Traitement auditif, traitement phonologique et acquisition de la morphologie dans la dyslexie développementale

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Conscience morphologique et habiletés d'orthographe chez les enfants du premier cycle du primaire ayant des difficultés en langage écrit : une étude d'intervention

Quel enfant ne s’est jamais cassé la tête sur la finale muette d’un mot? La morphologie et les accords grammaticaux qu’elle implique sont encodés dans une multitude de mots du français et constituent un des grands défis de l’apprentissage de l’orthographe. Elle s’avère d’autant plus complexe et obscure pour les élèves ayant des difficultés à manipuler la structure des mots, c’est à dire ayant de faibles habiletés de conscience morphologique. Afin d’aider ces enfants, cette recherche s’intéresse à l’intervention sur cette habileté langagière comme facilitateur de l’apprentissage de l’orthographe. Une intervention professionnelle a été élaborée et offerte à des enfants québécois de 2e année du 1er cycle ayant des difficultés en langage écrit. Celle-ci s’est avérée efficace, c’est-à-dire qu’elle a mené à une amélioration significative et durable des compétences en orthographe des élèves ciblés. La conscience morphologique pouvant aussi être intégrée dans l’enseignement de l’orthographe en classe, une formation ponctuelle a été développée, toujours dans le cadre de cette recherche, et son actualisation s’est faite via l’infrastructure sociotechnique de l’École éloignée en réseau. Cette formation a mené à une prise de conscience des enseignants quant au recours à des connaissances en morphologie dans leurs pratiques quotidiennes pour l’enseignement de l’orthographe. À la lumière des résultats obtenus, il importe de développer et mettre en place des interventions ciblées sur la morphologie et ses relations avec l’écriture des mots pour le développement optimal des habiletés d’orthographe des enfants tout-venant et en difficulté. Celles-ci peuvent s’inscrire tant dans l’action professionnelle d’intervenants spécialisés que dans un enseignement en salle de classe, et ce, dès la 2e année du 1er cycle

Communauté de pratique, technologie et réponse à l'intervention en compréhension de lecture pour le développement de pratiques enseignantes soutenant les habiletés langagières réceptives chez les enfants de milieux défavorisés

Dès le 2e cycle, les élèves relèvent divers défis en compréhension de lecture (CL) dont la réussite repose sur leurs habiletés langagières. Pour ce faire, les enseignants ont un rôle incontournable à jouer pour les amener à devenir des lecteurs stratégiques qui comprennent bien ce qu’ils lisent. Ce rôle est d’autant plus important pour les élèves issus de milieux défavorisés qui sont fortement à risque de présenter des difficultés langagières. Toutefois, les enseignants se sentent peu outillés pour favoriser le développement de la CL chez ces enfants. La communauté de pratique (CoP) ÉCRIT a été développée et mise en place sur la plateforme Web d’École en Réseau (ÉER). Elle a mené des enseignantes du primaire œuvrant auprès d’une clientèle défavorisée à comprendre et à appliquer nombre de notions sur le langage et son rôle dans la CL, en termes de connaissances, stratégies d’enseignement et comportements à adopter. Prises de conscience, initiatives pédagogiques et intégration de nouvelles pratiques pédagogiques en classe ont été au rendez-vous. Selon le regard des enseignants, une modification des pratiques qui inclue un soutien plus explicite des habiletés langagières a des répercussions positives sur la réussite scolaire des élèves, leur motivation et leur participation. Ainsi, l’instauration d’une CoP orientée sur les habiletés langagières et la CL s’avère un levier puissant pour outiller les enseignants dans leurs enseignements auprès des élèves et ainsi soutenir le développement de pratiques pédagogiques reconnues optimales par la recherche. Dans le cadre d’une approche Réponse à l’Intervention, telle que préconisée par le MEES, ce moyen permet de contribuer à l’amélioration continue de la qualité de l’enseignement en salle de classe (palier 1)

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

DMTs and Covid-19 severity in MS: a pooled analysis from Italy and France

We evaluated the effect of DMTs on Covid-19 severity in patients with MS, with a pooled-analysis of two large cohorts from Italy and France. The association of baseline characteristics and DMTs with Covid-19 severity was assessed by multivariate ordinal-logistic models and pooled by a fixed-effect meta-analysis. 1066 patients with MS from Italy and 721 from France were included. In the multivariate model, anti-CD20 therapies were significantly associated (OR = 2.05, 95%CI = 1.39–3.02, p < 0.001) with Covid-19 severity, whereas interferon indicated a decreased risk (OR = 0.42, 95%CI = 0.18–0.99, p = 0.047). This pooled-analysis confirms an increased risk of severe Covid-19 in patients on anti-CD20 therapies and supports the protective role of interferon

Autoantibodies neutralizing type I IFNs are present in ~4% of uninfected individuals over 70 years old and account for ~20% of COVID-19 deaths

Publisher Copyright: © 2021 The Authors, some rights reserved.Circulating autoantibodies (auto-Abs) neutralizing high concentrations (10 ng/ml; in plasma diluted 1:10) of IFN-alpha and/or IFN-omega are found in about 10% of patients with critical COVID-19 (coronavirus disease 2019) pneumonia but not in individuals with asymptomatic infections. We detect auto-Abs neutralizing 100-fold lower, more physiological, concentrations of IFN-alpha and/or IFN-omega (100 pg/ml; in 1:10 dilutions of plasma) in 13.6% of 3595 patients with critical COVID-19, including 21% of 374 patients >80 years, and 6.5% of 522 patients with severe COVID-19. These antibodies are also detected in 18% of the 1124 deceased patients (aged 20 days to 99 years; mean: 70 years). Moreover, another 1.3% of patients with critical COVID-19 and 0.9% of the deceased patients have auto-Abs neutralizing high concentrations of IFN-beta. We also show, in a sample of 34,159 uninfected individuals from the general population, that auto-Abs neutralizing high concentrations of IFN-alpha and/or IFN-omega are present in 0.18% of individuals between 18 and 69 years, 1.1% between 70 and 79 years, and 3.4% >80 years. Moreover, the proportion of individuals carrying auto-Abs neutralizing lower concentrations is greater in a subsample of 10,778 uninfected individuals: 1% of individuals 80 years. By contrast, auto-Abs neutralizing IFN-beta do not become more frequent with age. Auto-Abs neutralizing type I IFNs predate SARS-CoV-2 infection and sharply increase in prevalence after the age of 70 years. They account for about 20% of both critical COVID-19 cases in the over 80s and total fatal COVID-19 cases.Peer reviewe

Penilaian Kinerja Keuangan Koperasi di Kabupaten Pelalawan

This paper describe development and financial performance of cooperative in District Pelalawan among 2007 - 2008. Studies on primary and secondary cooperative in 12 sub-districts. Method in this stady use performance measuring of productivity, efficiency, growth, liquidity, and solvability of cooperative. Productivity of cooperative in Pelalawan was highly but efficiency still low. Profit and income were highly, even liquidity of cooperative very high, and solvability was good

New genetic loci link adipose and insulin biology to body fat distribution.

Body fat distribution is a heritable trait and a well-established predictor of adverse metabolic outcomes, independent of overall adiposity. To increase our understanding of the genetic basis of body fat distribution and its molecular links to cardiometabolic traits, here we conduct genome-wide association meta-analyses of traits related to waist and hip circumferences in up to 224,459 individuals. We identify 49 loci (33 new) associated with waist-to-hip ratio adjusted for body mass index (BMI), and an additional 19 loci newly associated with related waist and hip circumference measures (P < 5 × 10(-8)). In total, 20 of the 49 waist-to-hip ratio adjusted for BMI loci show significant sexual dimorphism, 19 of which display a stronger effect in women. The identified loci were enriched for genes expressed in adipose tissue and for putative regulatory elements in adipocytes. Pathway analyses implicated adipogenesis, angiogenesis, transcriptional regulation and insulin resistance as processes affecting fat distribution, providing insight into potential pathophysiological mechanisms

Juxtaposing BTE and ATE – on the role of the European insurance industry in funding civil litigation

One of the ways in which legal services are financed, and indeed shaped, is through private insurance arrangement. Two contrasting types of legal expenses insurance contracts (LEI) seem to dominate in Europe: before the event (BTE) and after the event (ATE) legal expenses insurance. Notwithstanding institutional differences between different legal systems, BTE and ATE insurance arrangements may be instrumental if government policy is geared towards strengthening a market-oriented system of financing access to justice for individuals and business. At the same time, emphasizing the role of a private industry as a keeper of the gates to justice raises issues of accountability and transparency, not readily reconcilable with demands of competition. Moreover, multiple actors (clients, lawyers, courts, insurers) are involved, causing behavioural dynamics which are not easily predicted or influenced. Against this background, this paper looks into BTE and ATE arrangements by analysing the particularities of BTE and ATE arrangements currently available in some European jurisdictions and by painting a picture of their respective markets and legal contexts. This allows for some reflection on the performance of BTE and ATE providers as both financiers and keepers. Two issues emerge from the analysis that are worthy of some further reflection. Firstly, there is the problematic long-term sustainability of some ATE products. Secondly, the challenges faced by policymakers that would like to nudge consumers into voluntarily taking out BTE LEI

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia