Niveaux de compétences des internes de médecine générale d'Angers en prévention éducation dépistage (Etude qualitative)

Introduction : Le développement d'outils d'évaluation et de certification des internes de médecine générale en médecin compétent est actuellement en cours au niveau national. La compétence éducation prévention et dépistage a été attribuée au grand ouest. Le travail effectué à la faculté de médecine d'Angers avait pour but de rechercher des indices de niveaux de développement de la compétence. Matériel et Méthode : 21 internes de médecine générale ont été répartis en trois focus group : novice , intermédiaire et compétent , selon leur avancée dans le cursus de l'internat. Une analyse thématique de chacun des verbatims a recherché les représentations des internes pour la compétence. Résultats : Les internes du groupe novice savaient que le patient devait avoir une place centrale dans sa prise en charge mais oubliaient de l'intégrer en pratique. Les internes du groupe intermédiaire commençaient à donner une place au patient mais acceptaient difficilement des opinions différentes. Les internes du groupe compétent intégraient le patient dans la décision médicale et anticipaient la prise en charge dans le temps et en réseau. Discussion : Des indices de niveau de compétence ont pu être retrouvés. Les différences entre le discours et la pratique rendent nécessaire l'évaluation en situation authentique. Conclusion : Ce travail s'intègre avec les 5 autres travaux du Grand Ouest afin de permettre l'élaboration d'un outil d'évaluation.Introduction : the development of evaluation tools and certification of general practice interns is in progress on a national scale. The competency education, prevention, screening has been allocated to the big west region of France. The work performed in the University of Angers aimed at searching evidence of proficiency for the competency. Material an methods : 21 interns of general practice were divided into 3 FG defined as either "novice""intermediary"and "competent", according to their advance in the program. A thematic analysis of the interviews material defined the interns representations for the competency Result : The interns of the novice group knew that the patient must have a central place in his care but forgot to include him in the practice. The interns of the intermediary group started to give him a central place but accepted different opinions with difficulties. The interns of the competent group implied the patient in the decision and anticipated the care in time and with the other praticer.. Discussion :some Iindicators of the level of competency could be found. The differencies between the speech and the practice make necessary the evaluation in au thentic situations.Conclusion : this work is integred with 5 other same work of the big West region in order to develop assessment toolsANGERS-BU Médecine-Pharmacie (490072105) / SudocSudocFranceF

Interfacial and emulsifying properties of amaranth (<i>Amaranthus hypochondriacus</i>) protein isolates under different conditions of pH

Amaranth proteins have adequate amino acid balance for substituting either partly or completely animal proteins in human nutrition. However, they present poor emulsifying properties in basic conditions corresponding to their extraction medium. Consequently their use in acidic conditions could be envisaged to better exploit their potentialities. To better understand their emulsifying properties we have studied their interfacial activities at pHs 2.0 and 8.0 and tried to make the link between 2D and 3D properties. Our results clearly demonstrate the better properties of AI at pH 2.0 than at pH 8 in terms of protein solubility, spreading, adsorption, viscoelastic properties of interfaces and emulsion stability. These results are in relation with the denaturated state of proteins at pH 2.0 where proteins form a harder interfacial film, as compared to pH 8.0. Thus the potential use of amaranth proteins in emulsifying applications should be oriented towards acidic applications.Centro de Investigación y Desarrollo en Criotecnología de Alimento

Human genetic polymorphisms in T1R1 and T1R3 taste receptor subunits affect their function.

International audienceUmami is the typical taste induced by monosodium glutamate (MSG), which is thought to be detected by the heterodimeric G protein-coupled receptor, T1R1 and T1R3. Previously, we showed that MSG detection thresholds differ substantially between individuals and we further showed that nontaster and hypotaster subjects are associated with nonsynonymous single polymorphisms occurring in the T1R1 and T1R3 genes. Here, we show using functional expression that both amino acid substitutions (A110V and R507Q) in the N-terminal ligand-binding domain of T1R1 and the 2 other ones (F749S and R757C), located in the transmembrane domain of T1R3, severely impair in vitro T1R1/T1R3 response to MSG. A molecular model of the ligand-binding region of T1R1/T1R3 provides a mechanistic explanation supporting functional expression data. The data presented here support causal relations between the genotype and previous in vivo psychophysical studies in human evaluating sensitivity to MSG

Genome Evolution of Two Genetically Homogeneous Infectious Bursal Disease Virus Strains During Passages in vitro and ex vivo in the Presence of a Mutagenic Nucleoside Analog

The avibirnavirus infectious bursal disease virus (IBDV) is responsible for a highly contagious and sometimes lethal disease of chickens (Gallus gallus). IBDV genetic variation is well-described for both field and live-attenuated vaccine strains, however, the dynamics and selection pressures behind this genetic evolution remain poorly documented. Here, genetically homogeneous virus stocks were generated using reverse genetics for a very virulent strain, rvv, and a vaccine-related strain, rCu-1. These viruses were serially passaged at controlled multiplicities of infection in several biological systems, including primary chickens B cells, the main cell type targeted by IBDV in vivo. Passages were also performed in the absence or presence of a strong selective pressure using the antiviral nucleoside analog 7-deaza-2′-C-methyladenosine (7DMA). Next Generation Sequencing (NGS) of viral genomes after the last passage in each biological system revealed that (i) a higher viral diversity was generated in segment A than in segment B, regardless 7DMA treatment and viral strain, (ii) diversity in segment B was increased by 7DMA treatment in both viruses, (iii) passaging of IBDV in primary chicken B cells, regardless of 7DMA treatment, did not select cell-culture adapted variants of rvv, preserving its capsid protein (VP2) properties, (iv) mutations in coding and non-coding regions of rCu-1 segment A could potentially associate to higher viral fitness, and (v) a specific selection, upon 7DMA addition, of a Thr329Ala substitution occurred in the viral polymerase VP1. The latter change, together with Ala270Thr change in VP2, proved to be associated with viral attenuation in vivo. These results identify genome sequences that are important for IBDV evolution in response to selection pressures. Such information will help tailor better strategies for controlling IBDV infection in chickens

Particles Systems for Mean Reflected BSDEs

International audienceIn this paper, we deal with Reflected Backward Stochastic Differential Equations for which the constraint is not on the paths of the solution but on its law as introduced by Briand, Elie and Hu in [3]. We extend the recent work [2] of Briand, Chaudru de Raynal, Guillin and Labart on the chaos propagation for mean reflected SDEs to the backward framework. When the driver does not depend on z, we are able to treat general reflexions for the particles system. We consider linear reflexion when the driver depends also on z. In both cases, we get the rate of convergence of the particles system towards the square integrable deterministic flat solution to the mean reflected BSDE

Une statuette d’Épona retrouvée en territoire vénète au Goh-Quer en Plumergat (Morbihan)

Briand Émilie, Mavéraud-Tardiveau Hélène. Une statuette d’Épona retrouvée en territoire vénète au Goh-Quer en Plumergat (Morbihan). In: Aremorica. Études sur l'ouest de la Gaule romaine, n°5, 2012. pp. 33-47

Marques de l’émotion dans la prosodie et fluence d’un patient cérébrolésé : Étude préliminaire de faisabilité

National audienceThe emotional regulation therapy (Gremo) for patients with an acquired cerebral lesion raises the issue of assessing emotion in clinical speech. Indeed, a better emotional regulation would be a sign of the success of the therapy which should be reflected in the patients' speech. The present work is a preliminary feasibility study, looking at a patient's speech to see if fluency and speech organization are congruent phonetic markers with lexical annotation for identifying parts of speech as emotion-bearing elements, especially negative ones. The first results indicate a slower and less hesitant speech, implying a better emotional regulation after the therapeutic treatment, which partially validates our experimental protocol. It will be necessary to complete these data with a larger cohort of patients and control speakersLa thérapie de régulation émotionnelle auprès de patients atteints d’une lésion cérébrale acquise soulève la question de l’évaluation de l’émotion dans le discours clinique. En effet, une meilleure régulation émotionnelle serait le signe de l’efficacité de la thérapie ce qui devrait se traduire dans le discours des patients. Le présent travail est une étude préliminaire de faisabilité où il s’agit d’étudier le discours d’un patient. Nous souhaitons voir si la fluence et l’organisation du discours sont des marqueurs phonétiques congruents avec l’annotation lexicale permettant d’identifier des parties du discours comme étant porteuses d’émotion, en particulier négatives. Les premiers résultats indiquent un discours plus lent et moins hésitant, supposant une meilleure régulation émotionnelle après la prise en charge thérapeutique ce qui valide partiellement notre protocole expérimenta

Marques de l’émotion dans la prosodie et fluence d’un patient cérébrolésé : Étude préliminaire de faisabilité

National audienceThe emotional regulation therapy (Gremo) for patients with an acquired cerebral lesion raises the issue of assessing emotion in clinical speech. Indeed, a better emotional regulation would be a sign of the success of the therapy which should be reflected in the patients' speech. The present work is a preliminary feasibility study, looking at a patient's speech to see if fluency and speech organization are congruent phonetic markers with lexical annotation for identifying parts of speech as emotion-bearing elements, especially negative ones. The first results indicate a slower and less hesitant speech, implying a better emotional regulation after the therapeutic treatment, which partially validates our experimental protocol. It will be necessary to complete these data with a larger cohort of patients and control speakersLa thérapie de régulation émotionnelle auprès de patients atteints d’une lésion cérébrale acquise soulève la question de l’évaluation de l’émotion dans le discours clinique. En effet, une meilleure régulation émotionnelle serait le signe de l’efficacité de la thérapie ce qui devrait se traduire dans le discours des patients. Le présent travail est une étude préliminaire de faisabilité où il s’agit d’étudier le discours d’un patient. Nous souhaitons voir si la fluence et l’organisation du discours sont des marqueurs phonétiques congruents avec l’annotation lexicale permettant d’identifier des parties du discours comme étant porteuses d’émotion, en particulier négatives. Les premiers résultats indiquent un discours plus lent et moins hésitant, supposant une meilleure régulation émotionnelle après la prise en charge thérapeutique ce qui valide partiellement notre protocole expérimenta