From expression pattern to genetic association in asthma and asthma-related phenotypes

Background : Asthma is a complex disease characterized by hyperresponsiveness, obstruction and inflammation of the airways. To date, several studies using different approaches as candidate genes approach, genome wide association studies, linkage analysis and genomic expression leaded to the identification of over 300 genes involved in asthma pathophysiology. Combining results from two studies of genomic expression, this study aims to perform an association analysis between genes differently expressed in bronchial biopsies of asthmatics compared to controls and asthma-related phenotypes using the same French-Canadian Caucasian population. Results : Before correction, 31 of the 85 genes selected were associated with at least one asthma-related phenotype. We found four genes that survived the correction for multiple testing. The rs11630178 in aggrecan gene (AGC1) is associated with atopy (p=0.0003) and atopic asthma (p=0.0001), the rs1247653 in the interferon alpha-inducible protein 6 (IFI6), the rs1119529 in adrenergic, alpha-2A-, receptor (ADRA2A) and the rs13103321 in the alcohol dehydrogenase 1B (class I), beta polypeptide (ADH1B), are associated with asthma (p=0.019; 0.01 and 0.002 respectively). Conclusion : To our knowledge, this is the first time those genes are associated with asthma and related traits. Consequently, our study confirms that genetic and expression studies are complementary to identify new candidate genes and to investigate their role to improve the comprehension of the complexity of asthma pathophysiology

La santé psychologique et la conciliation travail-famille des infirmières en soins ambulatoires à l’ère de la COVID-19 : résultats d’une enquête

Introduction: The COVID-19 pandemic impacted nurses’ psychological health and work-family balance, including in ambulatory care settings. The results presented in this article are part of a study aiming to describe and contextualize the psychological health and changes in nurses’ follow-up practices in Quebec (Canada) during the COVID-19 pandemic. Objective: Explore and describe factors that influenced ambulatory care nurses’ psychological health and work-family balance during the first wave of the COVID-19 pandemic. Methods: Exploratory mixed data cross-sectional study using the SurveyMonkey platform. We collected data from July 2020 to September 2020. The target population comprised all practicing nurses in Quebec whose clinical activities included the follow-up of ambulatory patients, 200 of whom completed the survey.  Results: Multiple linear regression models indicated that anxiety (GAD-7 scores) and depressive symptoms (PHQ-9 scores) were associated with younger age, living alone, worries about transmitting COVID-19, and feeling that one’s work was not coherent with one’s values. Work-family balance was considered more difficult than before the pandemic by 54.5 % of participants. Factors perceived as influencing work-family balance were either related to work conditions (e.g., schedule and time at work, access to work from home, redeployment to another work setting), to family-related responsibilities/tasks or were specific to the pandemic. Discussion and conclusion: Apart from age, the feeling that one’s work was not coherent with their values was the only variable correlated with both GAD-7 and PHQ-9 in multivariate models. Further research should investigate the relationships between sense of coherence, psychological health, and work conditions like schedule flexibility and access to work from home.Introduction : La pandémie a eu des répercussions sur la santé psychologique et la conciliation travail-famille des infirmières, y compris dans les milieux de soins ambulatoires. Les résultats présentés dans cet article font partie d’une étude visant à décrire et contextualiser la santé psychologique et l’évolution des pratiques de suivi infirmier au Québec (Canada) lors de la pandémie de COVID-19. Objectif : Explorer et décrire les facteurs qui ont influencé la santé psychologique et la conciliation travail-famille des infirmières en soins ambulatoires pendant la première vague de la pandémie de COVID-19. Méthodes : Enquête exploratoire avec données mixtes par le biais de la plateforme SurveyMonkey. Les données ont été collectées de juillet 2020 à septembre 2020. La population cible était toutes les infirmières du Québec dont les activités cliniques incluaient le suivi de patients ambulatoires ; 200 infirmières ont participé. Résultats : Les modèles de régression ont indiqué que les symptômes anxieux (scores au GAD-7) et dépressifs (scores au PHQ-9) étaient associés à un plus jeune âge, au fait de vivre seul, aux inquiétudes concernant la transmission de la COVID-19 et au sentiment que son travail n’était pas cohérent avec ses valeurs. La conciliation travail-famille était jugée plus difficile qu’avant la pandémie par 54,5 % des participants. Les facteurs perçus comme l’influençant étaient soit liés aux conditions de travail (p. ex., horaire et temps de travail, télétravail, délestage), aux tâches familiales, ou étaient spécifiques à la pandémie. Discussion et conclusion : Outre l’âge, le sentiment que son travail n’était pas cohérent avec ses valeurs était la seule variable corrélée à la fois avec le GAD-7 et le PHQ-9. Les futures recherches devraient s’intéresser à la relation entre le sentiment de cohérence, la santé psychologique et les conditions de travail favorables à la conciliation travail-famille

The Psychological Health and Work-Family Balance of Ambulatory Care Nurses in the COVID-19 era: a Cross-Sectional Survey

Introduction: The COVID-19 pandemic impacted nurses’ psychological health and work-family balance, including in ambulatory care settings. The results presented in this article are part of a study aiming to describe and contextualize the psychological health and changes in nurses’ follow-up practices in Quebec (Canada) during the COVID-19 pandemic. Objective: Explore and describe factors that influenced ambulatory care nurses’ psychological health and work-family balance during the first wave of the COVID-19 pandemic. Methods: Exploratory mixed data cross-sectional study using the SurveyMonkey platform. We collected data from July 2020 to September 2020. The target population comprised all practicing nurses in Quebec whose clinical activities included the follow-up of ambulatory patients, 200 of whom completed the survey.  Results: Multiple linear regression models indicated that anxiety (GAD-7 scores) and depressive symptoms (PHQ-9 scores) were associated with younger age, living alone, worries about transmitting COVID-19, and feeling that one’s work was not coherent with one’s values. Work-family balance was considered more difficult than before the pandemic by 54.5 % of participants. Factors perceived as influencing work-family balance were either related to work conditions (e.g., schedule and time at work, access to work from home, redeployment to another work setting), to family-related responsibilities/tasks or were specific to the pandemic. Discussion and conclusion: Apart from age, the feeling that one’s work was not coherent with their values was the only variable correlated with both GAD-7 and PHQ-9 in multivariate models. Further research should investigate the relationships between sense of coherence, psychological health, and work conditions like schedule flexibility and access to work from home

The COVID-19 Pandemic: Challenges and Needs Experienced by Indigenous People of Urban Areas

The world was caught off guard by the swift spread of the COVID-19 pandemic at the beginning of 2020. For vulnerable populations such as the urban Indigenous, the first wave of the pandemic was even more challenging for multiple reasons. Many of their usual culturally safe services were interrupted, thus they found themselves struggling on different levels. Our team conducted a needs assessment to shed light on how urban Indigenous people living in the X region, in the province of Quebec, Canada, dealt with this situation and what were the most important services regarding holistic health they wished they could have relied on. To respect Indigenous culture, data collection was completed through sharing circles in addition to a web-based survey. The results indicated that participants experienced anxiety and psychological distress during the pandemic. They identified unmet needs related to family services, support in homeschooling, access to traditional medicine and spiritual and cultural practices to name a few. Future work should involve the implementation of culturally safe services, adapted to the pandemic era, for Indigenous people living in urban area

Step-by-step Strategies for an Integrated Patient-Oriented Research: Lessons Learned from a Multicentered Study

Introduction: The literature on Patient-Oriented Research (POR) and, more specifically, on the collaborative experience between research teams and patient partners (PPs), varies in the way it reports experiences. In Canada, since a few years, POR has been upgraded and literature now provides several guidelines and tools to support effective engagement of PPs in research. However, scientific literature most often presents elements from the researchers’ or from the PPs’ perspective, but rarely from both simultaneously. Objective: This paper objective is to enhance the current literature and provide examples of day-to-day pre, per, and post POR activities. Methods: Based on the 4 guiding principles of the Strategy for POR of the Canadian Institutes of Health Research, we present a step-by-step description of our POR strategies used during our research project. We also give concrete examples and tips shared by PPs and researchers. Discussion and conclusion: We favored 3 steps to engage positively our team in a POR approach. These steps led us to 3 main lessons. First, there is a necessity to adapt training on POR. Second, researchers must demonstrate open-mindedness and humility throughout the collaboration. Third, PPs’ recognition needs to be emphasized including a normalization of financial aspect. The reflections made in this article will help, hopefully, research teams to begin their patient-centered research process by building on the previous experiences of other teams, such as ours.Introduction : La littérature sur la recherche axée sur le patient (RAP), particulièrement celle relatant l’expérience collaborative entre les patients partenaires et les équipes de recherche, varie dans la façon dont l’expérience est rapportée. Au Canada, depuis quelques années, la littérature concernant la RAP émerge et fournit davantage de recommandations sur les façons efficaces d’engager les patients dans la recherche. Cependant, celle-ci rapporte le plus souvent l’expérience soit des chercheurs ou des patients partenaires, mais rarement celles des deux perspectives mises en commun. Objectif : Cet article a pour objectif d’enrichir la littérature sur la RAP et de fournir des exemples d’activités quotidiennes avant, pendant et après la RAP. Méthodes : En nous basant sur les 4 principes de la RAP des Instituts de recherche en santé du Canada, nous présentons les stratégies « pas à pas » utilisées pendant notre projet de recherche. Nous fournissons également des exemples et des astuces partagées par les patients partenaires et les chercheurs. Discussion et conclusion : Afin d’engager positivement notre équipe dans une démarche de RAP, nous avons retenu 3 étapes qui nous ont permis de dégager 3 leçons de cette expérience. Premièrement, il est nécessaire d’adapter les formations portant sur la RAP selon les publics concernés dans le projet de recherche. Ensuite, les chercheurs doivent faire preuve d’humilité et d’ouverture d’esprit pour reconnaitre les expériences variées. Puis, la contribution des patients partenaires doit être reconnue incluant la normalisation d’une rétribution financière pour leur travail effectué. Les réflexions apportées dans cet article aideront, nous l’espérons, des équipes de recherche à construire leur RAP en bénéficiant des expériences comme celle que nous rapportons

Chronic conditions patient’s perception of post-COVID-19 pandemic teleconsulting continuation in primary care clinics: a qualitative descriptive study

Objectives The COVID-19 pandemic has led to the prioritisation of teleconsultation instead of face-to-face encounters. However, teleconsultation revealed some shortcomings and undesirable effects that may counterbalance benefits. This study aims to explore the perspective of patients with chronic diseases on teleconsultation in primary care. This article also proposes recommendations to provide patient-oriented and appropriate teleconsultations.Design We conducted a qualitative descriptive study that explored the patients’ perception regarding teleconsultation services and the following themes: access, perceived benefits and disadvantages, interprofessional collaboration, patient-centred approach, specific competencies of professionals, and patient’s global needs and preferences.Setting Six primary care clinics in three regions of Quebec.Participants 39 patients were interviewed by telephone through semistructured qualitative interviews.Results Patients want to maintain teleconsultation for the postpandemic period as long as their recommendations are followed: be able to choose to come to the clinic if they wish to, feel that their individual and environmental characteristics are considered, feel involved in the choice of the modality of each consultation, feel that interprofessional collaboration and patient-centred approach are promoted, and to maintain the professionalism, which must not be lessened despite the remote context.Conclusion Patients mainly expressed high satisfaction with teleconsultation. However, several issues must be addressed. Patients do and should contribute to the implementation of teleconsultation in primary care. They wish to be frequently consulted about their preferred consultation modality, which may change over time. The patient perspective must, therefore, be part of the balanced implementation of optimal teleconsultation that is currently taking place