Développement d'un outil d'évaluation du statut fonctionnel pour les personnes âgées en visite à l'urgence

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

Detection and quantification of airborne norovirus during outbreaks in healthcare facilities

Background. Noroviruses are responsible for at least 50% of all gastroenteritis outbreaks worldwide. Noroviruses GII can infect humans via multiple routes including direct contact with an infected person, fecal matter, or vomitus, and contact with contaminated surfaces. Although norovirus is an intestinal pathogen, aerosols could, if inhaled, settle in the pharynx and later be swallowed. The aims of this study were to investigate the presence of norovirus GII bioaerosols during gastroenteritis outbreaks in healthcare facilities and to study the in vitro effects of aerosolization and air sampling on the noroviruses using murine norovirus as a surrogate. Methods. A total of 48 air samples were collected during norovirus outbreaks in 8 healthcare facilities. Samples were taken 1 m away from each patient, in front of the patient's room and at the nurses' station. The resistance to aerosolization stress of murine norovirus type 1 (MNV-1) bioaerosols was also tested in vitro using an aerosol chamber. Results. Norovirus genomes were detected in 6 of 8 healthcare centers. The concentrations ranged from 1.35 × 101 to 2.35 × 103 genomes/m3 in 47% of air samples. MNV-1 preserved its infectivity and integrity during in vitro aerosol studies. Conclusions. Norovirus genomes are frequently detected in the air of healthcare facilities during outbreaks, even outside patients' rooms. In addition, in vitro models suggest that this virus may withstand aerosolization

Overview of the assessment practices of occupational therapists working in Quebec

Description. L'évaluation du client est primordiale dans la pratique de l'ergothérapie, notamment pour établir les priorités de traitement et pour vérifier l'efficacité des interventions. Les pratiques évaluatives des ergothérapeutes sont cependant peu documentées. But. Dresser un portrait des pratiques évaluatives des ergothérapeutes du Québec selon les dimensions personne-environnement-occupation et les clientèles. Méthodologie. Une enquête transversale a été réalisée à l'aide d'un sondage en ligne envoyé aux ergothérapeutes du Québec. Résultats. En pédiatrie, les ergothérapeutes utilisent majoritairement des outils standardisés des aptitudes physiques et neurologiques. L'évaluation d'adultes cible principalement les aptitudes physiques et la productivité. Auprès des aînés, l'évaluation repose surtout sur les aspects fonctionnels, particulièrement les aptitudes physiques, les soins personnels et la sécurité à domicile, et sur le dépistage des difficultés cognitives. Implications pour la pratique. L'évaluation ergothérapique serait généralement axée sur les aptitudes physiques. Pour assurer une approche holistique, l'occupation et l'environnement devraient être davantage considérés dans l'évaluation.Abstract : Background. In occupational therapy practice, client assessments are essential for establishing treatment priorities and determining the effectiveness of interventions. However, occupational therapists' assessment practices are not well documented. Purpose. This work aimed to provide an overview of the assessment practices of Quebec occupational therapists based on the person–environment–occupation components and clienteles. Method. A cross-sectional survey was conducted using an online survey that was sent to occupational therapists in Quebec. Findings. In paediatrics, occupational therapists tend to use standardized tools to assess physical and neurological abilities. Adult assessment focuses mainly on physical abilities and productivity. For seniors, assessment focuses mainly on functional aspects (physical abilities, personal care, and home safety) and screening for cognitive difficulties. Implications. Occupational therapy assessment mostly focuses on physicial abilities. To ensure a holistic approach, more occupational and environmental components should be included in the assessment practices

Esterification of free fatty acids with methanol to biodiesel using heterogeneous catalysts: From model acid oil to microalgae lipids

SSCI-VIDE+CARE+MVE:AGFInternational audienc

Biodiesel from microalgae lipids: from inorganic carbon to energy production

SSCI-VIDE+CARE:INGENIERIE+MVE:AGFInternational audienceFollowing the United Nations Conference on Climate Change, COP21 (Paris, France), several countries have attempted to reduce their greenhouse gas emissions. In order to reach this objective, microalgae could be used to capture carbon dioxide and transform it into a biomass composed essentially of lipids, carbohydrates and proteins. Moreover, cultivating microalgae does not require arable land, in opposition to several oleaginous plants used to produce biofuels. Despite the fact that microalgae could be transformed into several biofuels such as bioethanol (by fermentation of hydrocarbons) and biomethane (by anaerobic digestion), transforming lipids into biodiesel could allow the reduction of oil-based diesel consumption. However, microalgae biodiesel production costs remain high for a short-term commercialization. The microalgae lipids can be transesterified into biodiesel in the presence of catalysts (homogeneous or heterogeneous). In order to commercialize biodiesel from microalgae, biodiesel physicochemical properties must respect the American Society for Testing and Materials (ASTM) standards. The aim of the study was to describe the current technologies available to produce biodiesel from microalgae

Conifer Needle Phyllosphere as a Potential Passive Monitor of Bioaerosolised Antibiotic Resistance Genes

Monitoring antibiotic resistance genes (ARGs) is vital to the One Health approach to tackling the antibiotic resistance crisis. It has been suggested that conifer needles can be used as passive bioaerosol samplers. Here, the use of conifer needles as biomonitors of ARGs in bioaerosols was assessed as a proof-of-concept. Needles were collected from trees surrounding pig farms, villages, and forest sites in Québec, Canada. Needles were homogenised and DNA was extracted. Results of qPCR analyses showed biomass estimates were consistent across samples. Number and quantity of ARGs was significantly lower in forest sites when compared to the farm and village, comprising a distinct resistome. Consistent with previous findings, the most common ARGs were tetracyclines and sulfonamides, which were found close to agricultural activities. Although results were limited, there is great potential for using the conifer phyllosphere as a passive bioaerosol sampler. This method represents an accessible way to promote ARG surveillance over long distances from point sources

Shifting the narrative from living at risk to living with risk: validating and pilot-testing a clinical decision support tool: a mixed methods study

Abstract Background When there are safety concerns, healthcare professionals (HCPs) may disregard older adults’ wishes to return or remain at home. A paradigm shift is needed for HCPs to move from labelling older adults as living at risk to helping them live with risk. The Living with Risk: Decision Support Tool (LwR:DST) was developed to support older adults and HCPs with difficult decision-making regarding living with risk. The study objectives were to: (1) validate, and (2) pilot-test the LwR:DST in hospital and community settings. Methods The study was conducted across Canada during the pandemic. The LwR:DST’s content was validated with quantitative and qualitative data by: (1) 71 HCPs from hospital and community settings using the Delphi method, and (2) 17 older adults and caregivers using focus groups. HCPs provided feedback on the LwR:DST’s content, format and instruction manual while older adults provided feedback on the LwR:DST’s communication step. The revised LwR:DST was pilot-tested by 14 HCPs in one hospital and one community setting, and 17 older adults and caregivers described their experience of HCPs using this approach with them. Descriptive and thematic analysis were performed. Results The LwR:DST underwent two iterations incorporating qualitative and quantitative data provided by HCPs, older adults and caregivers. The quantitative Delphi method data validated the content and the process of the LwR:DST, while the qualitative data provided practical improvements. The pilot-testing results suggest that using the LwR:DST broadens HCPs’ clinical thinking, structures their decision-making, improves their communication and increases their competence and comfort with risk assessment and management. Our findings also suggest that the LwR:DST improves older adults’ healthcare experience by feeling heard, understood and involved. Conclusions This revised LwR:DST should help HCPs systematically identify frail older adults’ risks when they remain at or return home and find acceptable ways to mitigate these risks. The LwR:DST induces a paradigm shift by acknowledging that risks are inherent in everyday living and that risk-taking has positive and negative consequences. The challenges involved in integrating the LwR:DST into practice, i.e., when, how and with whom to use it, will be addressed in future research

Preferential aerosolization of Streptococcus suis

Streptococcus suis is a swine pathogen that causes pneumonia, septicaemia and meningitis. It is also an important zoonotic agent responsible of several outbreaks in China. S. suis strains are classified into 35 serotypes based on the composition of their polysaccharide capsule. S. suis serotype 2 causes the majority of severe infections and it is subdivided into sequence types (STs) based on multilocus sequence typing. The ST1 is associated with highly virulent strains. In North America, the strains most commonly isolated belong to ST25 and ST28, which are respectively moderately and weakly virulent in a mouse model. The presence of S. suis bioaerosols in the air of swine confinement buildings has been previously demonstrated. The aim of this study was to better understand the aerosolization behaviour of S. suis by investigating of the preferential aerosolization of different strains of S. suis. The highly virulent serotype 2 ST1 strains appeared to be preferentially aerosolized. This study increases our knowledge on the potential aerosol transmission of S. suis and emphasises the importance of developing an exposure prevention strategy to protect the swine and the swine producers

Ozone efficacy for the control of airborne viruses: Bacteriophage and norovirus models.

This study was designed to test the efficacy of an air treatment using ozone and relative humidity (RH) for the inactivation of airborne viruses. Four phages (φX174, PR772, MS2 and φ6) and one eukaryotic virus (murine norovirus MNV-1) were exposed to low ozone concentrations (1.23 ppm for phages and 0.23 ppm for MNV-1) and various levels of RH for 10 to 70 minutes. The inactivation of these viruses was then assessed to determine which of the tested conditions provided the greatest reduction in virus infectivity. An inactivation of at least two orders of magnitude for φX174, MS2 and MNV-1 was achieved with an ozone exposure of 40 minutes at 85% RH. For PR772 and φ6, exposure to the reference condition at 20% RH for 10 minutes yielded the same results. These findings suggest that ozone used at a low concentration is a powerful disinfectant for airborne viruses when combined with a high RH. Air treatment could therefore be implemented inside hospital rooms ventilated naturally