L’expérience de l’injustice

Compte-rend

"Préservation du stock osseux acétabulaire lors de l'arthroplastie de la hanche : étude clinique randomisée et étude de modélisation par ordinateur "

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

The SPO1-related bacteriophages

A large and diverse group of bacteriophages has been termed ‘SPO1-like viruses'. To date, molecular data and genome sequences are available for Bacillus phage SPO1 and eight related phages infecting members of other bacterial genera. Many additional bacteriophages have been described as SPO1-related, but very few data are available for most of them. We present an overview of putative ‘SPO1-like viruses' and shall discuss the available data in view of the recently proposed expansion of this group of bacteriophages to the tentative subfamily Spounavirinae. Characteristics of SPO1-related phages include (a) the host organisms are Firmicutes; (b) members are strictly virulent myoviruses; (c) all phages feature common morphological properties; (d) the phage genome consists of a terminally redundant, non-permuted dsDNA molecule of 127-157kb in size; and (e) phages share considerable amino acid homology. The number of phages isolated consistent with these parameters is large, suggesting a ubiquitous nature of this group of viruse

Les effets perçus de la répétition mentale sur l’anxiété et la performance d’étudiants en sciences infirmières lors d’une simulation clinique

La simulation clinique peut causer un sentiment d’anxiété chez les participants, pouvant affecter, entre autres, leur capacité à intégrer des apprentissages. Des stratégies efficaces, mais non suffisantes, sont utilisées durant le prébriefing par les formateurs afin de diminuer ce sentiment d’anxiété. Une stratégie intéressante, mais peu étudiée dans un contexte de simulation clinique est la visualisation de type répétition mentale. Le but de ce mémoire était d’évaluer, auprès d’étudiants en sciences infirmières, l’effet d’une intervention de répétition mentale sur le sentiment d’anxiété et sur la perception de la performance en contexte de simulation clinique. La théorie de moyenne portée sur la simulation de la NLN/Jeffries et al. (2015) et les facteurs identifiés dans les écrits comme pouvant causer un sentiment d’anxiété ont encadré cette étude. L’intervention, d’une durée de 30 minutes, consistait en quatre étapes adaptées de la méthode d’Ignacio et al. (2016) : introduction à la répétition mentale, activité d’orientation interactive en ligne, activité de relaxation et activité de répétition mentale guidée. L’intervention a été proposée en prébriefing d’une simulation clinique en soins critiques auprès de 121 étudiants en sciences infirmières. Post-intervention, un questionnaire anonyme et autoadministré a été rempli par des participants sur une base volontaire (n=45 ; taux de réponse de 37 %). Les réponses ont été analysées selon l’approche inductive de Elo et Kyngäs (2008). Les résultats de l’analyse ont permis d’identifier trois catégories : effets positifs et négatifs sur le sentiment d’anxiété et sur la perception de la performance, et facteurs ayant diminué l’efficacité de l’intervention.Clinical simulation can elicit a feeling of anxiety to participants. This feeling can have negative impacts on the capacity to retain knowledge, among others. Even though most educator-driven strategies used in prebriefing seem effective, they can be insufficient to mitigate the feeling of anxiety for some participants. Mental rehearsal is a strategy that has not been studied much in a nursing clinical simulation. The aim of this memoir was to evaluate the effects of a mental rehearsal intervention on the feeling of anxiety and on the perception of performance of undergraduate nursing students in a context of clinical simulation. The mid-range simulation theory by NLN/ Jeffries et al. (2015) and the factors identified in the literature as contributors to a feeling of anxiety in a simulation were the framework for this study. The 30 minutes intervention consisted of four phases, adapted from the method proposed by Ignacio et al. (2016): an introduction to mental rehearsal, an interactive online activity, a relaxation activity, and a guided mental rehearsal activity. The intervention was offered to 121 undergraduate nursing students during the prebriefing of a clinical simulation in critical care. After the intervention, an anonymous self-administered survey has been completed by participants on a voluntary basis (n=45; 37 % answering rate). The data analysis process followed the inductive approach proposed by Elo et Kyngäs (2008). Three categories were identified as results of the analysis: positive and negative effects on the perception of anxiety and performance, and factors that decreased the effectiveness of the intervention

Experimental phage therapy of burn wound infection : difficult first steps

Antibiotic resistance has become a major public health problem and the antibiotics pipeline is running dry. Bacteriophages (phages) may offer an ‘innovative’ means of infection treatment, which can be combined or alternated with antibiotic therapy and may enhance our abilities to treat bacterial infections successfully. Today, in the Queen Astrid Military Hospital, phage therapy is increasingly considered as part of a salvage therapy for patients in therapeutic dead end, particularly those with multidrug resistant infections. We describe the application of a well-defined and quality controlled phage cocktail, active against Pseudomonas aeruginosa and Staphylococcus aureus, on colonized burn wounds within a modest clinical trial (nine patients, 10 applications), which was approved by a leading Belgian Medical Ethical Committee. No adverse events, clinical abnormalities or changes in laboratory test results that could be related to the application of phages were observed. Unfortunately, this very prudent ‘clinical trial’ did not allow for an adequate evaluation of the efficacy of the phage cocktail. Nevertheless, this first ‘baby step’ revealed several pitfalls and lessons for future experimental phage therapy and helped overcome the psychological hurdles that existed to the use of viruses in the treatment of patients in our burn unit