Évaluation de la variabilité du transfert d’immunité passive dans les troupeaux laitiers du Québec

Les veaux naissent quasi agammaglobulinémiques, ils doivent donc ingérer les immunoglobulines provenant du colostrum de leur mère; c’est le transfert de l’immunité passive (TIP). Un TIP adéquat réduit le risque de mortalité et de morbidité pendant les premières semaines de vie. Un pourcentage élevé de TIP réussi dans un troupeau maximise les chances d’avoir un troupeau avec des veaux en bonne santé. Les objectifs de cette étude étaient de déterminer la prévalence de TIP adéquat et d’étudier son lien avec la gestion du colostrum. Au total, 59 troupeaux laitiers commerciaux du Québec ont été choisis par convenance pour participer à cette étude observationnelle. Dans chacun des troupeaux participants, un minimum de 14 échantillons sanguins de veaux holstein a été prélevé pour estimer la prévalence du TIP adéquat en utilisant un réfractomètre Brix numérique. Des échantillons de colostrum servis à chacun de ces veaux ont été prélevés pour évaluer la qualité immunologique en utilisant un réfractomètre de Brix numérique et évaluer la qualité bactériologique en utilisant des systèmes de Pétrifilm. Un questionnaire sur les pratiques de gestion du colostrum a été rempli par les producteurs laitiers participants pour évaluer les pratiques à la ferme. La prévalence intra-troupeau du TIP adéquat (qui est définis comme le pourcentage de veau avec un degré Brix sérique ≥ 8,4 %) variait de 24 % à 100 % et la médiane était de 67 %. Dans le modèle de régression linéaire multiple, la prévalence intra-troupeau de TIP adéquat était associée à la prévalence du volume adéquat (défini comme le pourcentage de veaux recevant ≥ 2 litres de colostrum au premier repas), à la prévalence de qualité adéquate du colostrum (défini comme ≥ 20,9 % de degrés Brix) et à la prévalence de délai adéquat du premier repas (défini comme le pourcentage de veaux recevant du colostrum ≤3 heures après la naissance), mais n’était pas associée à la prévalence de contamination bactérienne ou au sexe. En résumé, la prévalence de TIP adéquat dans les troupeaux variait considérablement et était influencée par les pratiques de gestion des producteurs laitiers.Calves are born almost agammaglobulinemic, so they must ingest immunoglobulins from their mother's colostrum; it’s the transfer of passive immunity (TPI). An adequate TPI reduces the risk of mortality and morbidity during the first weeks of life. A high percentage of success of TPI in herds maximizes the chances of having a herd with healthy calves. The objectives of this herd-level study were to quantify the prevalence of adequate TPI, and to investigate its association with colostrum management. A total of 59 Quebec commercial dairy herds were selected by convenience to participate to this observational study. In every participating herd, a minimum of 14 blood samples from Holstein calves were sampled to estimate their prevalence of adequate TPI using a digital Brix refractometer. Samples of colostrum served to each of these calves were collected to evaluate immunological quality using a digital Brix refractometer and bacteriological quality using Petrifilm systems. A questionnaire on colostrum management practices was completed by dairy producers to assess on-farm practices. The herd-level prevalence of adequate TPI (defined as the percentage of calf with serum Brix degree ≥ 8.4%) success ranged from 24% to 100%, and the median was 67%. In the multivariable linear regression models, the prevalence of adequate TPI was associated with the prevalence of adequate volume (defined as the percentage of calves receiving ≥ 2 liters of colostrum at first meal), prevalence of adequate colostrum quality (defined as the percentage of calves receiving a colostrum with ≥ 20,9 Brix degrees), and prevalence of adequate time to the first meal (defined as the percentage of calves receiving colostrum within ≤3h after birth), but was not associated with the gender or bacterial contamination prevalence. In summary, the prevalence of success of TPI varied greatly and was influenced by management practices of dairy farmers

Pratiques d’enseignement en lecture-écriture et apprentissages des élèves au début du primaire

Esta investigação pretende contribuir para o desenvolvimento da investigação interessada nas questões relativas ao ensino/ aprendizagem do modo escrito nos primeiros anos do primeiro ciclo do ensino básico, particularmente tendo em conta as práticas mais propensas a apoiar a aprendizagem bem-sucedida da leitura e de escrita. Especificamente, esta investigação tem como objetivo descrever as práticas de ensino observadas nas áreas da leitura e da escrita com 22 professores, mas também para relacionar essas práticas observadas com o desempenho em leitura e escrita dos seus alunos do primeiro e do segundo ano. Globalmente, os resultados indicam que as práticas observadas, tanto do ponto de vista dos Dispositivos mobilizados como do conteúdo ensinado, são variadas e contribuem para uma visão complexa da entrada na escrita. As análises de correlação sugerem que determinadas práticas, que geralmente procuram a participação activa das crianças e as interações com os outros, estão relacionados com o progresso dos alunos durante o ano letivo.Résumé : La présente étude vise à alimenter les recherches qui s’intéressent à l’enseignement/apprentissage de la langue écrite au début de l’école primaire, en prenant particulièrement en compte les pratiques les plus à même de soutenir un apprentissage réussi de la lecture et de l’écriture. Plus précisément, cette étude vise à décrire les pratiques d’enseignement observées en lecture et en écriture auprès de 22 enseignants, mais aussi à mettre en relation ces pratiques observées et les performances en lecture et en écriture des élèves appartenant à ces classes de 1re et 2e années du primaireGlobalement, les résultats indiquent que les pratiques observées, tant du point de vue des dispositifs mobilisés que des contenus enseignés, sont variées et concourent à une vision complexe de l’entrée dans l’écrit. Les analyses de corrélations suggèrent que certaines pratiques, qui le plus souvent sollicitent une participation active de l’élève et des interactions avec autrui, sont en lien avec la progression des élèves au cours de l’année scolaire.Abstract : This study is a contribution to research addressing issues related to the teaching/learning of the written language during the early years of primary education, with particular emphasis on practices most likely to foster successful acquisition of reading and writing skills. More specifically, our study aims to describe the observed teaching practices of 22 teachers and to relate these practices to the performance of their pupils in the first and second years. Overall, results would suggest that these practices, both in terms of methodologies adopted and contents taught, are varied and reflect a complex attitude towards early writing. Analysis further indicates that certain practices, usually involving pupil participation and interaction, are related to pupils‘progress over the year

La différenciation pédagogique du point de vue d’enseignants québécois : quelles différences pour les pratiques d’enseignement en contexte d’entrée dans l’écrit?

Adapting teaching to the needs of students and their skill level is now acknowledged as a key ingredient to their success at school. However, little progress appears to have been made in regular classes in accompanying students with differing needs (McLeskey & Waldron, 2002). Our study seeks to describe declared differentiated teaching practices implemented at the beginning of writing learning by 20 teachers viewed as exemplary in this regard. Globally, our study results show that practices involve for the most part adapting the support offered to students and adapting teaching strategies and methods to student characteristics. However, the teachers we questioned appear to lack references with regard to the formal evaluation of acquired competencies.Keywords : Differentiation, evidence-based practices, literacy, primary grade. L’adaptation de l’enseignement aux besoins de l’élève est aujourd’hui reconnue essentielle à sa réussite scolaire. Cependant, peu de progrès semble avoir été réalisé durant la dernière décennie, en classe ordinaire, dans l’accompagnement des élèves présentant des besoins différents (McLeskey & Waldron, 2002). Notre recherche vise à rendre compte de pratiques déclarées de différenciation pédagogique instaurées en contexte d’entrée dans l’écrit par 20 enseignants considérés exemplaires. Globalement, les résultats de notre étude montrent que ces pratiques se traduisent surtout par l’adaptation du soutien offert aux élèves et par l’adaptation des stratégies et méthodes d’enseignement aux caractéristiques des élèves. Toutefois, les enseignants interrogés semblent manquer de repères face aux pratiques d’évaluation formelle des acquis en contexte de différenciation.Mots-clés : Différenciation, pratiques exemplaires, litéracie, enseignement élémentair

Effect of aneurysm size on procedure-related rupture in patients with subarachnoid hemorrhage treated with coil occlusion

Objective: Procedure-related rupture is one of the most feared complications in treating patients with cerebral aneurysm. The primary aim of this study was to estimate the effect of aneurysm size on procedure-related rupture. We also estimated its effect on peri-procedural thromboembolic events. Methods: This observational study was conducted using routinely-collected health data on patients admitted for subarachnoid hemorrhage and treated with aneurysm coil occlusion in the CHU de Québec — Enfant-Jésus hospital from January 1st, 2000 until sample size was reached. Patients were identified from the Discharge Abstract Database using the Canadian Classification of Health codes. Assessment of complications was blind to aneurysm size. Logistic regression models were performed to test associations between aneurysm size and procedure-related rupture or peri-procedural thromboembolic events, and between both procedure-related rupture and thromboembolic events and patients' outcomes. Results: This study included 532 aneurysms treated with coil occlusion in 505 patients. Procedure-related rupture occurred in 34 patients (6.7%) and thromboembolic events in 53 (10.5%) patients. Aneurysms of 2 to 3 mm inclusively were not more significantly associated with procedure-related rupture or thromboembolic events than those larger than 3 mm (OR 1.02, 95% CI: 0.9–1.16, p = 0.78 and OR 1.06, 95% CI: 0.96–1.17, p = 0.3, respectively). However, procedure-related rupture had a significant effect on patient mortality (OR 3.86, 95% CI: 1.42–10.53, p < 0.01). Conclusions: Very small aneurysm size should not preclude aneurysm coil occlusion. Every measure should be taken to prevent procedure-related rupture as it is strongly associated with higher mortality

Patient Advisors: How to implement a process for involvement at all levels of governance in a healthcare organization

Patient involvement at the operational (clinical care and services), tactical (management), and strategic (board of directors and executive management) levels of establishments is increasingly sought after. To address this specific challenge, a Canadian healthcare organization, the Centre intégré universitaire de santé et de services sociaux de la Mauricie-et-du-Centre-du-Québec, has developed an integrated strategy based on three principles: (1) shared leadership between a patient and a manager to build the strategy; (2) a clear process for recruiting, training, and coaching patient advisors (PA) so that they can participate in decision-making at the various levels of governance of the establishment; and (3) a feedback process for improving the strategy over time. This initiative gave rise to a pool of 30 patient advisors who reviewed documentation (39.07%), presented testimonies to establishment practitioners (13.73%), participated in process improvement activities (12.97%) and committees (8.93%), and helped train students in health sciences (11.61%). It also led to the development of a request form for all persons wishing to involve PAs in their projects. This PA involvement, highly appreciated by both managers (94%) and PAs (81%), brought back the fundamental meaning of the patient–practitioner relationship and helped incorporate patients’ experiential knowledge into the care and service improvement process. This strategy can serve as a model for other organizations wishing to structure optimal patient engagement at the different levels of governance of their organization

Differences in Attitudes Toward Reading: A Survey of Pupils in Grades 5 to 8

Recent research on literacy has highlighted the impact of affective factors on learning to read. Among these factors, attitudes toward reading have been clearly shown to influence the development of reading skills and academic success. Nevertheless, differences in children’s attitudes across schooling have yet to be properly documented, especially for the French language and the transition between elementary and secondary education. In this cross-sectional study, our goal was to gauge the attitudes of French-speaking pupils across this transitional period. We therefore administered a computer-based questionnaire to 469 pupils in Grades 5 to 8 in Quebec (Canada), to gather their views about leisure reading and academic reading. Results showed that their stated attitudes toward reading remained stable across the final 2 years of elementary school, as well as across the first 2 years of middle school, but differences were observed for the transition from one education level to the next, with stated attitudes toward reading being less positive in the latter. This effect, which was observed for both leisure and academic reading, concerned girls and boys alike. We discuss possible explanations for these differences in reading attitudes at this juncture in children’s schooling

Portrait des jeunes Sherbrookois de 4 à 17 ans en matière d’alimentation et d’activité physique et sportive – Rapport final

Remerciements 9 ; Liste des acronymes 11 ; Résumé 13 ; Pascale Morin, Ph.D., CSSS-IUGS et Université de Sherbrooke et Marie-Andrée Roy, CSSS-IUGS PARTIE 1 — AVANT-PROPOS 15; Références 16 ; Pascale Morin, Ph.D., CSSS-IUGS et Université de Sherbrooke et Marie-Andrée Roy, CSSS-IUGS PARTIE 2 — QUELLES SONT LES PRATIQUES ALIMENTAIRES DES JEUNES SHERBROOKOIS? 17 ; 1) SAUT DU LIT ET SAUT DU DÉJEUNER 18 2) REPAS MAISON OU RESTAURATION RAPIDE? 19 ; 3) LES JEUNES DES CUISTOTS? 23 ; 4) LES JEUNES ET LES SOUPERS EN FAMILLE 24 ; 5) LE GUIDE ALIMENTAIRE SUGGÈRE , LES JEUNES INGÈRENT 25 ; 6) NOS ADOS FONT-ILS LE POIDS? 31 ; Références 35 ; Gino Perreault, ASSSE avec la collaboration de Daniel Auger, Kino-Québec et Sylvain Turcotte, Ph.D., Université de Sherbrooke — textes adaptés et graphiques reproduits avec le permission de Québec en forme PARTIE 3 — QUELLES SONT LES PRATIQUES EN ACTIVITÉ PHYSIQUE DES JEUNES SHERBROOKOIS? 37 ; 1) COMBIEN DE TEMPS FAUT-IL BOUGER? 39 ; 2) LES ACTIVITÉS PHYSIQUES ET SPORTIVES ORGANISÉES, C’EST « COOL », MAIS 40 ; 3) LES ACTIVITÉS PHYSIQUES ET SPORTIVES LIBRES, SOURCES DE PLAISIR 46 ; 4) LES PARENTS, DES MODÈLES 49 ; 5) QU’EN PENSENT LES JEUNES ET LES PARENTS? 50 ; Références 52 ; Pascale Morin, Ph.D., CSSS-IUGS et Université de Sherbrooke, Marie-Andrée Roy, CSSS-IUGS avec la collaboration de Geneviève Martin, CSSS-IUGS PARTIE 4 — LES ÉCOLES SHERBROOKOISE : QU’OFFRENT-ELLES À MANGER? 53 ; 1) COMMENT S’ORGANISE L’OFFRE EN ALIMENTATION DANS LES ÉCOLES 54 ; 2) MISE EN OEUVRE DE LA POLITIQUE-CADRE DU MELS 56 ; 3) COMMENT SONT PRÉPARÉS LES ALIMENTS? 57 ; 4) QUELS SONT LES ALIMENTS OFFERTS DANS LES ÉCOLES? 59 ; 5) QUELS SONT LES LIEUX ET LES CONDITIONS DE REPAS? 65 ; 6) QUELS SONT LES ALIMENTS OFFERTS LORS DE CAMPAGNES DE FINANCEMENT? 69 ; 7) QUELLES SONT LES ACTIVITÉS D’ÉVALUATION ET DE PROMOTION D’UNE SAINE ALIMENTATION? 69 ; Références 73 ; Équipe Québec en forme PARTIE 5 — LES ÉCOLES DE SHERBROOKE : QUELLES APS OFFRENT-ELLES? 75 ; 1) LES LIEUX DE PRATIQUE EN APS 75 ; 2) LES OCCASIONS UNIVERSELLES DE PRATIQUE D’ACTIVITÉS PHYSIQUES ET SPORTIVES 80 ; 3) LES OCCASIONS SÉLECTIVES DE PRATIQUE D’ACTIVITÉS PHYSIQUES ET SPORTIVES 82 ; ; Pascale Morin, Ph.D., CSSS-IUGS et Université de Sherbrooke et Marie-Andrée Roy, CSSS-IUGS PARTIE 6 — LES ORGANISMES MUNICIPAUX ET COMMUNAUTAIRES : QU’OFFRENT-ILS À MANGER? 91 ; 1) QUELLES SONT LES ORIENTATIONS EN MATIÈRE DE SAINE ALIMENTATION À LA VILLE DE SHERBROOKE 92 ; 2) QUELS SONT LES ALIMENTS OFFERTS DANS LES ORGANISMES? 92 ; 3) QUELLES SONT LES ACTIVITÉS D’ÉDUCATION ET DE PROMOTION D’UNE SAINE ALIMENTATION DANS LES ORGANISMES? 97 ; Références 97 ; Équipe Québec en forme PARTIE 7 -— LES ORGANISMES MUNICIPAUX ET COMMUNAUTAIRES : QUELLES APS OFFRENT-ILS? 99 ; 1) LES LIEUX DE PRATIQUE EN APS 100 ; 2) LES INSCRIPTIONS AUX ACTIVITÉS OFFERTES PAR LES ORGANISMES DU MILIEU 104 ; 3) LES CARACTÉRISTIQUES DES INTERVENANTS 112 ; Pascale Morin, Ph.D., CSSS-IUGS et Université de Sherbrooke, Marie-Andrée Roy, CSSS-IUGS, Gino Perreault, ASSSE, Daniel Auger, Kino-Québec et Sylvain Turcotte, Ph. D., Université de Sherbrooke PARTIE 8 -— QUE POUVONS-NOUS AMÉLIORER? 117 ; Références 121 ; LES PRATIQUES DES JEUNES ET L’OFFRE ALIMENTAIRE 123 ; LES HABITUDES DES JEUNES ET L’OFFRE D’ACTIVITÉ PHYSIQUE ET SPORTIVE 125

A pharmacist-led intervention to improve kidney transplant recipient outcomes and identify patients at risk of highly variable trough tacrolimus levels: a cohort study

International audienceObjectivesGiven the positive impact of appropriate medication management on graft outcome and therefore of patient survival and graft function, the pharmacist's role in the kidney transplantation team has evolved over recent decades. The primary objective of this study was to determine whether pharmacist-led intervention after kidney transplantation is associated with a lower graft rejection rate and intra-patient variation in tacrolimus trough concentrations (C-min). The study's secondary objective was to develop a questionnaire to identify patients at risk for highly variable C-min. MethodsWe retrospectively analysed kidney transplant recipients at Rennes University Hospital (France) between January 2013 and December 2020. Patients who received pharmacist-led education (intervention group, n=139) were compared with patients who did not (control group, n=131), according to graft survival at 1 year post-transplant, coefficient of variation (%CV) for the tacrolimus C-min, age, sex, length of hospital stay post-transplantation, body mass index, and Charlson Comorbidity Index. In the intervention group, a questionnaire assessing patient knowledge was introduced to compare scores with the %CV. ResultsIn the intervention group, 1 year post-transplant graft survival was higher (95.7% vs 88.5%, p=0.0289) and patients had fewer variabilities in C-min. The %CV was correlated with questionnaire scores (r=-0.9758, p&lt;0.0001). ConclusionsPharmacist-led interventions may have contributed to improved graft survival and patient management of immunosuppressants. Because %CV correlates with the patient questionnaire score, its introduction could be useful in identifying kidney transplant patients who would benefit most from a pharmacist-led patient education

Area under the curve of tacrolimus using microsampling devices: towards precision medicine in solid organ transplantation?

International audiencePurpose - Therapeutic drug monitoring of tacrolimus using trough concentration (C) is mandatory to ensure drug efficacy and safety in solid organ transplantation. However, C is just a proxy for the area under the curve of drug concentrations (AUC) which is the best pharmacokinetic parameter for exposure evaluation. Some studies suggest that patients may present discrepancies between these two parameters. AUC is now easily available through mini-invasive microsampling approach. The aim of this study is to evaluate the relationship between AUC and C in patients benefiting from a complete pharmacokinetic profile using a microsampling approach. Methods - Fifty-one transplant recipients benefited from a complete pharmacokinetic profile using a microsampling approach, and their 24-h AUC were calculated using the trapezoidal method. The correlation with C was then explored. In parallel, we estimated AUC using the sole C and regression equations according to the post-transplantation days and the galenic form. Results - Weak correlations were found between 24-h AUC observed and the corresponding C (R = 0.60) and between AUC observed and expected using the sole C (R = 0.62). Therapeutic drug monitoring of tacrolimus using C leads to over- or under-estimate drug exposure in 40.3% of patients. Conclusion - Tacrolimus C appears to be an imperfect reflection of drug exposure. Evaluating AUC using a microsampling approach offers a mini-invasive strategy to monitor tacrolimus treatment in transplant recipients