciences de la nature (niveau collégial)

Projet réalisé dans le cadre du Programme de recherche et d'expérimentation du réseau de l'enseignement collégial privé

La « tripe » : trousse de ressources Internet pour les professeurs de chimie du programme Sciences de la nature (niveau collégial) /

Projet réalisé dans le cadre du Programme de recherche et d'expérimentation du réseau de l'enseignement collégial privé

Exploring the use of a participative design in the early development of a predictive test : the importance of physician involvement

In this study, we contribute to the personalized medicine and health care management literature by developing and testing a new participative design approach. We propose that involving gastroenterologists in the development of a predictive test to assist them in their clinical decision-making process for the treatment of inflammatory bowel diseases will increase the likelihood of their acceptance of the innovation. Based on data obtained from 6 focus groups across Canada from a total of 28 physicians, analyses reveal that current tools do not enable discriminating between treatment options to find the best fit for each patient. Physicians expect a new predictive tool to have the capability of showing clear reliability and significant benefits for the patient, while being accessible in a timely manner that facilitates clinical decisions. Physicians also insist on their key role in the implementation process, hence confirming the relevance and importance of participative designs in personalized medicine

Patients’ perception of their involvement in shared treatment decision making : key factors in the treatment of inflammatory bowel disease

Objectives This study aims to characterize the relationships between the quality of the information given by the physician, the involvement of the patient in shared decision making (SDM), and outcomes in terms of satisfaction and anxiety pertaining to the treatment of inflammatory bowel disease (IBD). Methods A Web survey was conducted among 200 Canadian patients affected with IBD. The theoretical model of SDM was adjusted using path analysis. SAS software was used for all statistical analyses. Results The quality of the knowledge transfer between the physician and the patient is significantly associated with the components of SDM: information comprehension, patient involvement and decision certainty about the chosen treatment. In return, patient involvement in SDM is significantly associated with higher satisfaction and, as a result, lower anxiety as regards treatment selection. Conclusions This study demonstrates the importance of involving patients in shared treatment decision making in the context of IBD. Practice implications Understanding shared decision making may motivate patients to be more active in understanding the relevant information for treatment selection, as it is related to their level of satisfaction, anxiety and adherence to treatment. This relationship should encourage physicians to promote shared decision making

Using a community-based definition of poverty for targeting poor households for premium subsidies in the context of a community health insurance in Burkina Faso

Background: One of the biggest challenges in subsidizing premiums of poor households for community health insurance is the identification and selection of these households. Generally, poverty assessments in developing countries are based on monetary terms. The household is regarded as poor if its income or consumption is lower than a predefined poverty cut-off. These measures fail to recognize the multi-dimensional character of poverty, ignoring community members? perception and understanding of poverty, leaving them voiceless and powerless in the identification process. Realizing this, the steering committee of Nouna's health insurance devised a method to involve community members to better define `perceived? poverty, using this as a key element for the poor selection. The community-identified poor were then used to effectively target premium subsidies for the insurance scheme. Methods: The study was conducted in the Nouna's Health District located in northwest Burkina Faso. Participants in each village were selected to take part in focus-group discussions (FGD) organized in 41 villages and 7 sectors of Nouna's town to discuss criteria and perceptions of poverty. The discussions were audio recorded, transcribed and analyzed in French using the software NVivo 9. Results: From the FGD on poverty and the subjective definitions and perceptions of the community members, we found that poverty was mainly seen as scarcity of basic needs, vulnerability, deprivation of capacities, powerlessness, voicelessness, indecent living conditions, and absence of social capital and community networks for support in times of need. Criteria and poverty groups as described by community members can be used to identify poor who can then be targeted for subsidies. Conclusion: Policies targeting the poorest require the establishment of effective selection strategies. These policies are well-conditioned by proper identification of the poor people. Community perceptions and criteria of poverty are grounded in reality, to better appreciate the issue. It is crucial to take these perceptions into account in undertaking community development actions which target the poor. For most community-based health insurance schemes with limited financial resources, using a community-based definition of poverty in the targeting of the poorest might be a less costly alternative

The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis.

Background: Molecular diagnostics are considered the most promising route to achievement of rapid, universal drug susceptibility testing for Mycobacterium tuberculosis complex (MTBC). We aimed to generate a WHO-endorsed catalogue of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. Methods: In this systematic analysis, we used a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for 13 WHO-endorsed antituberculosis drugs. We collected existing worldwide MTBC whole-genome sequencing data and phenotypic data from academic groups and consortia, reference laboratories, public health organisations, and published literature. We categorised phenotypes as follows: methods and critical concentrations currently endorsed by WHO (category 1); critical concentrations previously endorsed by WHO for those methods (category 2); methods or critical concentrations not currently endorsed by WHO (category 3). For each mutation, we used a contingency table of binary phenotypes and presence or absence of the mutation to compute positive predictive value, and we used Fisher's exact tests to generate odds ratios and Benjamini-Hochberg corrected p values. Mutations were graded as associated with resistance if present in at least five isolates, if the odds ratio was more than 1 with a statistically significant corrected p value, and if the lower bound of the 95% CI on the positive predictive value for phenotypic resistance was greater than 25%. A series of expert rules were applied for final confidence grading of each mutation. Findings: We analysed 41 137 MTBC isolates with phenotypic and whole-genome sequencing data from 45 countries. 38 215 MTBC isolates passed quality control steps and were included in the final analysis. 15 667 associations were computed for 13 211 unique mutations linked to one or more drugs. 1149 (7·3%) of 15 667 mutations were classified as associated with phenotypic resistance and 107 (0·7%) were deemed consistent with susceptibility. For rifampicin, isoniazid, ethambutol, fluoroquinolones, and streptomycin, the mutations' pooled sensitivity was more than 80%. Specificity was over 95% for all drugs except ethionamide (91·4%), moxifloxacin (91·6%) and ethambutol (93·3%). Only two resistance mutations were identified for bedaquiline, delamanid, clofazimine, and linezolid as prevalence of phenotypic resistance was low for these drugs. Interpretation: We present the first WHO-endorsed catalogue of molecular targets for MTBC drug susceptibility testing, which is intended to provide a global standard for resistance interpretation. The existence of this catalogue should encourage the implementation of molecular diagnostics by national tuberculosis programmes. Funding: Unitaid, Wellcome Trust, UK Medical Research Council, and Bill and Melinda Gates Foundation

IMPORTANCE DE L'ORIGNAL DANS LE RÉGIME ALIMENTAIRE DES OURS NOIRS DU SUD-OUEST IN QUÉBEC

Afin d'évaluer l'impact possible de la prédation de l'Ours noir sur la dynamique des populations d'Orignaux, on a tenté de déterminer sa densité sur un territoire de 100 km2 par la méthode de capture et recapture et de préciser son régime alimentaire par l'analyse des fèces (n = 35). Les poils de mammifères constituaient seulement 2% du volume total des crottins. Les poils de Lièvre d'Amérique occupient le premier rang, suivis de ceux de l'Orignal adulte, de Castor, de l'Ours noir, de la Marmotte, de petits mammifères et du Cerf de Virginie. Une seule fèces contenait un sabot de faon Orignal. Même si la méthode de marquage-racapture a été inefficace, la densité de l'Ours noir dans le secteur d'étude a été évaluée à un minimum de 0,23 ours/km2

Une analyse des déterminants de la mobilité linguistique intergénérationnelle des immigrants allophones au Québec

l’immigration prend une importance accrue dans la croissance démographique québécoise et, selon Statistique Canada, 30 % des résidents de la région métropolitaine de recensement de Montréal pourraient être nés à l’étranger en 2031. Les allophones sont appelés à prendre une place plus importante numériquement et leurs choix linguistiques auront donc un effet accru sur l’équilibre du Québec. L’objectif de cet article est d’analyser les facteurs démographiques, ethnoculturels et socio-économiques associés à une transition linguistique intergénérationnelle vers l’une ou l’autre des deux langues officielles, au moyen d’une régression logistique appliquée aux microdonnées du recensement canadien de 2006. L’analyse porte sur les familles composées de deux parents de sexe opposé et au moins d’un enfant âgé de moins de 15 ans. Les résultats mettent en évidence l’effet des dispositions de la Charte de la langue française (loi 101) pour expliquer les choix linguistiques des allophones, ainsi que l’importance de la sélection d’immigrants francotropes. Néanmoins, l’attrait de l’anglais demeure important pour les allophones s’établissant au Québec, surtout chez les plus éduqués et parmi les classes socioprofessionnelles les plus favorisées.Immigration is playing a larger part in demographic growth in Quebec ; according to Canada Statistics, by 2031 30 % of residents of the metropolitan census area of Montreal may be born outside the area. Allophones will be numerically more important, and their linguistic choices will therefore have an increased effect on the demolinguistic balance of Quebec. The aim of this article is to analyse the demographic, ethno-cultural and socio-economic factors associated with intergenerational linguistic transfer to one or the other of the two official languages, using a logistic regression applied to the micro-data of the 2006 Canadian census. The analysis is of families made up of two parents of opposite sexes and at least one child aged under 15. The results demonstrate the effects of the provisions of the Charte de la langue française (law 101) in explaining the linguistic choices of allophones, and also the importance of the selection of Francotrope immigrants. However the attraction of English remains significant for allophones settling in Quebec, especially for the most highly educated and for the better-off socio-professional classes

VI. Du déterminisme technologique à l’acteur réseau. Un parcours théorique sur l’adoption de la technologie d’identification génétique au Canada

INTRODUCTION À l’instar d’autres nations occidentales, et sans trop de remous public et médiatique, le Canada s’est doté en l’an 2000 d’un dispositif permanent de mise en banque d’échantillons biologiques sur lesquels sont effectuées des analyses génétiques. La Banque nationale de données génétiques (BNDG) procède au pairage entre deux fichiers. Le premier est un fichier contenant des profils d’identification génétique développés à partir de substances corporelles prélevées sur les lieux de c..

Perspectives économiques 2024

Malgré le fort durcissement des conditions monétaire et financière, l’économie belge a progressé de manière significative durant les premiers trimestres de 2023. Selon nos prévisions, sa progression devrait se poursuivre au dernier trimestre 2023 et en 2024. Son rythme de croissance devrait toutefois ralentir quelque peu au cours des prochains trimestres. D’une part, plusieurs facteurs contraires à la croissance demeurent actuellement présents : la conjoncture industrielle demeure maussade en Belgique et au niveau mondial, l’économie allemande est proche de la récession, des problèmes internes contraignent la croissance économique chinoise, les conditions financières sont toujours très restrictives, les créations d’emplois sont moins nombreuses et les risques géopolitiques sont élevés. D’autre part, il semble que l’expansion économique belge soit soutenue depuis plusieurs trimestres par certains éléments particuliers, dont l’impact devrait être moins positif à l’avenir. Ainsi, au cours des trimestres passés, la consommation privée a probablement été soutenue par l’épargne excédentaire que les ménages ont accumulé durant la pandémie. On peut raisonnablement penser que cet effet sera moins actif à l’avenir