Les services intensifs : une nouvelle approche dans l’intervention auprès des familles à risque

L'augmentation du nombre de placements d'enfants et l'échec relatif de cette mesure dans le traitement des problèmes familiaux amènent les professionnels des services sociaux à réfléchir sur de nouvelles façons d'aider les familles à résoudre leurs difficultés tout en maintenant l'unité familiale intacte. Les services intensifs à la famille appartiennent à ce courant de renouveau. Le présent article décrit cette nouvelle forme d'intervention. Plus précisément, trois grands thèmes sont abordés. Le premier porte sur l'historique de ces programmes, leur philosophie et leurs principes, de même que sur les trois principaux modèles mis en oeuvre sous le vocable des services intensifs à la famille, soit les programmes Homebuilders, Familieset Family Treatment. Dans un second temps, l'efficacité des programmes de sauvegarde de la famille est examinée en apportant une attention particulière aux problèmes méthodologiques que soulève leur évaluation. L'article se termine par une présentation des conditions nécessaires à l'implantation de ces programmes dans les services sociaux québécois

Early multifocal stenosis after coronary artery snaring during off-pump coronary artery bypass in a patient with diabetes

AbstractJ Thorac Cardiovasc Surg 2001;122:1044-

Optimisation de la culture de microalgues pour la production de biodiésel

Affiche présentée dans le cadre du colloque de l'ARC "La gestion de la propriété intellectuelle : courants de pensée et facteurs de succès", lors du 81e Congrès de l'Acfas à l'Université Laval, le 8 mai 2013.Le troisième prix a été décerné à Marc-Olivier Béliveau, Virginie Bertrand-Lehouillier, Jessica Carrier et Joannie Tremblay au concours des Prix étudiants 2012-2013 de l'ARC.Dans l’optique de production de biodiésel, notre projet consistait à évaluer des conditions de culture de microalgues influençant la croissance et la production lipidique. Les souches Chlorella vulgaris, Scenedesmus sp. et Pseudokirchneriella subcapitata ont été cultivées dans différents milieux, dont des eaux usées, en version immobilisée tout comme en suspension. En plus d’avoir comparé les biomasses obtenues, des analyses en contenu lipidique des cultures ont été réalisées par coloration in situ et quantification par fluorescence

Reflexivity as a tool for medical students to identify and address gender bias in clinical practice: a qualitative study

ABSTRACT Objectives Gender bias interferes with medical care for both men and women, leading to health inequalities. Reflexivity is used in medical education to improve health provision. This study aims to understand if a reflective approach integrated in medical practice enables raising awareness of gender bias during medical school teaching. Methods We conducted this study in general ambulatory medicine in Lausanne Hospital, Switzerland with 160 Master’s students. Through group discussions and reflection questionnaires, students were asked to discuss clinical cases they encountered focusing on potential gender bias. We analyzed the data using a thematic analysis approach. Results The reflection on the clinical reasoning steps from a real case identified gender bias at each stage of the clinical case management. The analysis revealed two factors that facilitated gender reflexivity: guidance from a gender expert and peer-to-peer exchange. Conclusions Our study shows that a reflective approach integrated in medical practice enables raising awareness of gender bias during medical teaching. It provides students with a systematic method they can apply in their future clinical work, thus improving care processes and experiences towards more equitable care

Temporary coronary artery occlusion during off-pump coronary artery bypass grafting with the new poloxamer P407 does not cause endothelial dysfunction in epicardial coronary arteries

ObjectiveThe aim of this study was to assess the efficacy of the novel reversible thermosensitive gel poloxamer 407 for occlusion of the coronary vessel necessary for minimally invasive operations and its effects on coronary endothelium.MethodsDomestic swine were submitted to occlusion of the left anterior descending or right coronary artery using the poloxamer. The left and right internal thoracic arteries were used as grafts to perform coronary artery bypasses. Animals were humanely killed after 3 hours of perfusion (acute; n = 8) or 3 days (subacute; n = 6). The vascular reactivity of coronary artery was evaluated in response to serotonin and bradykinin. Histologic studies were performed to analyze cardiomyocyte necrosis and endothelial coverage.ResultsThe gel led to an occlusion of 7.8 ± 2.2 minutes. Concentration-response curves of occluded coronary segments showed no difference of endothelium-dependent relaxations in both operated groups (P < .05 vs control). Histologic studies demonstrated the absence of cardiomyocyte necrosis after coronary artery occlusion in the acute group; a small infarct zone was detected in 1 animal in the subacute group, resulting from an occlusion of the first diagonal branch. The endothelial layer coverage was preserved in both groups.ConclusionThe poloxamer 407 represents a promising technique for obtaining hemostasis at the site of anastomosis during construction of bypasses during beating heart coronary artery surgery, without damage to the endothelium or ischemic consequence

Cardiac transplantation in patients over 50 years of age

Sixty-two patients underwent cardiac transplantation at the University of Arizona from March 1979 to March 1985. Thirteen patients (11 men and 2 women) were over 50 years of age at the time of transplantation and 49 were under the age of 50. The mean age (± SEM) of the patients over 50 was 53 ± 1 years. Eight of these patients were treated with conventional immunosuppressive therapy (azathioprine, prednisone and rabbit antithymocyte globulin) and Ave, beginning in January 1983, were treated with cyclosporine, prednisone and rabbit antithymocyte globulin.Early mortality (0 to 90 days) was 16% in the group over 50 versus 18% for those under 50. The late mortality (> 90 days) was 36 and 33%, respectively. In both groups, rejection and infection were the principal causes of death. The incidence of infection was 1.9 ± 0.5 episodes per patient in those patients over 50 and 1.9 ± 0.4 in those under 50. The incidence of rejection was 1.3 episodes per patient-year in patients over 50 and 1.7 episodes per patient-year in those under 50. Actuarial survival at 1 year was 72 ± 14% in the group over 50 and 66 ± 7% in the group under 50 years of age.These data indicate that the results of cardiac transplantation for patients over 50 do not differ significantly from those for patients under 50. Therefore, it is concluded that a rigidly defined age criterion for cardiac transplant recipients is not acceptable. Each potential recipient must be evaluated in terms of individual risk and benefit from the procedure

Ajustement de faisceaux du SLAM revisité en utilisant un capteur RGB-D

International audienceNous présentons dans ce papier une méthode qui intègre l'information de profondeur fournie par un capteurRGB-D, pour la cartographie et la localisation simultanée ou (Simultanuous Localization And Mapping, SLAM) afind'améliorer la précision de la localisation. Nous présentons un nouvel ajustement de faisceaux local qui permet de combiner des données ayant une information de profondeur et des données visuelles dans une même fonction de coût totalement exprimée en pixels. L'approche proposée est évaluée sur des séquences de benchmark et comparée aux méthodes de l'état de l'art</p

Non-radial oscillations in the red giant HR7349 measured by CoRoT

Convection in red giant stars excites resonant acoustic waves whose frequencies depend on the sound speed inside the star, which in turn depends on the properties of the stellar interior. Therefore, asteroseismology is the most robust available method for probing the internal structure of red giant stars. Solar-like oscillations in the red giant HR7349 are investigated. Our study is based on a time series of 380760 photometric measurements spread over 5 months obtained with the CoRoT satellite. Mode parameters were estimated using maximum likelihood estimation of the power spectrum. The power spectrum of the high-precision time series clearly exhibits several identifiable peaks between 19 and 40 uHz showing regularity with a mean large and small spacing of Dnu = 3.47+-0.12 uHz and dnu_02 = 0.65+-0.10 uHz. Nineteen individual modes are identified with amplitudes in the range from 35 to 115 ppm. The mode damping time is estimated to be 14.7+4.7-2.9 days.Comment: 8 pages, A&A accepte