Cross-cultural adaptation of the Dutch version of the Functional Index for Hand Osteoarthritis (FIHOA) and a study on its construct validity

SummaryObjectiveTo validate a cross-culturally translated and adapted Dutch version of the Functional Index for Hand Osteoarthritis (FIHOA) in patients with osteoarthritis (OA) of the hands and to evaluate its construct validity by comparing with the Australian/Canadian Osteoarthritis Hand Index (AUSCAN).MethodsThe FIHOA was translated into Dutch and cross-culturally adapted. The questionnaire was administered to 72 patients with hand OA (female/male ratio: 64/8, handedness: right: 62/left: 7/both: 3). A visual analogue scale (VAS) pain scale (100mm) and the AUSCAN questionnaire were also recorded. An item–item analysis was performed. Test–retest reliability (time interval: 5 days) was assessed in 21 patients with intraclass correlation coefficient (ICC) and Bland and Altman graphical method. Construct validity was assessed by Spearman rank correlation coefficient between the FIHOA and AUSCAN.ResultsInternal consistency was high (Cronbach's alpha=0.89). All items, except for one (‘Are you able to clench the fist?’), and the mean total FIHOA scores were statistically different between the subgroups based on the VAS (mean total score=7.46 and 14.19, in a-/mild symptomatic and symptomatic group, respectively (P<0.001)).The Spearman's correlation between all subscales of the AUSCAN (pain, stiffness, functionality) and the FIHOA was good, especially with the subscale functionality (r=0.81, P<0.01). Test–retest reliability was excellent with an ICC of 0.96 for the total score and the Bland and Altman plot showing a homogeneous distribution of the differences.ConclusionThe psychometric properties of the Dutch version of the FIHOA are excellent. There is a good correlation between the FIHOA and all subscales of the AUSCAN, especially the subscale functionality

Pratique politique étudiante au Québec

La mobilisation politique des populations étudiantes n'est pas en soi un phénomène vraiment contemporain. Certaines études ont déjà établi que des groupes étudiants ont participé à des mouvements politiques à diverses époques de l'histoire. Par contre, la pratique politique étudiante, ces dernières années, s'est amplifiée en même temps qu'elle se caractérisait par des traits plus spécifiques et particuliers à cette population. Aussi a-t-on vu croître, en sociologie, un intérêt nouveau pour l'analyse de ces phénomènes. Les études consacrées à ce sujet se multiplient de même que les schémas d'analyse se diversifient. Pour l'étude de la pratique politique étudiante québécoise contemporaine, nous avons, pour notre part, opté pour une grille d'analyse qui n'enferme pas l'étudiant, comme agent politique, dans le système d'enseignement supérieur. Sa mobilisation politique ne nous semble pas, au premier chef, être fonction de sous-cultures étudiantes plus ou moins contestataires et typiques des milieux universitaires ou des seules difficultés de fonctionnement des systèmes universitaires. Encore moins sommes-nous portés à penser que la marginalité sociale de la jeunesse étudiante est un facteur déterminant de politisation : « camper hors de la nation » ou de la société n'est pas de nature à susciter la mobilisation politique.Au contraire, notre analyse ne produit une définition de l'étudiant comme agent politique qu'au moyen de déterminations structurelles qui conditionnent, provoquent et organisent la pratique politique étudiante qui vise elle-même à modifier le cadre sociétal où elle émerge. Au nombre des principales caractéristiques de la période des années '60 dans l'histoire du Québec, il nous faut retenir la politisation des problèmes de fonctionnement de l'appareil scolaire québécois : les rapports entretenus par cet appareil avec d'autres structures de la société, le système de production économique par exemple, devenaient l'enjeu de luttes et de rapports politiques. L'État et les diverses couches sociales qui appuyaient ses politiques d'intervention auprès de l'appareil scolaire rencontraient l'hostilité et l'opposition plus ou moins soutenues d'autres couches sociales qui appréciaient différemment les politiques de l'État en ce domaine.Avec l'adoption du bill 60 qui créait, en 1963, le Ministère de l'éducation du Québec, le parti au pouvoir imposa une restructuration de l'appareil scolaire qui impliquait une responsabilité plus nette et ferme accordée à l'État et la mise en place d'organes officiels de consultation, comme le Conseil supérieur de l'éducation, où l'Église était loin de conserver une fonction prépondérante. Le législateur devait même consulter, au moment de la formation du premier Conseil supérieur de l'éducation, de multiples associations qui n'avaient pu auparavant s'imposer comme interlocuteurs dans un secteur contrôlé par l'Église. Parmi celles-ci, notons les associations d'enseignants; les associations d'administrateurs dans le domaine scolaire; les associations de parents et parents-maîtres; les associations syndicales; et diverses associations d'affaires. Puis finalement, le législateur dut consentir, après que des représentations eurent été faites dans ce sens, à prendre aussi l'avis d'associations étudiantes et d'associations de professeurs et d'administrateurs universitaires.On a pu également observer, dans le processus de régionalisation de commissions scolaires, que même au niveau local et régional, les agents qui contrôlaient traditionnellement l'appareil scolaire pouvaient voir leur position sociale remise en cause. Bref, la politisation des problèmes d'éducation a modifié les rapports de force entre les divers groupes sociaux qui se préoccupaient des politiques d'intervention de l'État auprès de l'appareil scolaire. L'État devait aussi se lancer, au cours des années '60, dans des transformations importantes des structures académiques et du contenu des programmes d'enseignement. Ces mutations de structures et de programmes académiques visaient essentiellement à reprendre le retard que connaissait le Québec, par rapport aux principales provinces canadiennes, et notamment l'Ontario et la Colombie-Britannique, dans le développement de son appareil scolaire. On attribuait à ce retard les problèmes de développement économique du Québec qui se manifestaient par un revenu moyen inférieur à celui des provinces canadiennes riches et par une productivité industrielle, en général, plus faible.La main-d’œuvre québécoise ne présentait pas des standards de qualification très élevés, ni des niveaux d'instruction jugés satisfaisants. Aussi, l'intervention de l'État auprès de l'appareil scolaire québécois avait-elle un sens bien précis : elle concernait la préparation et la modernisation d'une main-d’œuvre professionnelle au moyen de transformations apportées aux structures et au contenu de l'enseignement. Afin d'assurer une plus grande adaptation de l'appareil scolaire aux exigences de développement de la société, l'État misait essentiellement sur le « capital humain » et le perfectionnement des « ressources humaines » comme facteur de production.Ainsi cette intervention s'est accompagnée d'une augmentation considérable des investissements en éducation. Les dépenses totales d'enseignement au Québec qui étaient, à la fin des années '50, de l'ordre de $300,000,000, passaient en 1963 à$719,319,000 ; elles ont donc plus que doublé sur une période de cinq ans. Les dépenses du Ministère de l'éducation sont passées de près de $200,000,000 en 1960-61 à près de$710,000,000 en 1967-68, puis à $1,100,114,000 en 1970-71 ; sur une période de dix ans, ces dépenses ont été multipliées à peu près par dix. Ces hausses représentent des taux d'augmentation annuelle qui sont légèrement supérieurs à l'augmentation annuelle des dépenses du gouvernement du Québec; ainsi, la proportion du budget total consacrée à l'enseignement est passée de 23% en 1959 à 32% en 1964, puis à 34.7% en 1969.Il faut encore souligner que cette intervention de l'État auprès de l'appareil scolaire s'est accompagné d'un discours idéologique de circonstance. L'État, au moyen de slogans tels « Qui s'instruit s'enrichit », devait expliquer à la population combien l'éducation était le moyen par excellence de la promotion collective de la communauté canadienne-française. Le Québec était invité à joindre les sociétés industrielles avancées qui valorisaient, comme politique de croissance et de progrès, le développement et le perfectionnement continus des «ressources humaines»

Differences in risk behaviours and HIV status between primary amphetamines and opioid injectors in Estonia and Russia

Background and objective People who inject drugs (PWID) account for over half of new HIV infections in Eastern Europe and central Asia, where opioids continue to be the dominant illicit drugs injected. Stimulants including amphetamines (ATS) have been associated with HIV infection risk in several settings. We sought to examine whether primary ATS injection was associated with greater HIV risk, compared to opioid injection in two European locales with significant HIV epidemics. Methods PWID in Kohtla-Järve and St. Petersburg were recruited using respondent-driven sampling in 2012–2013. Survey data on demographic characteristics, service use, injecting and sexual risk behaviours and HIV-status (and HCV in Kohtla-Järve) were compared between primary opioid and ATS injectors using logistic regression models. Results Of 591 injectors recruited in Kohtla-Järve and 811 in St. Petersburg, 195 (33%) and 27 (4%) primarily injected ATS in each city. In both cities, ATS injectors were younger than opioid injectors, initiated injection later, injected less frequently and were more likely to have been paid for sex. In both cities, PWID had high levels of multiple sex partners. In Kohtla-Järve, ATS-injectors had lower odds of back-loading and greater odds of polydrug use than opioid-injectors. In St. Petersburg, where over half of PWID reported unsafe sharing practices, ATS-injectors were less likely to report these practices. ATS-injection was negatively associated with being HIV positive in Kohtla-Järve (aOR = 0.6; 95%CI: 0.5–0.8) and St. Petersburg (aOR = 0.3; 95%CI: 0.1–0.7). ATS-injection was negatively associated with HCV-reactivity in Kohtla-Järve (aOR = 0.5; 95%CI: 0.3–0.6). Conclusions In both locations, primary ATS injection was associated with lower injecting risk behaviours, lower odds of HIV and being paid for sex compared to opioid injection. Interventions targeting the characteristics and needs of ATS injectors are needed to increase contact with services and reduce sexual and injecting risk. Harm reduction services, including sexual risk reduction, need to be expanded for all PWID in St. Petersburg

Commentary: osteoarthritis of the knee and glucosamine

peer reviewe

It Is the time to think about a treat-to-target strategy for knee osteoarthritis

Osteoarthritis (OA) is a rheumatic disease that affects the well-being of the patient, compromises physical and mental function, and affects other quality of life aspects. In the literature, several evidence-based guidelines and recommendations for the management of knee osteoarthritis (KOA) are available. These recommendations list the different therapeutic options rather than addressing a hierarchy between the treatments and defining the real target. Therefore, a question arises: are patients and physicians satisfied with the current management of KOA? Actually, the answer may be negative, thus suggesting a change in our therapeutic strategies. In this article, we address this challenge by suggesting that it is time to develop a “treat to target strategy” for KO

A framework to model global, regional, and national estimates of intimate partner violence

BACKGROUND: Accurate and reliable estimates of violence against women form the backbone of global and regional monitoring efforts to eliminate this human right violation and public health problem. Estimating the prevalence of intimate partner violence (IPV) is challenging due to variations in case definition and recall period, surveyed populations, partner definition, level of age disaggregation, and survey representativeness, among others. In this paper, we aim to develop a sound and flexible statistical modeling framework for global, regional, and national IPV statistics. METHODS: We modeled IPV within a Bayesian multilevel modeling framework, accounting for heterogeneity of age groups using age-standardization, and age patterns and time trends using splines functions. Survey comparability is achieved using adjustment factors which are estimated using exact matching and their uncertainty accounted for. Both in-sample and out-of-sample comparisons are used for model validation, including posterior predictive checks. Post-processing of models’ outputs is performed to aggregate estimates at different geographic levels and age groups. RESULTS: A total of 307 unique studies conducted between 2000–2018, from 154 countries/areas, and totaling nearly 1.8 million unique women responses informed lifetime IPV. Past year IPV had a similar number of studies (n = 332), countries/areas represented (n = 159), and individual responses (n = 1.8 million). Roughly half of IPV observations required some adjustments. Posterior predictive checks suggest good model fit to data and out-of-sample comparisons provided reassuring results with small median prediction errors and appropriate coverage of predictions’ intervals. CONCLUSIONS: The proposed modeling framework can pool both national and sub-national surveys, account for heterogeneous age groups and age trends, accommodate different surveyed populations, adjust for differences in survey instruments, and efficiently propagate uncertainty to model outputs. Describing this model to reproducible levels of detail enables the accurate interpretation and responsible use of estimates to inform effective violence against women prevention policy and programs, and global monitoring of elimination efforts as part of the Sustainable Development Goals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12874-022-01634-5

Plasmonically Enhanced Reflectance of Heat Radiation from Low-Bandgap Semiconductor Microinclusions

Increased reflectance from the inclusion of highly scattering particles at low volume fractions in an insulating dielectric offers a promising way to reduce radiative thermal losses at high temperatures. Here, we investigate plasmonic resonance driven enhanced scattering from microinclusions of low-bandgap semiconductors (InP, Si, Ge, PbS, InAs and Te) in an insulating composite to tailor its infrared reflectance for minimizing thermal losses from radiative transfer. To this end, we compute the spectral properties of the microcomposites using Monte Carlo modeling and compare them with results from Fresnel equations. The role of particle size-dependent Mie scattering and absorption efficiencies, and, scattering anisotropy are studied to identify the optimal microinclusion size and material parameters for maximizing the reflectance of the thermal radiation. For composites with Si and Ge microinclusions we obtain reflectance efficiencies of 57 - 65% for the incident blackbody radiation from sources at temperatures in the range 400 - 1600 {\deg}C. Furthermore, we observe a broadbanding of the reflectance spectra from the plasmonic resonances due to charge carriers generated from defect states within the semiconductor bandgap. Our results thus open up the possibility of developing efficient high-temperature thermal insulators through use of the low-bandgap semiconductor microinclusions in insulating dielectrics.Comment: Main article (8 Figures and 2 Tables) + Supporting Information (8 Figures

Past dynamics of HIV transmission among men who have sex with men in Montréal, Canada: a mathematical modeling study

BACKGROUND: Gay, bisexual, and other men who have sex with men (gbMSM) experience disproportionate risks of HIV acquisition and transmission. In 2017, Montréal became the first Canadian Fast-Track City, setting the 2030 goal of zero new HIV infections. To inform local elimination efforts, we estimate the evolving role of prevention and sexual behaviours on HIV transmission dynamics among gbMSM in Montréal between 1975 and 2019. METHODS: Data from local bio-behavioural surveys were analyzed to develop, parameterize, and calibrate an agent-based model of sexual HIV transmission. Partnership dynamics, HIV's natural history, and treatment and prevention strategies were considered. The model simulations were analyzed to estimate the fraction of HIV acquisitions and transmissions attributable to specific groups, with a focus on age, sexual partnering level, and gaps in the HIV care-continuum. RESULTS: The model-estimated HIV incidence peaked in 1985 (2.3 per 100 person years (PY); 90% CrI: 1.4-2.9 per 100 PY) and decreased to 0.1 per 100 PY (90% CrI: 0.04-0.3 per 100 PY) in 2019. Between 2000-2017, the majority of HIV acquisitions and transmissions occurred among men aged 25-44 years, and men aged 35-44 thereafter. The unmet prevention needs of men with > 10 annual anal sex partners contributed 90-93% of transmissions and 67-73% of acquisitions annually. The primary stage of HIV played an increasing role over time, contributing to 11-22% of annual transmissions over 2000-2019. In 2019, approximately 70% of transmission events occurred from men who had discontinued, or never initiated antiretroviral therapy. CONCLUSIONS: The evolving HIV landscape has contributed to the declining HIV incidence among gbMSM in Montréal. The shifting dynamics identified in this study highlight the need for continued population-level surveillance to identify gaps in the HIV care continuum and core groups on which to prioritize elimination efforts

The association between heterosexual anal intercourse and HIV acquisition in three prospective cohorts of women

The extent to which receptive anal intercourse (RAI) increases the HIV acquisition risk of women compared to receptive vaginal intercourse (RVI) is poorly understood. We evaluated RAI practice over time and its association with HIV incidence during three prospective HIV cohorts of women: RV217, MTN-003 (VOICE), and HVTN 907. At baseline, 16% (RV 217), 18% (VOICE) of women reported RAI in the past 3 months and 27% (HVTN 907) in the past 6 months, with RAI declining during follow-up by around 3-fold. HIV incidence in the three cohorts was positively associated with reporting RAI at baseline, albeit not always significantly. The adjusted hazard rate ratios for potential confounders (aHR) were 1.1 (95% Confidence interval: 0.8-1.5) for VOICE and 3.3 (1.6-6.8) for RV 217, whereas the ratio of cumulative HIV incidence by RAI practice was 1.9 (0.6-6.0) for HVTN 907. For VOICE, the estimated magnitude of association increased slightly when using a time-varying RAI exposure definition (aHR = 1.2; 0.9-1.6), and for women reporting RAI at every follow-up survey (aHR = 2.0 (1.3-3.1)), though not for women reporting higher RAI frequency (> 30% acts being RAI vs. no RAI in the past 3 months; aHR = 0.7 (0.4-1.1)). Findings indicated precise estimation of the RAI/HIV association, following multiple RVI/RAI exposures, is sensitive to RAI exposure definition, which remain imperfectly measured. Information on RAI practices, RAI/RVI frequency, and condom use should be more systematically and precisely recorded and reported in studies looking at sexual behaviors and HIV seroconversions; standardized measures would aid comparability across geographies and over time