Étude du mécanisme de rétrotransposition des ARN hY dans les cellules humaines

Chez l'humain, il y a présence de quatre petits ARN Y; soit les ARN hYl, hY3, hY4 et hY5. La longueur de ces ARN varie entre 84 (hY5) à 112 (hY1) nucléotides. Ces ARN forment une longue structure tige boucle pouvant être liée par une protéine nommée Ro60. Les ribonucléoprotéines Ro (Ro RNP) résultent de la liaison de Ro60 ainsi que celle de la protéine La aux ARN hY. Ces Ro RNP sont la cible d'auto-anticorps chez des patients atteints de pathologies du tissu conjonctif, comme le lupus érythémateux systémique. Les connaissances sur le rôle de ces petits ARN non-codants sont limitées. Cela rend leur étude d'autant plus importante. Par contre, quelques évidences suggèrent leur implication dans la réplication chromosomale. Récemment, environ mille pseudogènes Y ont été découverts dans le génome humain; leur présence suggère un mécanisme de rétrotransposition. L'étude des séquences adjacentes aux pseudogènes a permis d'identifier une signature de la machinerie des Long Interspersed Nuclear Elements 1 (LINE-1), suggérant un nouvel élément mobile similaire à Alu. De plus, la majorité des pseudogènes Y présentaient des mutations précises aux sites de liaison de plusieurs protéines, dont Ro60. Cela nous a amenés à explorer les différents aspects du mécanisme de rétroposition présumé des ARN hY. Pour ce faire, nous avons adapté un essai de rétrotransposition Ll dans les cellules HeLa. Notre principale hypothèse était de vérifier si l'absence de protéines liées à l'ARN Y pouvait influencer la rétrotransposition de l'ARN en question. La méthode de détection par dénombrement de colonies s'est avérée peu profitable puisqu'elle manquait de sensibilité. Les niveaux très faibles et le taux élevé de variation entre les différents essais ne permettaient pas d'émettre des conclusions claires et précises. Par la suite, nous avons développé une seconde méthode de détection basée sur la PCR quantitative en temps réel. Il s'agit d'une nouvelle application pour l'étude des événements de rétrotransposition. Celle-ci nous a permis de démentir notre hypothèse : la perte de liaison de certaines protéines ne favoriserait pas la prise en charge de l'ARN hY par la machinerie Ll

The breastfeeding experience of women with major difficulties who use the services of a breastfeeding clinic: a descriptive study

<p>Abstract</p> <p>Background</p> <p>Many women experience breastfeeding difficulties. Sometimes these difficulties lead to breastfeeding cessation. Breastfeeding clinics provide support for women facing such problems. This study aims to describe the breastfeeding experience of women, particularly those who use the services of the breastfeeding clinic located in the Greater Quebec City area.</p> <p>Methods</p> <p>This is a descriptive study based on information gathered through telephone questionnaires that were administered in 2006 to a sample of 86 women and semi-structured interviews conducted with 12 of these women.</p> <p>Results</p> <p>Painful nipples/breasts, low milk supply and latching difficulties were the three most frequent major breastfeeding problems identified by women. Their personal characteristics as well as the moral and physical support provided by family and friends and by health professional and clinicians at the breastfeeding clinic were the factors identified most often as having a positive influence on the breastfeeding experience.</p> <p>Conclusion</p> <p>The results suggest that breastfeeding clinics have a critical role to play in improving the breastfeeding experience of women with major difficulties.</p

Perspectives on strategies to foster inclusion through sports : advantages, disadvantages and considerations for implementation.

This article presents the results of a study on the perspectives of stakeholders from mainstream and specialised sports settings on seven strategies that could boost the impact of sports on social inclusion of people with intellectual disability. These strategies are: 1) developing Unified Sports; 2) conducting activities to raise awareness; 3) providing training to coaches; 4) using shadows; 5) developing a peer-support structure; 6) having a resource person available when needed; 7) facilitating engagement in non-playing roles. The perspectives of 28 stakeholders regarding the advantages, disadvantages and considerations for implementation of the different strategies were gathered in discussion groups. Findings could help diversify opportunities for athletes with intellectual disability and develop programs and policies that contribute to building inclusive communities through sports

A scoping review of clinical practice improvement methodology use in rehabilitation

CONTEXT: The Clinical Practice Improvement (CPI) approach is a methodological and quality improvement approach that has emerged and is gaining in popularity. However, there is no systematic description of its use or the determinants of its practice in rehabilitation settings. METHOD: We performed a scoping review of the use of CPI methodology in rehabilitation settings. RESULTS: A total of 103 articles were reviewed. We found evidence of 13 initiatives involving CPI with six different populations. A total of 335 citations of determinants were found, with 68.7% related to CPI itself. Little information was found about what type of external and internal environment, individual characteristics and implementation process might facilitate or hinder the use of CPI. CONCLUSION: Given the growing popularity of this methodological approach, CPI initiatives would gain from increasing knowledge of the determinants of its success and incorporating them in future implementation

Effect of rehabilitation length of stay on outcomes in individuals with traumatic brain injury or spinal cord injury : a systematic review protocol

Background: Rehabilitation interventions are a key component of the services required by individuals with neurotrauma to recover or compensate for altered abilities and achieve optimal social participation. Primary studies have produced evidence of the effect of rehabilitation length of stay on individuals with neurotrauma. However, to date no systematic review of this evidence has been performed. This makes it difficult for managers and clinicians to base their rehabilitation practices upon evidence. Method: Supported by a committee of stakeholders, we will search electronic databases for research articles examining the association between length of stay or intensity of inpatient rehabilitation services and outcomes or the determinants of inpatient rehabilitation length of stay in adults with neurotrauma published after January 1990. Two researchers will independently screen the article titles and abstracts for inclusion. Two reviewers will independently extract the data. Primary outcomes of interest will be level of function, participation and return to work. If the data allow it, a meta-analysis of the studies will be performed. Discussion: The results of this systematic review will clarify the factors that influence length of stay and intensity of rehabilitation services for individuals with TBI and SCI. They will give clinicians indications for optimal length of stay in these patient populations, contributing to better quality of care and better functional results

Consensus group sessions: a useful method to reconcile stakeholders’ perspectives about network performance evaluation

Background: Having a common vision among network stakeholders is an important ingredient to developing a performance evaluation process. Consensus methods may be a viable means to reconcile the perceptions of different stakeholders about the dimensions to include in a performance evaluation framework. Objectives: To determine whether individual organizations within traumatic brain injury (TBI) networks differ in perceptions about the importance of performance dimensions for the evaluation of TBI networks and to explore the extent to which group consensus sessions could reconcile these perceptions. Methods: We used TRIAGE, a consensus technique that combines an individual and a group data collection phase to explore the perceptions of network stakeholders and to reach a consensus within structured group discussions. Results: One hundred and thirty-nine professionals from 43 organizations within eight TBI networks participated in the individual data collection; 62 professionals from these same organisations contributed to the group data collection. The extent of consensus based on questionnaire results (e.g. individual data collection) was low, however, 100% agreement was obtained for each network during the consensus group sessions. The median importance scores and mean ranks attributed to the dimensions by individuals compared to groups did not differ greatly. Group discussions were found useful in understanding the reasons motivating the scoring, for resolving differences among participants, and for harmonizing their values

Mental health following acquisition of disability in adulthood-the impact of wealth

BACKGROUND: Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. METHODS: We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001-2012) from the Household, Income and Labour Dynamics in Australia survey-a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF-36 as the outcome. RESULTS: In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p&lt;0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). CONCLUSION: The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth

Pharmacological interventions for agitation in patients with traumatic brain injury: protocol for a systematic review and meta-analysis

Abstract Background Traumatic brain injury (TBI) is a worldwide leading cause of mortality and disability. Among TBI complications, agitation is a frequent behavioural problem. Agitation causes potential harm to patients and caregivers, interferes with treatments, leads to unnecessary chemical and physical restraints, increases hospital length of stay, delays rehabilitation, and impedes functional independence. Pharmacological treatments are often considered for agitation management following TBI. Several types of agents have been proposed for the treatment of agitation. However, the benefit and safety of these agents in TBI patients as well as their differential effects and interactions are uncertain. In addition, animal studies and observational studies have suggested impaired cognitive function with the use of certain antipsychotics and benzodiazepines. Hence, a safe and effective treatment for agitation, which does not interfere with neurological recovery, remains to be identified. Methods/design With the help of Health Sciences librarian, we will design a search strategy in the following databases: PubMed, Ovid MEDLINE®, EMBASE, CINAHL, PsycINFO, Cochrane Library, Google Scholar, Directory of Open Access Journals, LILACS, Web of Science, and Prospero. A grey literature search will be performed using the resources suggested in CADTH’s Grey Matters. We will include all randomized controlled, quasi-experimental, and observational studies with control groups. The population of interest is all patients, including children and adults, who have suffered a TBI. We will include studies in which agitation, not further defined, was the presenting symptom or one of the presenting symptoms. We will also include studies where agitation was not the presenting symptom but was measured as an outcome variable and studies assessing the safety of these pharmacological interventions in TBI patients. We will include studies evaluating all pharmacological interventions including beta-adrenergic blockers, typical and atypical antipsychotics, anticonvulsants, dopamine agonists, psychostimulants, antidepressants, alpha-2-adrenergic agonists, hypnotics, and anxiolytics. Discussion Although agitation is frequent following TBI and pharmacological agents that are often used, there is no consensus on the most efficacious and safest strategy to treat these complications. There is a need for an updated systematic review to summarize the evidence in order to inform practice and future research. Systematic review registration PROSPERO CRD4201603314

Strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities : a systematic literature review

Objective: Identifying effective strategies to reduce waiting times is a crucial issue in many areas of health services. Long waiting times for rehabilitation services have been associated with numerous adverse effects in people with disabilities. The main objective of this study was to conduct a systematic literature review to assess the effectiveness of service redesign strategies to reduce waiting times in outpatient rehabilitation services for adults with physical disabilities. Methods: We conducted a systematic review, searching three databases (MEDLINE, CINAHL and EMBASE) from their inception until May 2021. We identified studies with comparative data evaluating the effect of rehabilitation services redesign strategies on reducing waiting times. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. A narrative synthesis was conducted. Results: Nineteen articles including various settings and populations met the selection criteria. They covered physiotherapy (n = 11), occupational therapy (n = 2), prosthetics (n = 1), exercise physiology (n = 1) and multidisciplinary (n = 4) services. The methodological quality varied (n = 10 high quality, n = 6 medium, n = 3 low); common flaws being missing information on the pre-redesign setting and characteristics of the populations. Seven articles assessed access processes or referral management strategies (e.g. self-referral), four focused on extending/modifying the roles of service providers (e.g. to triage) and eight changed the model of care delivery (e.g. mode of intervention). The different redesign strategies had positive effects on waiting times in outpatient rehabilitation services. Conclusions: This review highlights the positive effects of many service redesign strategies. These findings suggest that there are several effective strategies to choose from to reduce waiting times and help better respond to the needs of persons experiencing physical disabilities