Troubles de l’alimentation et personnalité borderline : quelles affinités ?

Plusieurs types de preuves empiriques suggèrent que les troubles de l'alimentation (TA) peuvent être associés de façon importante avec ceux de la personnalité borderline (PB). Dans cet article, nous révisons les observations et données suggérant une affinité apparente entre la PB et la boulimie. Puis, nous discutons l'implication d'une PB comorbide quant à l'expression symptomatique et à la réponse au traitement des TA. Enfin, nous explorons les dimensions heuristiques permettant d'expliquer l'association spécifique de la PB avec les TA et une discussion propose des hypothèses de travail qui pourraient permettre de mieux distinguer l'impact des processus en cause dans les TA et la PB.Various forms of evidence suggest that eating disorders display a special co-aggregation with borderline personality disorder (BPD). In this article, the authors review findings suggesting an apparent affinity between BPD and bulimia. The authors then discuss the implication of BPD on the symptomatic expression and response to treatment of eating disorders. Finally, they explore heuristic dimensions that may explain the specific association of BPD with eating disorders. A discussion follows proposing researchable hypotheses that may permit a better differentiation of processes contributing to the evolution of eating disorders and BPD

Prévalence des attitudes et comportements inadaptés face à l’alimentation chez des adolescentes de la région de Montréal

La présente étude fait partie d'un projet de recherche portant sur les habitudes alimentaires des adolescentes et les facteurs de vulnérabilité aux troubles alimentaires. Nous présentons ici les résultats ayant trait à la pré valence des préoccupations et des troubles liés à T alimentation dans un groupe, nonre présentatif, de 1162 adolescentes de la région de Montréal. Les items de deux échelles souvent employées dans le domaine révèlent que le tiers des filles sont insatisfaites de leur corps et que 14% d'entre elles adoptent des attitudes et comportements inadaptés face à l'alimentation. À l'aide de différents critères, on estime la prévalence de l'anorexie nerveuse à environ 0,6% et celle de la boulimie nerveuse entre 0,5 et 2,5 %. Ces résultats se comparent à ceux rappor tés dans d'autres centres urbains occidentaux et font ressortir l'urgence de sensibiliser la population et les milieux de la santé québécois aux troubles alimentaires.The following study is part of a research project on the eating habits of adolescent girls and on the vulnerability factors concerning eating disorders. Here the authors focus on the prevalence of various concerns and problems linked to eating habits within a non-representative group of 1,162 adolescents in the Montréal region. Two parameters frequently used in the field reveal that a third of the girls are unhappy with their body and that 14 % of the sampling adopts unhealty attitudes and behaviours in regard to eating habits. Based on several criteria, the prevalence of nervous anorexia is estimated at approximately 0.6 % and that of nervous boulimia at between 0.5 and 2.5 %. These results are comparable to those obtained in other major urban centres of the Western world. In addition, they point to the urgent need to increase awareness among the population and the Québec healthcare field on the subject of eating disorders

The pharmacokinetics of nebulized nanocrystal budesonide suspension in healthy volunteers.

Nanocrystal budesonide (nanobudesonide) is a suspension for nebulization in patients with steroid-responsive pulmonary diseases such as asthma. The pharmacokinetics and safety of the product were compared to those of Pulmicort Respules. Sixteen healthy volunteers were administered nanobudesonide 0.5 and 1.0 mg, Pulmicort Respules 0.5 mg, and placebo in a four-way, randomized crossover design. All nebulized formulations were well tolerated, with no evidence of bronchospasm. Nebulization times were significantly shorter for nanobudesonide compared to Pulmicort Respules. Because of a low oral bioavailability, plasma concentration of budesonide is a good marker of lung-delivered dose. The pharmacokinetics of nanobudesonide 0.5 and 1.0 mg were approximately dose proportional with respect to Cmax, AUC(0-t), and AUC(0-infinity). Nanobudesonide 0.5 mg and Pulmicort Respules 0.5 mg exhibited similar AUCs, suggesting a similar extent of pulmonary absorption. A higher Cmax was noted with nanobudesonide 0.5 mg, and the tmax was significantly different, suggesting a more rapid rate of drug delivery of nanobudesonide 0.5 mg than Pulmicort Respules. In conclusion, nebulized nanobudesonide 0.5 mg was safe in healthy volunteers, with a similar extent of absorption as Pulmicort Respules

25 years of the WHO essential medicines lists: progress and challenges.

The first WHO essential drugs list, published in 1977, was described as a peaceful revolution in international public health. The list helped to establish the principle that some medicines were more useful than others and that essential medicines were often inaccessible to many populations. Since then, the essential medicines list (EML) has increased in size; defining an essential medicine has moved from an experience to an evidence-based process, including criteria such as public-health relevance, efficacy, safety, and cost-effectiveness. High priced medicines such as antiretrovirals are now included. Differences exist between the WHO model EML and national EMLs since countries face varying challenges relating to costs, drug effectiveness, morbidity patterns, and rationality of prescribing. Ensuring equitable access to and rational use of essential medicines has been promoted through WHO's revised drug strategy. This approach has required an engagement by WHO on issues such as the effect of international trade agreements on access to essential medicines and research and development to ensure availability of new essential medicines

A systematic review and secondary data analysis of the interactions between the serotonin transporter 5-HTTLPR polymorphism and environmental and psychological factors in eating disorders

Objectives: to summarize and synthesize the growing gene x environment (GxE) research investigating the promoter region of the serotonin transporter gene (5-HTTLPR) in the eating disorders (ED) field, and overcome the common limitation of low sample size, by undertaking a systematic review followed by a secondary data meta-analysis of studies identified by the review. Method: a systematic review of articles using PsycINFO, PubMed, and EMBASE was undertaken to identify studies investigating the interaction between 5-HTTLPR and an environmental or psychological factor, with an ED-related outcome variable. Seven studies were identified by the systematic review, with complete data sets of five community (n = 1750, 64.5% female) and two clinical (n = 426,100% female) samples combined to perform four secondary-data analyses: 5-I-M1PR x Traumatic Life Events to predict ED status (n = 909), 5-HTTLPR x Sexual and Physical Abuse to predict bulimic symptoms (n = 1097), 5-HTTLPR x Depression to predict bulimic symptoms (n = 1256), and 5-HTTLPRx Impulsiveness to predict disordered eating (n = 1149). Results: under a multiplicative model, the low function (s) allele of 5-HTTLPR interacted with traumatic life events and experiencing both sexual and physical abuse (but not only one) to predict increased likelihood of an ED and bulimic symptoms, respectively. However, under an additive model there was also an interaction between sexual and physical abuse considered independently and 5-HTTLPR, and no interaction with traumatic life events. No other GxE interactions were significant. Conclusion: early promising results should be followed-up with continued cross-institutional collaboration in order to achieve the large sample sizes necessary for genetic research

Signatures of the slow solar wind streams from active regions in the inner corona

Some of local sources of the slow solar wind can be associated with spectroscopically detected plasma outflows at edges of active regions accompanied with specific signatures in the inner corona. The EUV telescopes (e.g. SPIRIT/CORONAS-F, TESIS/CORONAS-Photon and SWAP/PROBA2) sometimes observed extended ray-like structures seen at the limb above active regions in 1MK iron emission lines and described as "coronal rays". To verify the relationship between coronal rays and plasma outflows, we analyze an isolated active region (AR) adjacent to small coronal hole (CH) observed by different EUV instruments in the end of July - beginning of August 2009. On August 1 EIS revealed in the AR two compact outflows with the Doppler velocities V =10-30 km/s accompanied with fan loops diverging from their regions. At the limb the ARCH interface region produced coronal rays observed by EUVI/STEREO-A on July 31 as well as by TESIS on August 7. The rays were co-aligned with open magnetic field lines expanded to the streamer stalks. Using the DEM analysis, it was found that the fan loops diverged from the outflow regions had the dominant temperature of ~1 MK, which is similar to that of the outgoing plasma streams. Parameters of the solar wind measured by STEREO-B, ACE, WIND, STEREO-A were conformed with identification of the ARCH as a source region at the Wang-Sheeley-Arge map of derived coronal holes for CR 2086. The results of the study support the suggestion that coronal rays can represent signatures of outflows from ARs propagating in the inner corona along open field lines into the heliosphere.Comment: Accepted for publication in Solar Physics; 31 Pages; 13 Figure

First Neutrino Observations from the Sudbury Neutrino Observatory

The first neutrino observations from the Sudbury Neutrino Observatory are presented from preliminary analyses. Based on energy, direction and location, the data in the region of interest appear to be dominated by 8B solar neutrinos, detected by the charged current reaction on deuterium and elastic scattering from electrons, with very little background. Measurements of radioactive backgrounds indicate that the measurement of all active neutrino types via the neutral current reaction on deuterium will be possible with small systematic uncertainties. Quantitative results for the fluxes observed with these reactions will be provided when further calibrations have been completed.Comment: Latex, 7 pages, 10 figures, Invited paper at Neutrino 2000 Conference, Sudbury, Canada, June 16-21, 2000 to be published in the Proceeding

Psychometric properties of the Chinese quality of life instrument (HK version) in Chinese and Western medicine primary care settings

Background: The Chinese Quality of Life Measure (ChQOL) had only been validated on a small number of selected subjects in Hong Kong and had never been tested in the Western medicine (WM) primary care setting. Aims: and objectives To test the psychometrics properties of ChQOL(HK version) in both TCM and WM general outpatient clinics. Methods: Three samples of Chinese adult patients [(1) 569 consulting TCM clinics for episodic illnesses; (2) 524 consulting WM clinics for episodic illnesses; (3) 205 consulting WM clinics for chronic disease follow-up] in Hong Kong were invited to complete the ChQOL(HK version) and the SF-36 Health Survey during their consultations and 2 weeks after consultations. The scaling assumptions, factor structure, convergent construct validity, reliability, responsiveness, and discriminatory power of the ChQOL were evaluated. Results: Majority of items satisfied the scaling assumptions. A two instead of 3-factor structure was found with physical form and emotion facets loading on one factor. Convergent construct validity was confirmed with moderate correlations with SF-36 scores. Internal consistency and test-retest reliability were satisfactory. The ChQOL(HK version) was able to detect significant improvements 2 weeks after consultations, and it was able to discriminate between groups with different illness severity, age, and sex. Conclusion The ChQOL(HK version) was shown to have satisfactory validity, reliability, discriminatory power, and responsiveness in both TCM and Western medicine primary care settings. The validity of the 3-domain scaling structure needs further evaluation. © The Author(s) 2011.published_or_final_versionSpringer Open Choice, 21 Feb 201

Independent measurement of the total active B8 solar neutrino flux using an array of He3 proportional counters at the Sudbury Neutrino Observatory

The Sudbury Neutrino Observatory (SNO) used an array of 3He proportional counters to measure the rate of neutral-current interactions in heavy water and precisely determined the total active (νx) 8B solar neutrino flux. This technique is independent of previous methods employed by SNO. The total flux is found to be 5.54-0.31+0.33(stat)-0.34+0.36(syst)×106  cm-2 s-1, in agreement with previous measurements and standard solar models. A global analysis of solar and reactor neutrino results yields Δm2=7.59-0.21+0.19×10-5  eV2 and θ=34.4-1.2+1.3 degrees. The uncertainty on the mixing angle has been reduced from SNO’s previous results

The role of diversity practices and inclusion in promoting trust and employee engagement

This paper investigates the association of diversity practices with an important aspect of workplace well-being, engagement. It was hypothesized that the association of diversity practices would be mediated by trust climate and that this mediation relationship would be stronger when employees experienced feelings of inclusion in the workplace. Using a sample of 4,597 health sector employees, results indicated that diversity practices are associated with a trusting climate that, in turn, is positively related to employee engagement. Furthermore, the relationship between diversity practices and trust climate was moderated by inclusion. Theoretical and practical implications of the study are discussed along with recommendations for future research