Le taux de divorce canadien, le revenu des femmes et leur taux de participation au marché du travail

Rapport de rechercheNuméro de référence interne originel : a1.1 g 101

Shallow Ultraviolet Transits of WD 1145+017

WD 1145+017 is a unique white dwarf system that has a heavily polluted atmosphere, an infrared excess from a dust disk, numerous broad absorption lines from circumstellar gas, and changing transit features, likely from fragments of an actively disintegrating asteroid. Here, we present results from a large photometric and spectroscopic campaign with Hubble, Keck , VLT, Spitzer, and many other smaller telescopes from 2015 to 2018. Somewhat surprisingly, but consistent with previous observations in the u' band, the UV transit depths are always shallower than those in the optical. We develop a model that can quantitatively explain the observed "bluing" and the main findings are: I. the transiting objects, circumstellar gas, and white dwarf are all aligned along our line of sight; II. the transiting object is blocking a larger fraction of the circumstellar gas than of the white dwarf itself. Because most circumstellar lines are concentrated in the UV, the UV flux appears to be less blocked compared to the optical during a transit, leading to a shallower UV transit. This scenario is further supported by the strong anti-correlation between optical transit depth and circumstellar line strength. We have yet to detect any wavelength-dependent transits caused by the transiting material around WD 1145+017.Comment: 16 pages, 11 figures, 6 tables, ApJ, in pres

Atraumatic (pencil-point) versus conventional needles for lumbar puncture:a clinical practice guideline

Is the needle tip configuration important when performing a lumbar puncture for any indication? A systematic review published in the Lancet in December 2017 suggests that it is. The review found that using atraumatic (pencil-point) lumbar puncture needles instead of conventional lumbar puncture needles reduced the risk of post-dural-puncture headache and of return to hospital for additional pain control.1 This guideline recommendation aims to promptly and transparently translate this evidence to a clinical recommendation, following standards for GRADE methodology and trustworthy guidelines.2 The BMJ Rapid Recommendations panel makes a strong recommendation for the use of atraumatic needles for lumbar puncture in all patients regardless of age (adults and children) or indication instead of conventional needles.3 4 Box 1 shows the article and evidence linked to this Rapid Recommendation. The main infographic provides an overview of the absolute benefits and harms (although none were present here) of atraumatic needles. Table 1 below shows any evidence that has emerged since the publication of this guideline.publishedVersio

A value-based comparison of the management of ambulatory respiratory diseases in walk-in clinics, primary care practices, and emergency departments : protocol for a multicenter prospective cohort study

Background: In Canada, 30%-60% of patients presenting to emergency departments are ambulatory. This category has been labeled as a source of emergency department overuse. Acting on the presumption that primary care practices and walk-in clinics offer equivalent care at a lower cost, governments have invested massively in improving access to these alternative settings in the hope that patients would present there instead when possible, thereby reducing the load on emergency departments. Data in support of this approach remain scarce and equivocal. Objective: The aim of this study is to compare the value of care received in emergency departments, walk-in clinics, and primary care practices by ambulatory patients with upper respiratory tract infection, sinusitis, otitis media, tonsillitis, pharyngitis, bronchitis, influenza-like illness, pneumonia, acute asthma, or acute exacerbation of chronic obstructive pulmonary disease. Methods: A multicenter prospective cohort study will be performed in Ontario and Québec. In phase 1, a time-driven activity-based costing method will be applied at each of the 15 study sites. This method uses time as a cost driver to allocate direct costs (eg, medication), consumable expenditures (eg, needles), overhead costs (eg, building maintenance), and physician charges to patient care. Thus, the cost of a care episode will be proportional to the time spent receiving the care. At the end of this phase, a list of care process costs will be generated and used to calculate the cost of each consultation during phase 2, in which a prospective cohort of patients will be monitored to compare the care received in each setting. Patients aged 18 years and older, ambulatory throughout the care episode, and discharged to home with one of the aforementioned targeted diagnoses will be considered. The estimated sample size is 1485 patients. The 3 types of care settings will be compared on the basis of primary outcomes in terms of the proportion of return visits to any site 3 and 7 days after the initial visit and the mean cost of care. The secondary outcomes measured will include scores on patient-reported outcome and experience measures and mean costs borne wholly by patients. We will use multilevel generalized linear models to compare the care settings and an overlap weights approach to adjust for confounding factors related to age, sex, gender, ethnicity, comorbidities, registration with a family physician, socioeconomic status, and severity of illness. Results: Phase 1 will begin in 2021 and phase 2, in 2023. The results will be available in 2025. Conclusions: The end point of our program will be for deciders, patients, and care providers to be able to determine the most appropriate care setting for the management of ambulatory emergency respiratory conditions, based on the quality and cost of care associated with each alternative

Analyse de l'absorption circumstellaire de WD 1145+017

WD 1145+017 est une étoile naine blanche polluée par des métaux avec un astéroïde en décomposition autour d’elle. Ce système est le premier à montrer la phase de décomposition active de l’objet polluant, et permet d’en apprendre sur cette phase du phénomène d’accrétion. Les différentes observations montrent un système très complexe qui est composé de plusieurs morceaux de l’objet rocheux, d’un disque de poussière et d’un disque de gaz, tous en orbite autour de la naine blanche polluée. Nous présentons un modèle de disque de gaz excentrique en précession conçu pour l’étude des zones d’absorption circumstellaire variables détectées pour WD 1145+017. Ce modèle, inspiré de celui récemment présenté par Cauley et al., calcule explicitement l’opacité du gaz pour toutes conditions physiques du disque prédéterminées et prédit la force et la forme de toutes les zones d’absorption, de l’ultraviolet au visible, à n’importe quelle phase du cycle de précession. Les réussites et échecs de ce modèle simple fournissent de l’information précieuse concernant les caractéristiques physiques du gaz qui entoure l’étoile, entre autres sa composition chimique, sa température et sa densité. Le modèle de disque excentrique met aussi en évidence le besoin de composantes supplémentaires, probablement des anneaux circulaires, pour expliquer la présence d’absorption à décalage de vitesse nul ainsi que celle de raies de Si hautement ionisé. Nous trouvons qu’une période de précession de 4.6±0.3 ans peut reproduire avec succès la forme et le profil de vitesse observé pour la majorité des époques d’observation d’avril 2015 à janvier 2018, bien que des différences mineures à certains moments indiquent que la configuration géométrique supposée n’est probablement pas encore optimale. Finalement, nous montrons que notre modèle peut expliquer quantitativement le changement morphologique des zones d’absorption durant les transits de l’objet en orbite autour de l’étoile.WD 1145+017 is a metal polluted white dwarf with an actively disintegrating asteroid orbiting around it. This system is the first to show the active decomposition phase of the accretion process. The different observed data show a complex system composed of many pieces of the rocky objets, a dust disk and a gaseous disk, all orbiting the polluted white dwarf. We present an eccentric precessing gas disk model designed to study the variable circumstellar absorption features detected for WD 1145+017. This model, inspired by one recently proposed by Cauley et al., calculates explicitly the gas opacity for any predetermined physical conditions in the disk, predicting the strength and shape of all absorption features, from the UV to the optical, at any given phase of the precession cycle. The successes and failures of this simple model provide valuable insight on the physical characteristics of the gas surrounding the star, notably its composition, temperature and density. This eccentric disk model also highlights the need for supplementary components, most likely circular rings, in order to explain the presence of zero velocity absorption as well as highly ionized Si lines. We find that a precession period of 4.6±0.3 yrs can successfully reproduce the shape of the velocity profile observed at most epochs from April 2015 to January 2018, although minor discrepancies at certain times indicate that the assumed geometric configuration may not be optimal yet. Finally, we show that our model can quantitatively explain the change in morphology of the circumstellar feature during transiting events

Le Conners CBRS : un questionnaire MULTI-INFORMANTS à large spectre de psychopathologie

Le Conners CBRS (Comprehensive behavior rating scale) est un questionnaire permettant d’évaluer un large spectre de psychopathologie chez les enfants. Il est peu connu au Québec, car il n’était pas disponible en français jusqu’à tout récemment. Il a été publié en 2008, puis révisé en 2014 avec l’arrivée du DSM-5. Nous l’avons traduit l’année dernière dans le cadre d’un projet de recherche, avec l’accord de l’éditeur et nous désirons le faire connaître aux cliniciens et chercheurs du Québec, puisqu’il nous apparaît comme une addition intéressante pour l’évaluation psychologique d’enfants et d’adolescents.The Conners CBRS (Comprehensive behavior rating scale) is a questionnaire intended to assess a broad spectrum of psychopathology in children. It is barely known in Quebec because the French edition wasn't available until recently. It was published in 2008 and revised in 2014 with the arrival of the DSM-5. With the agreement of the publisher, we translated it last year as part of a research project. Our aim is to make it known to clinicians and researchers in Quebec, since it appears to us as an interesting support for the psychological assessment of children and adolescents

Meta-analyses of the associations between disinhibited social engagement behaviors and child attachment insecurity or disorganization

Children with disinhibited social engagement disorder show reduced reticence with strangers, do not check back with their caregiver after venturing away, and may willingly leave with an unfamiliar adult. The recent DSM-5 has moved away from an attachment framework to understand disinhibited social engagement behavior (DSEB) due to studies indicating its presence in previously institutionalized children even after these children are adopted and show a selective, more secure attachment with their substitute caregiver (e.g. Chisholm et al., 1998). This meta-analysis aims to clarify the size of the associations between DSEB and attachment insecurity or disorganization. It also examines whether studies effect sizes differ according to various moderators (e.g., child age, type of attachment and DSEB measures). The results (k = 24) showed that the associations between DSEB and attachment insecurity (d = 0.48) or attachment disorganization (d = 0.47) were of small magnitude. There were no publication biases. As for moderator analyses on both attachment insecurity and disorganization, the effect sizes in studies using DSEB observational measures (respectively d = 0.63 and 0.57) were of moderate magnitude and stronger than those in studies not using an observational component (respectively d = 0.28 and 0.32). Given these small-to-moderate associations, attachment can be considered a relationship process associated with DSEB, and attachment-informed interventions could be potential tools to reduce DSEB in children. Nevertheless, given the sizable unshared portion of variance between DSEB and child attachment, future studies should examine other variables related to caregiving and noncaregiving contexts to further understand DSEB