Évolution des discours publics des autorités de santé au Québec en matière de gestion du poids

L’augmentation observée de la prévalence du surpoids et de l’obésité au Québec comme ailleurs en Occident inquiète tant les gouvernements que les autorités médicales. Afin de contenir ce phénomène qui est désormais décrit comme une pandémie d’obésité, ces organisations y sont allées de différentes initiatives et recommandations, dans un contexte d’inefficacité avérée des interventions de gestion de poids à caractère clinique et d’émergence de stratégies de prévention dont l’efficacité et la sécurité à long terme restent encore à démontrer. Méthode : L’objet de cette recherche a été de décrire l’évolution du discours des organismes officiels de santé au Québec en matière de gestion du poids par l’analyse de contenu. Cette analyse a eu recours à une grille de plus de 160 documents produits au cours des 60 dernières années par les gouvernements, les autorités professionnelles et les médias québécois. Résultats et discussion : L’analyse révèle que l’évolution du discours de ces organisations s’inscrit dans trois continuums : le pathologique (une évolution, une gradation, une inflation étymologique du sens qui est donné au poids problématique); la surveillance (avec l’établissement de critères rationnels, la surveillance d’abord individuelle est devenue collective et s’est institutionnalisée); la responsabilisation (la responsabilité du poids s’est déplacée de l’individu vers le collectif puis vers le social). Ces continuums illustrent un déplacement de la manière de conceptualiser le poids de la sphère privée vers la sphère publique. Cette analyse révèle aussi qu’il y a à l’œuvre un exercice disciplinaire propre à une moralisation qui s’appuie sur la prémisse que l’augmentation de la prévalence touche toute la population de manière égale. Or, il n’en est rien.The increase in overweight and obesity prevalence observed in Quebec as elsewhere worries governments and medical authorities. In order to contain what is described as an “obesity pandemic”, Quebec public health organisations have proposed a number of recommendations depsite the fact that long-term safety of clinical interventions have proven inefficient, and prevention strategies to manage weight undetermined. Objective: To examine the evolution of public discourses about weight management by Quebec’s public health organisations in order to identify if there is a moral standard being constructed and discuss what this reveals about modern societies. Method: Through content analysis of over 160 official documents produced by government, public health organisations and the media over the last 60 years, this thesis will describe and analyze weight management discourses of Quebec’s official health organisations. Results and Discussion: The evolution of public weight management discourses by official public health organisations can best be described using three distinct continuums which all illustrate a shift from the private domain to the public one in the way weight problems are conceptualised. These continuums are: the pathological, or the etymological evolution of meaning given to the problematic weight; surveillance, in that rational criteria has been established and surveillance is no longer in the realm of the personal but rather has become a problem of the collective and in so doing, has become institutionalised; and finally, responsibility, where weight management has migrated from the individual through to the collective and then firmly into the social domain. This analysis illustrates that the disciplinary exercise of weight management, which functions as a moralizing process, considers the increase in overweight and obesity prevalence is across the population. However, such is not the case

Apprendre à déceler le potentiel de développement des situations de travail : l’exemple de conseillers agricoles face aux enjeux de l’agro‑écologie

Les professionnels qui agissent avec et pour autrui, dont les activités et situations évoluent et ne sont pas stabilisées, ont pour enjeu de reconstruire avec leurs bénéficiaires le sens à donner à leurs activités et aux situations de travail conjointes. C’est le cas des conseillers agricoles mis en situation d’accompagner des agriculteurs dans une évolution de leurs pratiques pour répondre à des problématiques environnementales. Un dispositif d’échange entre pairs a été mis en place auprès de ces professionnels, réunis pour penser collectivement ce qui rend leur action efficace aujourd’hui et pour tenter d’autres pratiques, pour oser faire autrement demain. Nous avons réalisé une observation participante au sein de ce dispositif. Nous étudions plus particulièrement la façon dont, collectivement et individuellement, les participants se saisissent de deux « mises en milieu » conçues par les animatrices du dispositif autour d’une situation emblématique du conseil en production végétale : le tour de plaine. Nos descriptions et analyses montrent la façon différenciée dont les conseillers s’approprient le potentiel de développement des situations ainsi créées pour changer leur activité en situation réelle de conseil. Nous discutons du développement professionnel que cela traduit et pointons des pistes d’améliorations possibles de l’animation pour mieux intégrer la diversité des participants et de leur environnement de travail.For professionals who work with and for others and whose activities and situations evolve and are not yet stabilized, one of the challenges is that of reconstructing, with their beneficiaries, the purpose of their activities and of reconfiguring their work situations. This is the case for agricultural advisors who are in the position of accompanying farmers in a change of practices in order to cope with environmental problems. A system was designed to support exchanges between advisors so that they can collectively rethink the efficacy of their action, and dare to act differently. We conducted a participatory observation within this system. We studied the way in which, individually and collectively, the participants grasp the two “milieus” designed by the facilitators in relation to an emblematic advisory situation for crop production: the field tour. Our illustrations and analyses show the different ways that the advisors grasp the developmental potential of these designed situations in order to change their own activity in real work situations. We discuss the professional development that this creates. Finally, we highlight possible avenues for improving the facilitation work to better cope with the diversity of the participants and of their workplace

Occurrence of the cephalopod Martialia hyadesi (Teuthoidea: Ommastrephidae) at the Kerguelen Islands in the Indian Ocean sector of the Southern Ocean

In the Atlantic sector of the Southern Ocean, data from vertebrate predators and commercial fisheries suggests that the distribution of the ommast rephid squid Martialia hyadesi is related to the Antarctic Polar Frontal Zone, but it spreads further to the north in some years (Rodhouse, in press). A mass stranding of M. hyadesi occurred on Macquarie Island in 1971 (O'Sullivan et al. 1983) suggesting that its distribution is c ircumpolar (Rodhouse and Yeatman 1990). However, apart from a single beak collected from the s tomach of a wandering albatross at Mar ion Island (Imber and Berruti 1981) its presence has not, until now, been confirmed in the Indian Ocean sector and in particular it is not included in the list of cephalopods from the Kerguelenian Province (Lu and Mangold 1978). M. hyadesi is a major prey item of the grey-headed albatross, Diomedea chrysostoma, and the southern elephant seal, Mirounoa leonina, at South Georgia (Rodhouse et al. 1990; Rodhouse et al., unpublished data) and is present in the diet o f several other predators in the Scotia Sea area including the wandering albatross, Diomedea exulans (Rodhouse et al. 1987) and the giant petrels, Macronectes halli and M. gioanteus (Hunter 1983). It occasionally occurs as a significant by-catch in the lllex argentinus fishery on the Pa tagonian Shelf and has been taken during commercial squid jigging trials in the Scotia Sea at the Antarctic Polar Frontal Zone (Rodhouse, in press). It appears to have potential for commercial exploitation in the sub-Antarctic waters of the Atlantic sector of the Southern Ocean (Rodhouse 1990). In view of the ecological importance of M. hyadesi to Antarctic predators, and the likelihood that it will be commercially exploited in the future, it is important to thoroughly establish its geographical range, and in particular to confirm its circumpolar distribution

Regulation of the mTOR signaling pathway: from laboratory bench to bedside and back again

Recent publications have moved us significantly closer to a complete understanding of the mammalian target of rapamycin (mTOR) signaling pathway, which plays a central role in the control of growth and metabolism and is dysregulated in a broad spectrum of human diseases, including cancer, tuberous sclerosis, diabetes, and cardiovascular and neurodegenerative diseases. Rapamycin-related mTOR inhibitors have shown clinical efficacy in several of these diseases, and novel inhibitors currently in development will be valuable tools for further dissections of the mTOR signaling network in human health and disease

Immune Reconstitution following Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation: The Impact of Expanding CD28negative CD8+ T Cells on Relapse

AbstractAllogeneic stem cell transplantation has become standard therapy for hematologic malignancies through the positive immunologic graft-versus-leukemia effect. Initial immune recovery relies on peripheral expansion of infused T cells, which switch to a memory-like phenotype. This study prospectively investigated whether changes in subset composition precedes complications after myeloablative HLA-matched transplantation for hematologic malignancies. Of 80 allograft recipients, 18 were still free of clinical complication throughout 395 to 1564 days of follow-up. Compared with this complication-free subgroup, patients who developed chronic graft-versus-host disease (cGVHD) without relapsing recovered similar numbers of circulating T cells with predominance of CD8+ T cells lacking CC-chemokine receptor-7 and CD28 expression throughout the first year after transplantation. Conversely, poor CD8+ T cell recovery with diminished numbers of CD28neg CD8+ T cells (∼1/4th of that of relapse-free patients) preceded occurrence of malignant relapse. In multivariate analysis, lower CD28neg CD8+ T cell counts by day 60 postallograft were associated with a greater risk of subsequent relapse (hazard ratio [HR] 0.33; 95% confidence interval [CI]: 0.14-0.76; P = .01). Enumeration of CD28neg CD8+ T cells in patients could assist in predicting risk of relapse and help build an algorithm for accelerating the immune recovery by reducing the immunosuppressive treatment and considering the introduction of preemptive donor lymphocyte infusions

Commercial fishing patterns influence odontocete whale-longline interactions in the Southern Ocean

The emergence of longline fishing around the world has been concomitant with an increase in depredation-interactions by odontocete whales (removal of fish caught on hooks), resulting in substantial socio-economic and ecological impacts. The extent, trends and underlying mechanisms driving these interactions remain poorly known. Using long-term (2003–2017) datasets from seven major Patagonian toothfish (Dissostichus eleginoides) longline fisheries, this study assessed the levels and inter-annual trends of sperm whale (Physeter macrocephalus) and/or killer whale (Orcinus orca) interactions as proportions of fishing time (days) and fishing area (spatial cells). The role of fishing patterns in explaining between-fisheries variations of probabilities of odontocete interactions was investigated. While interaction levels remained globally stable since the early 2000s, they varied greatly between fisheries from 0 to >50% of the fishing days and area. Interaction probabilities were influenced by the seasonal concentration of fishing effort, size of fishing areas, density of vessels, their mobility and the depth at which they operated. The results suggest that between-fisheries variations of interaction probabilities are largely explained by the extent to which vessels provide whales with opportunities for interactions. Determining the natural distribution of whales will, therefore, allow fishers to implement better strategies of spatio-temporal avoidance of depredation

Heavy Ion Microbeam and Broadbeam Transients in SiGe HBTs

SiGe HBT heavy ion current transients are measured using microbeam and both high- and low-energy broadbeam sources. These new data provide detailed insight into the effects of ion range, LET, and strike location

Benchmark Workshop on selected stocks in the Western Waters in 2021 (WKWEST).

The goal of a benchmark is consensus agreement on an assessment methodology that is to be used in future update assessments. This assessment methodology can be an analytical assessment, but can also be non-analytical, for instance based on trends in an assessment or in a selected set of (survey) indicators, with or without forecasts. The result will be the 'best available' method that ICES advice will be based on. WKWEST 2021 dealt with the following stocks: Sardine (Sardina pilchardus) in Subarea 7 (southern Celtic Seas, and the English Channel); Pollack (Pollachius pollachius) in subareas 6-7 (Celtic Seas and the English Channel); Red gurnard (Chelidonichthys cuculus) in subareas 3–8 (Northeast Atlantic); Plaice (Pleuronectes platessa) in divisions 7.h–k (Celtic Sea South, southwest of Ireland); Sole (Solea solea) in divisions 8.c and 9.a (Cantabrian Sea and Atlantic Iberian waters)

Therapeutic alliance in telephone-administered cognitive–behavioral therapy for hematopoietic stem cell transplant survivors.

A strong therapeutic alliance has been found to predict psychotherapeutic treatment success across a variety of therapeutic modalities and patient populations. However, only a few studies have examined therapeutic alliance as a predictor of psychotherapy outcome among cancer survivors, and none have examined this relation in telephone administered cognitive behavioral therapy (T-CBT). This study evaluated the extent to which therapeutic alliance affected psychotherapy outcomes in survivors of hematopoietic stem cell transplantation (HSCT), a treatment for some cancers