Tendances environnementales en Afrique de l’Est au Plio-Pléistocène : étude des isotopes stables de carbone et d’oxygène de l’émail des herbivores

La vallée de l’Awash, le bassin Turkana et la basse vallée de l’Omo sont trois régions de l’Afrique de l’Est étant importantes en paléoanthropologie, car elles sont riches en hominines et documentent notre histoire évolutive. Cette étude a pour but de mieux comprendre le contexte environnemental dans lequel les hominines ont vécu en comparant ces trois régions de 7.4 Ma à 10 Ka à l’aide d’isotopes stables de carbone et d’oxygène provenant de l’émail dentaire des herbivores. Cette méthode permet de comparer les tendances en termes d’aridité aux changements de proportions de plantes ligneuses (C3) et d’herbes tropicales (C4). Vers 4.4 Ma, les données signalent un environnement ouvert à Aramis, avec de la végétation C3 dans des conditions mésiques. Il est donc possible qu’Ardipithecus ramidus ait préféré occuper un biome boisé dans un environnement généralement plus ouvert comme le signalent les valeurs de carbone de l’écosystème présenté dans ce travail. Vers 4 Ma, les résultats signalent un pic d’alimentation de plantes C3 dans la vallée de l’Awash et le bassin Turkana qui coïncide avec une aridité accrue vers 4 Ma, suggérant l’augmentation de plantes C3 adaptées aux conditions xériques. Ce signal coïncide avec l’apparition des premiers australopithèques et concilie les interprétations précédentes d’une alimentation C3 mais abrasive pour Australopithecus anamensis. Les résultats démontrent également que la basse vallée de l’Omo se distingue des deux autres bassins en étant particulièrement humide et évoquent la présence d’herbes tropicales dans des conditions environnementales mésiques après 3 Ma. Ainsi, les données suggèrent que les précipitations n’ont pas nécessairement les effets attendus en termes de proportions de plantes C3/C4.The Awash Valley, the Turkana Basin and the lower Omo Valley of East Africa, rich in hominins, are three regions that have been particularly important in paleoanthropology for documenting our evolutionary history. The aim of this study is to better document the environmental context of hominins by analyzing herbivores’ enamel stable carbon and oxygen isotopic values of the fossil fauna of the lower Omo Valley, the Turkana Basins and the Awash Valley from 7.4 Ma to 10 Ka. Based on a compilation of published isotopic data, this approach allows us to compare aridity as well as changes in the proportion of woody plants (C3) and tropical grasses (C4). At 4.4 Ma, results show open settings at Aramis with presence of C3 vegetation in relatively mesic conditions. Thus, it is possible that Ardipithecus ramidus preferred a wooded biome in a somewhat open environment according to the carbon value of the ecosystem presented in this study. Also, results indicate a peak of a C3 diet toward 4 Ma in the Awash Valley and the Turkana Bassin that is coincident with a peak of aridity in both regions, suggesting the expansion of xeric C3 bushes. This signal of an increase of C3 biomass in xeric conditions, that coincide with the appearance of the firsts australopiths, reconciliate previous interpretations of a diet dominated by C3 plants while showing signs of an abrasive diet in Australopithecus anamensis. Moreover, data show that the lower Omo Valley is different from the other two regions in being particularly humid and indicate the presence of mesic C4 grasses after 3 Ma. In conclusion, results of this study suggest that precipitations do not always have the expected effect on changes in C3/C4 plants proportions

Considerations for the Design and Implementation of COVID-19 Contact Tracing Apps: Scoping Review

BackgroundGiven the magnitude and speed of SARS-CoV-2 transmission, achieving timely and effective manual contact tracing has been a challenging task. Early in the pandemic, contact tracing apps generated substantial enthusiasm due to their potential for automating tracing and reducing transmission rates while enabling targeted confinement strategies. However, although surveys demonstrate public interest in using such apps, their actual uptake remains limited. Their social acceptability is challenged by issues around privacy, fairness, and effectiveness, among other concerns. ObjectiveThis study aims to examine the extent to which design and implementation considerations for contact tracing apps are detailed in the available literature, focusing on aspects related to participatory and responsible eHealth innovation, and synthesize recommendations that support the development of successful COVID-19 contact tracing apps and related eHealth technologies. MethodsSearches were performed on five databases, and articles were selected based on eligibility criteria. Papers pertaining to the design, implementation, or acceptability of contact tracing apps were included. Articles published since 2019, written in English or French, and for which the full articles were available were considered eligible for analysis. To assess the scope of the knowledge found in the current literature, we used three complementary frameworks: (1) the Holistic Framework to Improve the Uptake and Impact of eHealth Technologies, (2) the Montreal model, and (3) the Responsible Innovation in Health Assessment Tool. ResultsA total of 63 articles qualified for the final analysis. Less than half of the selected articles cited the need for a participatory process (n=25, 40%), which nonetheless was the most frequently referenced item of the Framework to Improve the Uptake and Impact of eHealth Technologies. Regarding the Montreal model, stakeholder consultation was the most frequently described level of engagement in the development of contact tracing apps (n=24, 38%), while collaboration and partnership were cited the least (n=2, 3%). As for the Responsible Innovation in Health framework, all the articles (n=63, 100%) addressed population health, whereas only 2% (n=1) covered environmental considerations. ConclusionsMost studies lacked fundamental aspects of eHealth development and implementation. Our results demonstrate that stakeholders of COVID-19 contact tracing apps lack important information to be able to critically appraise this eHealth innovation. This may have contributed to the modest uptake of contact tracing apps worldwide. We make evidence-informed recommendations regarding data management, communication, stakeholder engagement, user experience, and implementation strategies for the successful and responsible development of contact tracing apps

Social Robot Interventions in Mental Health Care and Their Outcomes, Barriers, and Facilitators: Scoping Review

BackgroundThe use of social robots as innovative therapeutic tools has been increasingly explored in recent years in an effort to address the growing need for alternative intervention modalities in mental health care. ObjectiveThe aim of this scoping review was to identify and describe social robot interventions in mental health facilities and to highlight their outcomes as well as the barriers and facilitators to their implementation. MethodsA scoping review of the literature published since 2015 was conducted using the Arksey and O’Malley’s framework. The MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and PsycINFO databases were searched, and 2239 papers were retrieved. The papers included were primary empirical studies published in peer-reviewed literature. Eligible studies were set in mental health facilities and they included participants with a known mental health disorder. The methodological quality of the included papers was also assessed using the Mixed Methods Appraisal Tool. ResultsA total of 30 papers met the eligibility criteria for this review. Studies involved participants with dementia, cognitive impairment, schizophrenia, depression, autism spectrum disorder, attention-deficit hyperactivity disorder, and an intellectual disability. The outcomes studied included engagement, social interaction, emotional state, agitation, behavior, and quality of life. ConclusionsThe methodological weaknesses of the studies conducted this far and the lack of diversity in the conditions studied limit the generalizability of the results. However, despite the presence of certain barriers to their implementation (eg, technical problems, unsuitable environment, staff resistance), social robot interventions generally show positive effects on patients with mental health disorders. Studies of stronger methodological quality are needed to further understand the benefits and the place of social robots in mental health care

Patient and family engagement in infection prevention in the context of the COVID-19 pandemic: defining a consensus framework using the Q methodology – NOSO-COVID study protocol

Introduction Healthcare-associated infections are an important patient safety concern, especially in the context of the COVID-19 pandemic. Infection prevention and control implemented in healthcare settings are largely focused on the practices of healthcare professionals. Patient and family engagement is also recognised as an important patient safety strategy. The extent to which patients and families can be engaged, their specific roles and the strategies that support their engagement in infection prevention remain unclear. The overarching objective of the proposed study is to explore how patients and families can effectively be engaged in infection prevention by developing a consensus framework with key stakeholders.Design and methods The proposed study is based on a cross-sectional exploratory study at one of the largest university hospitals in North America (Montreal, Canada). The targeted population is all healthcare professionals, managers and other non-clinical staff members who work on clinical units, and the in-patients and their families. The study is based on Q methodology that takes advantage of both quantitative and qualitative methods to identify the consensus among the various stakeholders. This exploratory Q research approach will provide a structured way to elicit the stakeholders’ perspectives on patient and family engagement in infection prevention.Ethics and dissemination The research ethics board approved this study. The research team plans to disseminate the findings through different channels of communication targeting healthcare professionals, managers in healthcare settings, and patients and family caregivers. The findings will also be disseminated through peer-reviewed journals in healthcare management and in quality and safety improvement

Public perspectives on exposure notification apps: A patient and citizen co-designed study

Canada deployed a digital exposure notification app (COVID Alert) as a strategy to support manual contact tracing. Our aims are to (1) assess the use, knowledge, and concerns of the COVID Alert app, (2) identify predictors of app downloads, and (3) develop strategies to promote social acceptability. A 36-item questionnaire was co-designed by 12 citizens and patients partnered with 16 academic researchers and was distributed in the province of Québec, Canada, from May 27 to 28 June 2021. Of 959 respondents, 43% had downloaded the app. Messaging from government sources constituted the largest influence on app download. Infrequent social contacts and perceived app inefficacy were the main reasons not to download the app. Cybersecurity, data confidentiality, loss of privacy, and geolocation were the most frequent concerns. Nearly half of the respondents inaccurately believed that the app used geolocation. Most respondents supported citizen involvement in app development. The identified predictors for app uptake included nine characteristics. In conclusion, this project highlights four key themes on how to promote the social acceptability of such tools: (1) improved communication and explanation of key app characteristics, (2) design features that incentivize adoption, (3) inclusive socio-technical features, and (4) upstream public partnership in development and deployment

Integrating accompanying patients into clinical oncology teams: limiting and facilitating factors

Abstract Objectives Since 2018, four establishments in Quebec have been instrumental in implementing the PAROLE-Onco program, which introduced accompanying patients (APs) into healthcare teams to improve cancer patients’ experience. APs are patient advisors who have acquired specific experiential knowledge related to living with cancer, using services, and interacting with healthcare professionals. They are therefore in a unique and reliable position to be able to provide emotional, informational, cognitive and navigational support to patients who are dealing with cancer. We aimed to explore APs’ perspectives regarding the limiting and facilitating factors in terms of how they are integrated into the clinical oncology teams. Methods A qualitative study based on semi-structured interviews and focus groups was conducted with 20 APs at the beginning of their intervention (T1) and, two years later, during a second data collection (T2). Limiting and facilitating factors of APs’ integration into clinical teams were analyzed in terms of governance, culture, resources and tools. Results The limited factors raised by APs to be integrated into clinical teams include the following: confusion about the specific roles played by APs, lifting the egos of certain professionals who feel they are already doing what APs typically do, lack of identification of patient needs, absence of APs in project governance organizational boundaries, and team members' availability. Various communication challenges were also raised, resulting in the program being inadequately promoted among patients. Also mentioned as limiting factors were the lack of time, space and compensation. Creating opportunities for team members to meet with APs, building trust and teaching team members how APs’ activities complement theirs were enhancing factors. Other facilitators include APs being involved in decision-making committees, being leaders in promoting the PAROLE-Onco program to patients and clinical team members and creating opportunities to communicate with team members to help enhance their work and provide feedback to improve patient services. Awareness of APs’ added value for the team and patients is also a key facilitator. Regarding tools, offering accompanying services by telephone allows both patients and APs to benefit from the flexibility they need. Conclusion Over time, APs were able to identify optimal factors for successful implementation. Recommendations include APs and professionals working in co-construction on organization, leadership, resources and status factors. This could help catalyze a change in culture within health establishments and allow people dealing with cancer to benefit from the experiential knowledge of other patients within their clinical team