Impact d'un programme modifiant les habitudes de vie sur la fonction diastolique ventriculaire gauche dans le syndrome métabolique

Il est reconnu que les changements au niveau des habitudes de vie ont des impacts favorables sur la santé cardiovasculaire. La dysfonction diastolique ventriculaire gauche est d’ailleurs un problème cardiaque très répandu. La réversibilité de ce trouble cardiaque suite à une intervention non-pharmacologique a peu été étudiée. Dans le cadre de cette maîtrise, il a été observé que la dysfonction diastolique est réversible suite à un programme de modification des habitudes de vie d’une durée d’un an. Les déterminants, en début d’étude, qui caractérisaient les participants ayant amélioré leur fonction diastolique en cours d’intervention étaient une tolérance au glucose détériorée, une tension artérielle systolique à l’effort plus élevée ainsi qu’une meilleure performance lors de l’épreuve maximale d’effort. Les bénéfices significatifs gagnés en cours de programme au niveau des différents indices d’adiposité, de la résistance à l’insuline ainsi que de la tolérance à l’effort n’étaient pas reliés à l’amélioration de la dysfonction diastolique.It is known that lifestyle changes have positive impact on cardiovascular risk factors. Left ventricular diastolic dysfunction is certainly the most prevalent cardiovascular disease. Not a lot is found in the literature regarding the reversibility of this dysfunction. During this project, it was observed that diastolic dysfunction is reversible following a 1-year lifestyle modification program. Baseline characteristics of participants who improved their diastolic function were an impaired glucose tolerance, a higher systolic blood pressure at maximal effort as well as a better performance at maximal effort test. Changes in adiposity measures, insulin resistance and exercise tolerance induced by this program did not correlate with improvements in diastolic function

Impacto da pandemia COVID-19 nas notificações de eventos adversos de medicamentos às autoridades de saúde: protocolo de revisão sistemática

The aim was to outline the protocol for carrying out the systematic review, which will have the objective of evaluating the impact of the COVID-19 pandemic on notifications of adverse drug events to health authorities worldwide. This is a systematic review protocol consistent with PRISMA 2020 regulations and checklist, will be conducted in accordance with the recommendations of the Cochrane Manual, will include original observational studies, letters to editors and editorials containing summary information on adverse drug events before and during the COVID-19 pandemic. The search strategy was developed for the MEDLINE, Embase, CINALH, SciELO and gray literature databases, using the Health Sciences Descriptors (DECs) and the Medical Subject Heading (MeSH). Two independent reviewers will investigate the eligibility of the articles, extract the data and assess the risk of bias. The results of this review will contribute to identifying the impact of COVID-19 on adverse drug event reporting, this will be a significant step in informing and preventing such events and will provide an essential evidence base for the development of strategies and improvements that will contribute to patient safety worldwide.Objetivou-se delinear o protocolo da realização da revisão sistemática que terá o objetivo de avaliar o impacto da pandemia COVID-19 nas notificações de eventos adversos a medicamentos às autoridades sanitárias em todo o mundo.  Trata-se de um protocolo de revisão sistemática consistente com as normativas e checklist PRISMA 2020, será conduzido de acordo com as recomendações do Manual Cochrane, incluirá estudos observacionais originais, cartas aos editores e editoriais contendo informações resumidas sobre os eventos adversos a medicamentos antes e durante a pandemia COVID-19. A estratégia de busca foi desenvolvida para as bases de dados MEDLINE, Embase, CINALH, SciELO e literatura cinzenta, utilizando os Descritores em Ciências da Saúde (DECs) e no Medical Subject Heading (MeSH). Dois revisores independentes investigarão a elegibilidade dos artigos, extrairão os dados e avaliarão o risco de viés. Os resultados desta revisão contribuirão para identificar o impacto da COVID-19 nas notificações de eventos adversos a medicamentos, este será um passo significativo para informar e prevenir tais eventos e fornecerá uma base de evidências essenciais para o desenvolvimento de estratégias e melhorias que contribuirão para a segurança do paciente em nível mundial

Impacto da pandemia COVID-19 nas notificações de eventos adversos de medicamentos às autoridades de saúde: protocolo de revisão sistemática

The aim was to outline the protocol for carrying out the systematic review, which will have the objective of evaluating the impact of the COVID-19 pandemic on notifications of adverse drug events to health authorities worldwide. This is a systematic review protocol consistent with PRISMA 2020 regulations and checklist, will be conducted in accordance with the recommendations of the Cochrane Manual, will include original observational studies, letters to editors and editorials containing summary information on adverse drug events before and during the COVID-19 pandemic. The search strategy was developed for the MEDLINE, Embase, CINALH, SciELO and gray literature databases, using the Health Sciences Descriptors (DECs) and the Medical Subject Heading (MeSH). Two independent reviewers will investigate the eligibility of the articles, extract the data and assess the risk of bias. The results of this review will contribute to identifying the impact of COVID-19 on adverse drug event reporting, this will be a significant step in informing and preventing such events and will provide an essential evidence base for the development of strategies and improvements that will contribute to patient safety worldwide.Objetivou-se delinear o protocolo da realização da revisão sistemática que terá o objetivo de avaliar o impacto da pandemia COVID-19 nas notificações de eventos adversos a medicamentos às autoridades sanitárias em todo o mundo.  Trata-se de um protocolo de revisão sistemática consistente com as normativas e checklist PRISMA 2020, será conduzido de acordo com as recomendações do Manual Cochrane, incluirá estudos observacionais originais, cartas aos editores e editoriais contendo informações resumidas sobre os eventos adversos a medicamentos antes e durante a pandemia COVID-19. A estratégia de busca foi desenvolvida para as bases de dados MEDLINE, Embase, CINALH, SciELO e literatura cinzenta, utilizando os Descritores em Ciências da Saúde (DECs) e no Medical Subject Heading (MeSH). Dois revisores independentes investigarão a elegibilidade dos artigos, extrairão os dados e avaliarão o risco de viés. Os resultados desta revisão contribuirão para identificar o impacto da COVID-19 nas notificações de eventos adversos a medicamentos, este será um passo significativo para informar e prevenir tais eventos e fornecerá uma base de evidências essenciais para o desenvolvimento de estratégias e melhorias que contribuirão para a segurança do paciente em nível mundial

Reporting rates of opioid-related adverse events since 1965 in Canada : a descriptive retrospective study

Background : Patients with chronic or acute/postoperative pain frequently use opioids. However, opioids may cause considerable adverse reactions (ARs), such as respiratory depression, which could be lethal. Unfortunately, only 5% of drug-related ARs (including those to opioids) are reported to health authorities. Therefore, little is known regarding the occurrence of opioid-related ARs at the population level. Objective : The aim of this study was to investigate how the rates of reported opioid-related ARs have changed in Canada since 1965. Methods : Our retrospective study examined trends of reported opioid-related ARs occurring in hospitalized and outpatients. Data on opioid-related ARs and mortality between 1965 and 2019 were obtained from the Canada Vigilance and Statistics Canada databases. Descriptive and Joinpoint regression analyses were performed. Results : Oxycodone and normethadone were the most and least involved opioid agents, respectively, among the 18,407 reported ARs. The highest rate of reported opioid ARs (3.8 per 100,000 person-years) was recorded in 2012, whereas the lowest was recorded in 1965 (0.1 per 100,000 person-years). Between 1965 and 2019, annual rates climbed by 4.2% (95% confidence interval [CI] 3.1–5.2), and many fluctuations were observed: 1965–1974: +22.3% (95% CI 12.0–33.6); 1974–2000: − 4.1% (95% CI − 5.3 to − 2.9); 2000–2008: +30.3% (95% CI 22.6–38.4); 2008–2014: +4.1% (95% CI − 1.5 to 10.1); 2014–2017: −26.0% (95% CI − 44.7 to − 0.9); and, finally, 2017–2019: +35.4% (95% CI 3.8–76.7). Conclusion : Reported opioid-related ARs have increased since 1965, although fluctuations were observed in recent decades. The absolute number of opioid-related ARs might be seriously underestimated. Future studies should look into how to close this gap

Prévenir les violences sexuelles en milieu autochtone : retour sur la formation au Programme Lanterne/Awacic

Objectifs : La violence sexuelle demeure un problème sociétal touchant tous les groupes sociaux comme les enfants. En ce sens, cette étude évalue un programme de formation à la prévention de la violence sexuelle chez les tout-petits en communautés autochtones. L’étude vise à documenter les effets de la formation au Programme Lanterne|Awacic ainsi qu’à identifier les barrières et les leviers propres à ce type de formation. Méthode : Menée auprès de 42 intervenants, cette étude évaluative de nature mixte a privilégié l’utilisation de trois types de collecte de données : le questionnaire, l’entrevue et le groupe de discussion. Résultats : Des effets positifs de la formation ont été observés à très court terme (p. ex., augmentation des connaissances et des croyances). Les résultats sont plus mitigés quant à son effet sur l’utilisation des outils à moyen terme (p. ex., faible utilisation des outils). Les résultats mettent également en exergue l’importance du processus de sécurisation culturelle dans les projets menés dans les communautés autochtones, la nécessité d’impliquer la population locale dans le projet et l’appréciation des participants face à la formation au Programme Lanterne|Awacic. Implications : La formation permet d’outiller les professionnels œuvrant auprès des enfants d’âge préscolaire à intervenir en matière de prévention de la violence sexuelle. Les résultats suggèrent néanmoins qu’un rappel de la formation aurait permis de maintenir les effets à plus long terme. En somme, les résultats indiquent la pertinence de poursuivre les efforts de prévention dans les communautés autochtones

Predictors of mental health among male university employees during the first year of the COVID-19 pandemic

Background: The COVID-19 pandemic forced university staff to change their work practices. This has had an impact on their work performance and has caused various stresses. Until now, little attention has been paid to males working in this type of educational institution. In this study, we sought to determine the impact of the COVID-19 pandemic on males working in educational institutions. Methods: A quantitative study with three phases of data collection was conducted at eleven Canadian universities. Between 264 and 371 males completed an online questionnaire with validated tests to measure their level of anxiety, depression and post-traumatic stress. Results: During the first year of the pandemic, anxiety and depression scale scores increased while post-traumatic stress scores decreased. This study also revealed that the feelings and meanings that males gave to the pandemic played a very important role in their mental health. Conclusions: University administrations should not underestimate the suffering that male employees may experience during a crisis such as the COVID-19 pandemic

Stressed and distressed: how is the COVID-19 pandemic associated with sexual frequency, sexual satisfaction, and relationship satisfaction?

Background: The Canadian government’s response to the ongoing COVID-19 pandemic included the implementation of several restrictive measures since March 2020. These actions sought to decrease social contact and increase physical distancing, including that within universities. Such constraints were required to impede the transmission of the virus; however, concerns remain about their impact on the sexual and intimate relationships of university employees and students. Aim: This study examined the associations between COVID-19–related stress and sexual frequency, sexual satisfaction, and relationship satisfaction, also testing the mediating role of psychological distress. Methods: The models were tested with Canadian data collected from university employees and students in 2 phases: the first wave in April-May 2020 (T1; n = 2754) and the second wave in November-December 2021 (T2; n = 1430), 18 months afterward. Participants completed self-report questionnaires online. Path analyses were performed to test the associations of the mediation models. Outcomes: The principal outcomes included psychological distress determined via the Patient Health Questionnaire–4, relationship satisfaction measured via the Dyadic Adjustment Scale, and sexual satisfaction and sexual frequency ascertained through a single item each. Results: Overall, COVID-19–related stress was associated with higher psychological distress, which in turn was related to lower sexual frequency, sexual satisfaction, and relationship satisfaction. Similar results were obtained with T1 and T2 data, indicating the mediating effect of psychological distress. Clinical implications: These findings increase scholarly comprehension of the negative associations between stress/distress and sexual and romantic relationships. Sexuality and close relationships are vital to the quality of human life; thus, targeted interventions should be developed to reduce COVID-19–related stress and its impact on sexual and romantic relationships to mitigate the long-term influences of this unique global challenge. Strengths & Limitations: To our knowledge, this study is the first to use a large sample size and replicate findings in 2 waves. Nonetheless, it is limited by the use of cross-sectional data. Longitudinal studies with the same participants are mandated to better understand the evolution of these outcomes. Conclusion: COVID-19–related stress and psychological distress were found among participating university students and employees and were associated with lower sexual satisfaction, sexual frequency, and intimate relationship satisfaction. These results were observed at the early onset of the pandemic and 18 months afterward, suggesting that the stress generated by the pandemic were not mere reactions to the onset of the pandemic but persisted over time

Global prevalence of antidepressant utilization in the community: A protocol for a systematic review

Introduction Antidepressant drugs are the most frequently prescribed medication for mental disorders. They are also used off-label and for non-psychiatric indications. Prescriptions of antidepressants have increased in the last decades, but no systematic review exists on the extent of their use in the community. Methods and analysis We will conduct a systematic review to estimate the prevalence of antidepressant use in the community. We will search for studies published from 1 January 2010 in the Embase and MEDLINE databases using a combination of controlled vocabulary and keywords adjusted for each database without any language restriction. The main inclusion criterion is the presence of prevalence data of antidepressant utilization. Thus, we will include all studies with a descriptive observational design reporting the prevalence of antidepressant use in the community. Study selection (by title/abstract and full-text screening) and data extraction for included studies will be independently conducted by pairs of reviewers. We will then synthesize the data on the prevalence of antidepressant use in individuals living in the community. If possible, we will perform a meta-analysis to generate prevalence-pooled estimates. If the data allows it, we will conduct subgroup analyses by antidepressant class, age, sex, country and other sociodemographic categories. We will evaluate the risk of bias for each included study through a quality assessment using the Joanna Briggs Institute Critical Appraisal tool: Checklist for Studies Reporting Prevalence Data. DistillerSR software will be used for the management of this review. Ethics and dissemination Ethical approval is not required for this review as it will not directly involve human or animal subjects. The findings of our systematic review will be disseminated through publications in peer-reviewed journals, the Qualaxia Network (https://qualaxia.org), presentations at international conferences on mental health and pharmacoepidemiology, as well as general public events. PROSPERO registration number CRD42021247423

La conciliation travail-famille chez les employés universitaires ayant des enfants de 11 ans et moins dans le contexte de la pandémie de la COVID-19

Cadre de la recherche : Bien que tous les résidents du Québec aient été affectés par la pandémie de la COVID-19 et par les mesures sanitaires et sociales mises en place depuis le 13 mars 2020, les parents occupant un emploi rémunéré ont été particulièrement affectés par les différents stresseurs engendrés par cette crise, et ce, tant dans leur vie familiale que professionnelle. Dans un tel contexte, il apparaît pertinent de se pencher sur les conséquences engendrées par la pandémie sur la conciliation travail-famille, et plus particulièrement sur les facteurs qui y sont associés. Objectifs : La présente étude vise à documenter les caractéristiques personnelles, familiales et professionnelles associées à la conciliation travail-famille chez les employés universitaires ayant des enfants âgés de 11 ans ou moins dans le contexte de la pandémie. Méthodologie : Les données utilisées pour la présente étude ont été collectées entre le 24 avril et le 5 juin 2020 par le biais d’un sondage en ligne. Au total, 217 membres du personnel de dix établissements du Réseau de l’Université du Québec (RUQ) ont rempli le questionnaire, comprenant notamment des questions liées à la conciliation travail-famille. Des régressions linéaires multiples ont permis de déterminer l’influence respective des facteurs associés à la conciliation travail-famille. Résultats : De façon générale, cette étude indique que les employés universitaires ayant des enfants âgés de 11 ans ou moins présentent majoritairement un conflit travail-famille modéré ou élevé dans le contexte de la pandémie. Elle permet également de mettre en lumière certains facteurs susceptibles de favoriser ou de faire obstacle à la conciliation travail-famille dans cette population de parents, à savoir : le niveau de pression dans l’exercice du rôle parental, la satisfaction du partage des tâches liées aux soins et à l’éducation des enfants, la catégorie d’emploi, la stabilité du rendement au travail et le nombre de jeunes enfants d’âge scolaire. Conclusions : Ces résultats soulignent l’importance de mettre en œuvre des programmes de soutien professionnels et familiaux ainsi que des mesures de répit pour les parents ayant de jeunes enfants d’âge scolaire, afin de les aider à concilier leurs responsabilités familiales et professionnelles en temps de crise. Contribution : Bien que certaines études aient permis de documenter des facteurs associés à la conciliation travail-famille en temps de pandémie, ces dernières demeurent peu nombreuses et une seule a été réalisée en contexte québécois. Or, la conciliation travail-famille est susceptible d’être vécue différemment au Québec, qui se distingue des autres pays en ce qui a trait à sa politique familiale. De plus, cette étude est la première à s’intéresser aux employés universitaires, un groupe de travailleurs faisant partie des premiers à avoir été affectés par les fermetures des établissements scolaires au printemps 2020. Research Framework : Although all Quebec residents have been affected by the COVID-19 pandemic and by the health and social measures put in place since March 2020, working parents have been particularly affected by the various stressors caused by this crisis, in both their family and professional life. In such a context, it seems relevant to examine the consequences of the pandemic on work-family balance, and more specifically on the factors associated with it. Objectives : The purpose of this study is to document the personal, family and work characteristics associated with work-family balance among university employees with children aged 11 or younger in the context of the pandemic. Methodology : The data used for this study were collected between April 24 and June 5, 2020, through an online survey. A total of 217 staff members from ten institutions of the Quebec University Network completed the survey, which included questions related to work-family balance. Multiple linear regressions were used to determine the respective influence of factors associated with the work-family balance. Results : Overall, this study shows that university employees having children aged 11 or younger present a majority of moderate to high work-family conflict in the context of the pandemic. It also highlights some of the factors that may help or hinder work-family balance in this population of parents, namely level of parenting strain, satisfaction with sharing childcare and parenting duties, job category, stability of job performance, and number of young school-aged children. Conclusions : These findings underscore the importance of implementing work and family support programs and respite measures for parents with young school-aged children to help them balance their family and work responsibilities in times of crisis. Contribution : Although some studies have documented factors associated with work-family balance in times of pandemic, they remain few and only one has been conducted in the Quebec context. Work-family balance is likely to be experienced differently in Quebec, which is different from other countries in terms of its family policy. In addition, this study is the first to look at university employees, a group of workers who were among the first to be affected by the school closures in the spring of 2020