Psychothérapie de la perte et du deuil

Pendant de longues années, en Israël et ailleurs, les survivants de l'Holocauste n'ont pas laissé de place dans leurs vies aux souvenirs de leur passé, craignant d'en être submergés et d'en contaminer leurs enfants. Lorsque ces personnes arrivent à l'âgé où elles font le bilan de leurs vies, le processus de deuil et celui de la perte sont réactivés par le besoin de porter témoignage. Elles souhaitent aussi se retrouver en continuité avec les événements cruciaux de leur passé, en particulier la séparation avec la famille d'origine, avec l'entourage et avec leur culture. La deuxième génération a grandi dans cette coupure avec les origines de la famille, coupure qui permet le développement de fantasmes souvent liés à une culpabilisation diffuse. Deux cas cliniques sont présentés ici et illustrent ces deux thèmes.For many years, survivors of the Holocaust in Israel and elsewhere have made little space in their lives for past memories. Indeed, they feared being overcome by them and influencing their children negatively as a result. When these people reach the age of putting their whole life into perspective, the mourning and loss processes are reactivated by the need to hold testimony. Also, they seek to be part of the continuity of crucial events that marked their past, particularly concerning the separation from their family of origin, network of friends and cultural community. Furthermore, since people belonging to the second generation grew up with this separation from family roots, they would develop fantasies often linked to a somewhat guilty complex. The authors present two clinical cases to illustrate each of the two themes in the article

The Complete Calibration of the Color-Redshift Relation (C3R2) Survey: Survey Overview and Data Release 1

A key goal of the Stage IV dark energy experiments Euclid, LSST and WFIRST is to measure the growth of structure with cosmic time from weak lensing analysis over large regions of the sky. Weak lensing cosmology will be challenging: in addition to highly accurate galaxy shape measurements, statistically robust and accurate photometric redshift (photo-z) estimates for billions of faint galaxies will be needed in order to reconstruct the three-dimensional matter distribution. Here we present an overview of and initial results from the Complete Calibration of the Color-Redshift Relation (C3R2) survey, designed specifically to calibrate the empirical galaxy color-redshift relation to the Euclid depth. These redshifts will also be important for the calibrations of LSST and WFIRST. The C3R2 survey is obtaining multiplexed observations with Keck (DEIMOS, LRIS, and MOSFIRE), the Gran Telescopio Canarias (GTC; OSIRIS), and the Very Large Telescope (VLT; FORS2 and KMOS) of a targeted sample of galaxies most important for the redshift calibration. We focus spectroscopic efforts on under-sampled regions of galaxy color space identified in previous work in order to minimize the number of spectroscopic redshifts needed to map the color-redshift relation to the required accuracy. Here we present the C3R2 survey strategy and initial results, including the 1283 high confidence redshifts obtained in the 2016A semester and released as Data Release 1.Comment: Accepted to ApJ. 11 pages, 5 figures. Redshifts can be found at http://c3r2.ipac.caltech.edu/c3r2_DR1_mrt.tx

Are We Making Progress in Medical Education?

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75582/1/j.1525-1497.2006.00446.x.pd

Estrogen worsens incipient hypertriglyceridemic glomerular injury in the obese Zucker rat

Estrogen worsens incipient hypertriglyceridemic glomerular injury in the obese Zucker rat.BackgroundThe obese Zucker rat (OZR) is a model of glomerulosclerosis and renal failure in the setting of hyperlipidemia, hyperinsulinemia, and obesity. Our prior work in OZRs has shown that ovariectomy attenuates glomerulosclerosis, while added estrogen worsens it. To investigate the mechanism of estrogen's effects on glomerular disease in this model, we evaluated the effects of ovariectomy and estrogen supplementation on seven-week peripubertal OZRs. At this time point, rats exhibit no overt histologic glomerular disease, but are just beginning to show elevated urinary albumin excretion.MethodsFemale OZRs fed ad libitum were ovariectomized at four weeks, with or without estrogen supplementation to raise estrogen levels to just below those of preoestral adults (mean 16.5 pg/mL). Sham-operated controls were included.ResultsOvariectomy normalized albuminuria, lowered total and very low-density lipoprotein triglycerides, and reduced glomerular fibronectin expression. Estrogen supplementation worsened albuminuria and raised total/very low-density lipoprotein triglycerides and total cholesterol. Estrogen-supplemented rats exhibited enhanced glomerular deposition of apo A-IV and apo B, increased glomerular expression of desmin and type IV collagen, and increased interstitial macrophage deposition.ConclusionEstrogen may be permissive for the early development of renal disease in OZRs and may act by increasing triglyceride-rich lipoproteins, which then bind to glomerular cells and initiate or accelerate glomerulosclerosis

Methodological guidance for the conduct of mixed methods systematic reviews.

Objective: The objective of this paper is to outline the updated methodological approach for conducting a JBI MMSR with a focus on data synthesis, specifically, methods related to how data are combined and the overall integration of the quantitative and qualitative evidence. Introduction: Mixed methods systematic reviews (MMSRs) provide a more complete basis for complex decision making than that currently offered by single method reviews, thereby maximizing their usefulness to clinical and policy decision makers. Although MMSRs are gaining traction, guidance regarding the methodology of combining quantitative and qualitative data is limited. In 2014, the JBI Mixed Methods Review Methodology Group developed guidance for MMSRs; however, since the introduction of this guidance, there have been significant developments in mixed methods synthesis. As such, the methodology group recognized the need to revise the guidance to align it with the current state of knowledge on evidence synthesis methodology Methods: Between 2015 and 2019, the JBI Mixed Methods Review Methodology Group undertook an extensive review of the literature, held annual face-to-face meetings (which were supplemented by teleconferences and regular email correspondence), sought advice from experts in the field and presented at scientific conferences. This process led to the development of guidance in the form of a chapter included in the JBI Reviewer’s Manual, the official guidance for conducting JBI systematic reviews. In 2019, the guidance was ratified by the JBI International Scientific Committee. Results: The updated JBI methodological guidance for conducting an MMSR recommends that reviewers take a convergent approach to synthesis and integration whereby the specific method utilized is dependent on the nature/type of question(s) that is (are) posed in the systematic review. The JBI guidance is primarily based on Hong et al. and Sandelowski’s typology on MMSRs. If the review question can be addressed by both quantitative and qualitative research designs, the convergent integrated approach should be followed, which involves data transformation and allows reviewers to combine quantitative and qualitative data. If the focus of the review is on different aspects or dimensions of a particular phenomenon of interest, the convergent segregated approach is undertaken, which involves independent synthesis of quantitative and qualitative data leading to the generation of quantitative and qualitative evidence, which are then integrated together. Conclusions: The updated guidance on JBI MMSRs provides foundational work to a rapidly evolving methodology and aligns with other seminal work undertaken in the field of mixed methods synthesis. Limitations to the current guidance are acknowledged, and a series of methodological projects identified by the JBI Mixed Methodology Group to further refine the methodology are proposed. Mixed methods review offers an innovative framework for generating unique insights related to the complexities associated with healthcare quality and safety

The experiences and effectiveness of canine-assisted interventions (CAIs) on the health and well-being of older people residing in long-term care: a mixed methods systematic review protocol. [Protocol]

The aim of this mixed methods review is to synthesize and integrate the best available evidence on the experiences and effectiveness of canine-assisted interventions (CAIs) on the health and well-being of older people residing in long-term care. More specifically the review questions are: 1) What are the experiences of older people residing in long-term care who receive CAIs? 2) What are the views of people directly or indirectly involved in delivering CAIs to older adults (such as family and friends of the residents, healthcare workers and volunteers) regarding CAIs for older people residing in long-term care facilities? 3) What is the effectiveness of CAIs on the health and well-being of older people residing in long-term care facilities

Multidisciplinary Staffing in a Graduate Writing Center: Making Writing Labor Visible, Valued, and Shared

Writing studies and writing center scholars have recently focused much-needed attention on how graduate student writers are taught, mentored, and supported. This scholarship also points to a persistent and stubborn conundrum: Graduate students must write their way into disciplinary belonging, yet most advisors lack a language for, or even awareness of, the specialized practices and tacit expectations shaping written discourse in their fields. While graduate student–serving writing centers help fill this writing-support gap, a reliance on English and humanities graduate students for staff reproduces a status quo in which the genre awareness and rhetorical vocabulary needed to mentor advanced academic writers are neither widely distributed nor recognized and valued. This essay offers the counterexample of a graduate writing center whose consultants hail primarily from master’s and doctoral programs in the sciences and social sciences. Using feminist social reproduction theory to examine this case study of one graduate writing center, the authors explore how multidisciplinary staffing resists the enclaving of writing process and rhetorical knowledge and points to a future in which the responsibility for mentoring graduate student writers is visible, valued, and shared

Barriers and enablers to implementation of pressure injury prevention in hospitalized adults: a mixed methods systematic review protocol.

Objective: The objective of the proposed systematic review is to determine the barriers and enablers (or facilitators) to the implementation of pressure injury prevention among adults receiving care in the hospital setting. Introduction: Hospital-acquired pressure injuries are preventable; however, they remain an ongoing safety and quality healthcare concern in many countries. There are various evidence-based preventative interventions for pressure injuries, but their implementation in clinical practice is limited. An understanding of the different factors that support (enablers or facilitators) and inhibit (barriers) the implementation of these interventions from different perspectives is important, so that targeted strategies can be incorporated into implementation plans. Inclusion criteria: This review will include quantitative, qualitative and mixed-methods studies that investigate barriers and/or enablers in relation to hospital-acquired pressure injury prevention in hospitalized adults. Only English publications will be considered, with no publication date restrictions. Methods: The systematic review will be conducted in accordance with the JBI methodology for mixed methods systematic review. Published studies will be searched in PubMed, CINAHL, Embase, PsycINFO and Scopus. Gray literature will also be considered. Critical appraisal and data extraction will be performed using standardized tools, followed by data transformation. Data synthesis will follow the convergent integrated approach

How do women prepare for pregnancy? Preconception experiences of women attending antenatal services and views of health professionals

Copyright: © 2014 Stephenson et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Main objective - To determine the extent to which women plan and prepare for pregnancy. Methods - Cross-sectional questionnaire survey of pregnant women attending three maternity services in London about knowledge and uptake of preconception care; including a robust measure of pregnancy planning, and phone interviews with a range of health care professionals. Main results - We recruited 1173/1288 (90%) women, median age of 32 years. 73% had clearly planned their pregnancy, 24% were ambivalent and only 3% of pregnancies were unplanned. 51% of all women and 63% of those with a planned pregnancy took folic acid before pregnancy. 21% of all women reported smoking and 61% reported drinking alcohol in the 3 months before pregnancy; 48% of smokers and 41% of drinkers reduced or stopped before pregnancy. The 51% of all women who reported advice from a health professional before becoming pregnant were more likely to adopt healthier behaviours before pregnancy [adjusted odds ratios for greatest health professional input compared with none were 2.34 (95% confidence interval 1.54–3.54) for taking folic acid and 2.18 (95% CI 1.42–3.36) for adopting a healthier diet before pregnancy]. Interviews with 20 health professionals indicated low awareness of preconception health issues, missed opportunities and confusion about responsibility for delivery of preconception care. Significance of the findings - Despite a high level of pregnancy planning, awareness of preconception health among women and health professionals is low, and responsibility for providing preconception care is unclear. However, many women are motivated to adopt healthier behaviours in the preconception period, as indicated by halving of reported smoking rates in this study. The link between health professional input and healthy behaviour change before pregnancy is a new finding that should invigorate strategies to improve awareness and uptake of pre-pregnancy health care, and bring wider benefits for public health.Department of Healt

Accurate and sensitive quantification of protein-DNA binding affinity

Transcription factors (TFs) control gene expression by binding to genomic DNA in a sequence-specific manner. Mutations in TF binding sites are increasingly found to be associated with human disease, yet we currently lack robust methods to predict these sites. Here, we developed a versatile maximum likelihood framework named No Read Left Behind (NRLB) that infers a biophysical model of protein-DNA recognition across the full affinity range from a library of in vitro selected DNA binding sites. NRLB predicts human Max homodimer binding in near-perfect agreement with existing low-throughput measurements. It can capture the specificity of the p53 tetramer and distinguish multiple binding modes within a single sample. Additionally, we confirm that newly identified low-affinity enhancer binding sites are functional in vivo, and that their contribution to gene expression matches their predicted affinity. Our results establish a powerful paradigm for identifying protein binding sites and interpreting gene regulatory sequences in eukaryotic genomes