Viscoelastically active sutures – A stitch in time?

We present results to show that a commercially available polypropylene suture filament (Ethicon Prolene), following annealing and tensile creep can, after creep load removal, release viscoelastically stored energy over a period of several weeks. Specifically, over 0.1–1000 h, the suture undergoes a time-dependent contraction of ~4% and, following a short recovery time (~3 min) to a fixed strain, produces a progressively increasing recovery force of ~0.1–1 N. We suggest that this time-dependent energy release may facilitate wound healing by the action of viscoelastically induced mechanotransduction (VIM). Moreover, our recent (published) findings have led to evidence of reduced hydrophobicity from viscoelastically recovering polymeric filaments and speculation that this may emanate from the long-term release of electric charges. Thus, we propose that the latter may enhance the VIM mechanism. In this paper, we report on the direct detection of these charges and the first findings from an investigation involving the presence of cell cultures on Prolene samples that are (i) viscoelastically recovering, (ii) annealed only and (iii) in as-received condition. From (i), the results demonstrate a significant increase in cell motility, with migration towards the suture, compared to (ii) and (iii). This suggests greater stimulation of the wound healing process, an effect which is expected to continue for the duration of the viscoelastic recovery period

Philosophical Reflection and Cooperative Practices in an Elementary School Mathematics Classroom

Following Matthew Lipman (Lipman, 1991; Lipman, Sharp, & Oscanyan, 1980), we introduced philosophical dialogue (PD) about mathematics in an elementary school to help pupils consider mathematical and meta-mathematical matters. This article describes the social and cognitive activity when pupils engage in PD and some pedagogical conditions necessary to foster the development of PD. Changes in pupils’ discussions from the begin- ning to the end of the test period showed that the dynamic evolved from monological exchanges to dialogical exchanges. Whereas early pupil responses could be characterized mainly as simple answers, later responses displayed more lower-order and even higher- order thinking skills. The data suggest that for PD about mathematics to develop, the teacher must be proficient in the role of mediator. À la suite de Matthew Lipman (Lipman, 1991; Lipman, Sharp et Oscanyan, 1980), les auteurs ont introduit le dialogue philosophique (DP) dans une école primaire afin d’aider les élèves à réfléchir aux questions d’ordre mathématique et méta-mathématique. Cet article décrit l’activité sociale et cognitive à laquelle donne lieu le DP ainsi que certaines des conditions pédagogiques qui doivent être réunies pour favoriser le développement du DP. L’analyse des discussions des élèves du début à la fin de la période d’essai a révélé une évolution de la dynamique, des échanges monologiques aux échanges dialogiques. Si en premier les élèves donnent de simples réponses, par la suite ils démontrent des capa- cités de raisonnement élémentaires et même de plus haut niveau. Ces données semblent indiquer que pour que le DP au sujet de la mathématique se développe, l’enseignant doit devenir un médiateur efficace.

Philosophical Reflection and Cooperative Practices in an Elementary School Mathematics Classroom

Following Matthew Lipman (Lipman, 1991; Lipman, Sharp, & Oscanyan, 1980), we introduced philosophical dialogue (PD) about mathematics in an elementary school to help pupils consider mathematical and meta-mathematical matters. This article describes the social and cognitive activity when pupils engage in PD and some pedagogical conditions necessary to foster the development of PD. Changes in pupils’ discussions from the begin- ning to the end of the test period showed that the dynamic evolved from monological exchanges to dialogical exchanges. Whereas early pupil responses could be characterized mainly as simple answers, later responses displayed more lower-order and even higher- order thinking skills. The data suggest that for PD about mathematics to develop, the teacher must be proficient in the role of mediator. À la suite de Matthew Lipman (Lipman, 1991; Lipman, Sharp et Oscanyan, 1980), les auteurs ont introduit le dialogue philosophique (DP) dans une école primaire afin d’aider les élèves à réfléchir aux questions d’ordre mathématique et méta-mathématique. Cet article décrit l’activité sociale et cognitive à laquelle donne lieu le DP ainsi que certaines des conditions pédagogiques qui doivent être réunies pour favoriser le développement du DP. L’analyse des discussions des élèves du début à la fin de la période d’essai a révélé une évolution de la dynamique, des échanges monologiques aux échanges dialogiques. Si en premier les élèves donnent de simples réponses, par la suite ils démontrent des capa- cités de raisonnement élémentaires et même de plus haut niveau. Ces données semblent indiquer que pour que le DP au sujet de la mathématique se développe, l’enseignant doit devenir un médiateur efficace.

Habiletés morphosyntaxiques des enfants sourds porteurs d’implants cochléaires: une revue systématique = Morphosyntactic skills in deaf children with cochlear implants: a systematic review

Thanks to an increasingly early implantation, the majority of children with cochlear implants (CCI) now succeed in reaching the standard with regards to overall language skills. However, some difficulties persist in morphology. This study therefore attempts to better understand morphosyntactic skills, the means to evaluate these skills and the tasks that provide a detailed description of same. In terms of methodology, a systematic review of the scientific literature published between 2000 and 2013 helped us identify 215 publications of which 18 studies analysed included children who received their implant before the age of 36 months. The results confirm the inferior performance in morphology by CCI’s, especially in the complex stages of grammatical development. Their typical errors, often omissions and substitutions, involve the less salient and more exacting morphemes with regards to perceptual, semantic, and grammatical processing, that is agreement markers for gender and number of determinants and clitic pronouns, as well as verbal flexions. Our study demonstrates that global tests, specialized tests, and questionnaires only provide a partial image of the difficulties in morphosyntax, such that the analysis of the spontaneous language still remains the best tool for the clinician to identify CCI’s real abilities and challenges. Future research should therefore attempt to develop standardised and more sensitive evaluation tools that are better adapted to the realities of CCI’s, leading to a more targeted and efficient intervention. © 2014 Canadian Association of Speech-Language Pathologists and Audiologists. All rights reserved

Action syndicale, démocratie et santé mentale au travail

La problématique de la santé mentale au travail est très présente dans les milieux syndicaux, replaçant au coeur de l’action syndicale l’importance de la qualité de vie au travail. Plusieurs recherches participatives, inspirées de la psychodynamique de travail et des récits de pratiques ont permis d’explorer le vécu et la réflexion de militants syndicaux sur la santé mentale au travail, tant dans leur travail à l’intérieur des structures syndicales que dans leurs interventions dans divers milieux de travail. Les nouvelles formes d’organisation du travail, marquées par l’idéologie néoproductiviste portent atteinte à la santé mentale de nombre de travailleurs et travailleuses, y compris chez les représentants et militants syndicaux. La difficile démocratisation au travail constitue un risque important pour la santé mentale au travail, un signe peut‑être de la toujours présente aliénation au travail.The mental health issue in the workplace is quite present in unions, putting at the core of action the centrality of working quality of life. Many participative researches, based on psychodynamic of work and practitioners’ narratives gave access to the reflective experience of unions workers about mental health at work, in their own union working context and through their interventions in external workplaces situations. New forms of working organisations, influenced by the “neoproductivist” ideology, have negative effect on mental health of numerous workers. The difficult access to democracy in the workplace is one important risk for mental health and the sign of a still prevalent condition of work alienation

Evaluation of the impact of immediate versus WHO recommendations-guided antiretroviral therapy initiation on HIV incidence: the ANRS 12249 TasP (Treatment as Prevention) trial in Hlabisa sub-district, KwaZulu-Natal, South Africa: study protocol for a cluster randomised controlled trial

Background: Antiretroviral therapy (ART) suppresses HIV viral load in all body compartments and so limits the risk of HIV transmission. It has been suggested that ART not only contributes to preventing transmission at individual but potentially also at population level. This trial aims to evaluate the effect of ART initiated immediately after identification/diagnosis of HIV-infected individuals, regardless of CD4 count, on HIV incidence in the surrounding population. The primary outcome of the overall trial will be HIV incidence over two years. Secondary outcomes will include i) socio-behavioural outcomes (acceptability of repeat HIV counselling and testing, treatment acceptance and linkage to care, sexual partnerships and quality of life); ii) clinical outcomes (mortality and morbidity, retention into care, adherence to ART, virologic failure and acquired HIV drug resistance), iii) cost-effectiveness of the intervention. The first phase will specifically focus on the trial's secondary outcomes.Methods/design: A cluster-randomised trial in 34 (2 × 17) clusters within a rural area of northern KwaZulu-Natal (South Africa), covering a total population of 34,000 inhabitants aged 16 years and above, of whom an estimated 27,200 would be HIV-uninfected at start of the trial. The first phase of the trial will include ten (2 × 5) clusters. Consecutive rounds of home-based HIV testing will be carried out. HIV-infected participants will be followed in dedicated trial clinics: in intervention clusters, they will be offered immediate ART initiation regardless of CD4 count and clinical stage; in control clusters they will be offered ART according to national treatment eligibility guidelines (CD4 <350 cells/μL, World Health Organisation stage 3 or 4 disease or multidrug-resistant/extensively drug-resistant tuberculosis). Following proof of acceptability and feasibility from the first phase, the trial will be rolled out to further clusters.Discussion: We aim to provide proof-of-principle evidence regarding the effectiveness of Treatment-as-Prevention in reducing HIV incidence at the population level. Data collected from the participants at home and in the clinics will inform understanding of socio-behavioural, economic and clinical impacts of the intervention as well as feasibility and generalizability. © 2013 Iwuji et al.; licensee BioMed Central Ltd

Du jeu des identités à la transformation de réalités partagées : un programme d’ateliers d’expression théâtrale pour adolescents immigrants et réfugiés

La migration à l’adolescence est particulièrement délicate à cause du fardeau conjugué que représente à ce stade de la vie l’intégration des multiples pertes associées à la migration et l’adaptation au statut de jeune adulte. Le programme d’ateliers d’expression théâtrale vise à faciliter l’adaptation des adolescents immigrants et réfugiés à leur nouvel environnement à partir d’un travail créatif autour des enjeux identitaires liés à la migration et à un statut de minorité. Ces ateliers conjuguent une approche inspirée du théâtre playback qui permet une mise en scène du vécu personnel et le théâtre forum de Boal qui met l’accent sur la transformation collective de l’expérience. Les résultats d’une évaluation qualitative des ateliers d’expression théâtrale suggèrent que ceux-ci constituent un lieu d’expression ou les participants se sentent en sécurité et soutenus par l’équipe ainsi que par le caractère rituel du jeu théâtral. Les ateliers permettent de représenter la multiplicité des valeurs et des références internes et externes de l’adolescent et de les renégocier sans dichotomiser le « eux » et le « nous », en s’adressant aux questions de justice sociale qui se posent à la collectivité. Ils favorisent aussi l’élaboration des transitions de l’adolescence en permettant l’évocation des pertes de la migration et le passage vers une identité hybride.Migration during adolescence represents a challenge for the youth who need to simultaneously work through the multiple losses associated with the migratory journey and adapt to a young adult status. The drama workshop program described here was designed to facilitate the adjustment of newly arrived immigrant teens. The aim of the program is to make it easier for adolescents to adjust to their new environment through creative group work around identity issues. The program also seeks to improve intergroup relations in multiethnic schools. The workshops are inspired both from playback theater and from Boal’s form theater which emphasizes the collective transformation of the singular experience. The qualitative assessment of the program effects on the adolescents suggests that the workshops constitute a safe space of expression, in which the team and the ritual nature of the play hold the participants. The workshops facilitate the representation of the multiplicity of values in the adolescent world and invite them to reconsider the way in which they interact, with their environment, without splitting between “us” and “them,” but rather creating solidarities around issues of social justice. The workshops also address the life transformation associated both with adolescence and migration and help the elaboration of the losses linked to the migratory journey and the construction of a hybrid identity.La migración en la adolescencia es particularmente delicada a causa de la carga conjunta que representa en esta etapa de la vida la integración de las múltiples pérdidas asociadas a la migración y la adaptación a un estatus de joven adulto. El programa de talleres de expresión teatral busca facilitar la adaptación de los adolescentes inmigrantes y refugiados a su nuevo entorno, a partir de un trabajo creativo relacionado con las cuestiones de identidad ligadas a la migración y a un estatus de minoría. Estos talleres conjugan un enfoque inspirado del teatro playback, que permite una puesta en escena de una experiencia personal, y el teatro forum de Boal, que pone el acento en la transformación colectiva de la experiencia. Los resultados de una evaluación cualitativa de los talleres de expresión teatral sugieren que éstos constituyen un lugar de expresión en el que los participantes se sienten seguros y apoyados por el equipo, así como por el carácter ritual de la representación teatral. Los talleres permiten representar la multiplicidad de los valores y referencias internas y externas del adolescente, y renegociarlos sin crear una dicotomía entre el “ellos” y “nosotros” al tratar cuestiones de justicia social que se plantean a la colectividad. Favorecen también la elaboración de las transiciones de la adolescencia al permitir la evocación de las pérdidas de la migración y el paso hacia una identidad híbrida.A imigração na adolescência é especialmente delicada, por causa do fardo conjugado que representa, neste ponto da vida, a integração das múltiplas perdas associadas à imigração e à adaptação ao estatuto de jovem adulto. O programa de ateliês de expressão teatral visa facilitar a adaptação dos adolescentes imigrantes e refugiados ao seu novo ambiente, a partir de um trabalho criativo a respeito das preocupações identitárias relacionadas à imigração e a um estatuto de minoria. Estes ateliês conjugam uma abordagem inspirada no teatro playback, que permite uma representação da vivência pessoal, e no teatro fórum de Boal, que ressalta a transformação coletiva da experiência. Os resultados de uma avaliação qualitativa dos ateliês de expressão teatral sugerem que estes continuam sendo um lugar de expressão onde os participantes sentem-se em segurança e apoiados pela equipe e pelo caráter ritual da representação teatral. Os ateliês permitem representar a multiplicidade dos valores e das referências internas e externas do adolescente e renegociá-los sem dicotomizar o “eles” e o “nós”, falando sobre questões de justiça social que são colocadas à coletividade. Os ateliês favorecem também a elaboração das transições da adolescência permitindo a evocação das perdas da imigração e a passagem para uma identidade híbrida

Évaluation objective structurée de l’animation du débriefing (ÉOSAD) : traduction, adaptation et validation d’une rubrique

Contexte : Le débriefing en simulation clinique requiert des habiletés d’animation de la part des formateurs. Bien que des outils d’évaluation validés existent et pourraient servir à leur formation, ils sont uniquement disponibles en anglais et ne sont pas adaptés à la réalité québécoise. But : (1) Traduire une rubrique d’évaluation de la qualité de l’animation du débriefing (Objective Structured Assessment of Debriefing) en français et l’adapter au contexte québécois ; et (2) en tester la validité et la fidélité dans un contexte de formation en sciences infirmières. Méthodes : La rubrique a été traduite et adaptée par trois traducteurs indépendants. Des experts en simulation (n = 11) en ont validé le contenu selon une méthode Delphi modifiée. La rubrique traduite a été mise à l’essai auprès d’animateurs en simulation (n = 10) qui ont évalué la qualité de débriefings filmés (n = 16). Résultats : La rubrique présente une forte validité de contenu selon les experts et une forte validité concomitante en comparaison avec un score d’évaluation générale du débriefing. Les résultats pour les fidélités interjuges et test-retest montrent une variabilité dans l’attribution des scores par les animateurs de débriefing. Conclusion : La rubrique fournit un langage et des critères communs pour évaluer la qualité d’animation des débriefings. Elle pourrait servir de base à la formation des formateurs en précisant des critères de performance et des descripteurs reflétant différents niveaux de performance. Les qualités psychométriques observées suggèrent toutefois qu’une formation plus exhaustive et des modifications dans les descripteurs seraient nécessaires avant que la rubrique ne soit utilisée en contexte de recherche.Context: Educators must be skilled to facilitate debriefing after healthcare simulations. While tools to assess the quality of debriefing exist and could guide educators’ training, they are only available in English and are not adapted to the reality of Quebec. Purpose: (1) To translate a rubric to assess the quality of debriefing (Objective Structured Assessment of Debriefing) in French and adapt it to the context of Quebec; and (2) to test the validity and fidelity of the translated and adapted rubric. Methods: Three independent translators translated and adapted the rubric. Simulation experts (n = 11) validated the rubric’s content through a modified Delphi process. The translated rubric was piloted with a sample of simulation educators (n = 10) whom assessed the quality of recorded debriefings (n = 16). Results: The rubric presented strong content validity according to simulation experts and strong concurrent validity when compared to a general debriefing assessment score. Results for interrater and test-retest reliability showed some variability among educators. Conclusion: The rubric offers a common language and a set of criteria to assess the quality of debriefing. The rubric could guide educators’ training by specifying performance criteria and descriptors reflecting various levels of performance. However, results regarding psychometric properties of the rubric suggest that extensive training and some modification to descriptors are required prior to its use as a research instrument