Post-exercise heart rate recovery and mortality in chronic obstructive pulmonary disease

SummaryAbnormal heart rate recovery (HRR) after exercise, a marker of cardiac autonomic dysfunction, is associated with poor prognosis in various populations. As chronic obstructive pulmonary disease (COPD) is associated with cardiac autonomic dysfunction, we tested the hypothesis that patients with COPD have a lower HRR than healthy people, and evaluated whether a delay in HRR is associated with an increased risk of mortality in COPD. The records of 147 COPD patients were reviewed (65.1±9.1 years, mean±sd, 42 women/105 men, forced expiratory volume in 1s (FEV1): 42±15% predicted) and compared to 25 healthy subjects (61.6±4.5 years, 5 women/20 men, FEV1: 100±14% predicted) during recovery after an exercise test. Heart rate was measured at peak exercise and at 1-min recovery, the difference between the two being defined as HRR (11±9 beats in COPD patients vs. 20±9 beats in healthy subjects, P<0.0001). During a mean follow-up of 43.1±22.0 months, 32 patients died. Abnormal HRR (⩽14 beats) was a strong predictor of mortality in COPD patients (adjusted hazard ratio: 5.12, 95% CI [1.54–17.00]). In conclusion, COPD patients have a lower HRR than healthy subjects, and have a worse prognosis when presenting abnormal HRR

Sionisme de gauche, agriculturalisme et immigration juive au Canada au lendemain de la Grande Guerre

Au lendemain de la Grande Guerre, la communauté juive montréalaise tente de convaincre les autorités canadiennes en matière d’immigration d’ouvrir la porte du pays à leurs coreli- gionnaires russes, aux prises avec une guerre civile meurtrière. Pour ce faire, certains acteurs du milieu communautaire juif de Montréal émettent un argumentaire autour du potentiel agricole des Juifs. Cet article observe les fondements idéologiques derrière la pensée agricultu- raliste, comme elle se présente chez les Juifs canadiens, les Canadiens anglais et les Canadiens français. Il soutient que ce débat a influencé durablement les rapports entre la communauté juive canadienne et les autorités canadiennes, notamment Frederick C. Blair qui demeura en poste jusqu’en 1943

À la croisée de la Révolution tranquille et du judaïsme orthodoxe : l’implantation de la communauté hassidique des Tasher au coeur du Québec francophone et catholique (1962-1967)

L’auteur se penche ici sur les premiers contacts entre une communauté juive hassidique et la population d’ascendance catholique et francophone de Sainte-Thérèse-Ouest, une municipalité rurale en pleine expansion industrielle. Selon lui, le contexte de la Révolution tranquille, caractérisé par une importante diminution de la pratique du catholicisme et par un mouvement d’affirmation nationale dont le vecteur principal est la langue française, favorise une ouverture nouvelle sur le judaïsme. Il s’agit de comprendre comment l’orthodoxie juive trouve un espace d’affirmation dans la modernité émergente du Québec, et de constater comment les Tasher composent avec les mécanismes de l’époque contemporaine pour mieux se prémunir contre ses périls.This article focusses on the first contacts between a Hasidic Jewish community and the Catholic and Francophone population of Sainte-Thérèse-Ouest, a rural municipality in the midst of industrial expansion. The context of the Quiet Revolution, which was marked by a significant lessening of Catholicism and a movement of national affirmation mainly driven by the French language, promoted a new openness toward Judaism. The article explores how the Tasher community dealt with the contemporary era’s mechanisms to better protect themselves against its perils.L’auteur se penche ici sur les premiers contacts entre une communauté juive hassidique et la population d’ascendance catholique et francophone de Sainte-Thérèse-Ouest, une municipalité rurale en pleine expansion industrielle. Selon lui, le contexte de la Révolution tranquille, caractérisé par une importante diminution de la pratique du catholicisme et par un mouvement d’affirmation nationale dont le vecteur principal est la langue française, favorise une ouverture nouvelle sur le judaïsme. Il s’agit de comprendre comment l’orthodoxie juive trouve un espace d’affirmation dans la modernité émergente du Québec, et de constater comment les Tasher composent avec les mécanismes de l’époque contemporaine pour mieux se prémunir contre ses périls.This article focusses on the first contacts between a Hasidic Jewish community and the Catholic and Francophone population of Sainte-Thérèse-Ouest, a rural municipality in the midst of industrial expansion. The context of the Quiet Revolution, which was marked by a significant lessening of Catholicism and a movement of national affirmation mainly driven by the French language, promoted a new openness toward Judaism. The article explores how the Tasher community dealt with the contemporary era’s mechanisms to better protect themselves against its perils

Teaching Residents to Teach: Do Program Directors and Trainees Agree on Format and Content?

Background: Despite the important number of teaching-skills programs described in the literature, previous needs assessment of such curricula have examined primarily residents&rsquo; perceived learning needs in this field. The purpose of this study was to identify the optimal content and format of a resident teaching-skills training curriculum and compare the perspective of medical students (MS), residents and residency program directors (PD).Methods: This needs assessment was an observational study with a cross-sectional design. Online or printed questionnaires were used to assess the preferred format and content for this curriculum among MS, residents from most postgraduate medical training programs, and PD from Facult&eacute; de m&eacute;decine de l&rsquo;Universit&eacute; Laval. Results: The questionnaires were completed by 26 PD (response rate 72.2%), 146 residents (response rate 21.9%) and 154 MS (response rate 15.7%). Among the list of potential subjects that could be included in the curriculum, Learning styles, Working with students in difficulty and Self-directed learning were scored high by both residents and PD. MS favored Learning styles, Teaching in the ambulatory care setting, Teaching health promotion and prevention, Teaching with time constraints and Direct supervision strategies. PD also favored Teaching conflict management and Teaching professionalism, however these were both among the residents&rsquo; lower scores. The preferred formats were One half-day, One day and Online learning for PD and One day, Two consecutive days and A few one-day sessions over several months for residents. Conclusion: The PD and MS perception of the optimal format and content for residents&rsquo; teaching-skills training showed some discrepancies when compared with residents&rsquo; preferences. Since PD are largely involved in curriculum development for their respective specialties and since MS are also well positioned to assess residents&rsquo; teaching performance, we suggest that PD, residents and MS should all be consulted locally before organizing any intervention for teaching curricula