Schizophrénie, approche spécialisée et continuité de soins. Le programme spécifique d’intervention Premier-Épisode de l’Hôtel-Dieu de Lévis

La schizophrénie est une maladie complexe à caractère évolutif. Reposant sur un cadre conceptuel d'orientation cognitive, le programme spécifique d'intervention Premier épisode de l'Hôtel-Dieu de Lévis fournit une évaluation complète et standardisée au plan individuel et familial. Puis sont rendues disponibles différentes modalités de traitement, selon une approche individuelle (psycho-éducation, psychothérapie) et de groupe (intervention psychologique au plan cognitif ou Integrated Psychological Therapy, de Brenner). L'intervention psycho-éducative familiale est également offerte aux familles. Les structures et la démarche décrites s'harmonisent avec celles qui étaient en place avant la création du programme, ce qui offre une continuité de soins. Le cadre conceptuel sous-jacent et les modalités du fonctionnement du programme sont aussi présentés.Schizophrenia is a complex illness with an evolutive character. Based on a conceptual framework of cognitive orientation, the specific intervention program First Episode of Hôtel-Dieu in Lévis includes a complete and standardized assessment to an individualized and family plan. Different methods of treatment acording to an individualized approach (psyhco-education, psychotherapy) as well as group therapy (psychological intervention at the cognitive level or Brenner's Integrated psychological therapy) are then proposed. Psycho-education intervention for families is also offered. Structures and different steps described here, harmonize with those already in place before the program's creation thus offering a continuity in care. The underlying conceptual framework and the different methods of functioning of the program are also presented.La esquizofrenia es una enfermedad compleja da caracter evolu-tivo. El programa especifico de intervention Primer episodio de Hôtel-Dieu de Lévis que reposa en un marco conceptual de orientaciôn cognoscitiva, ofrece una evaluaciôn compléta y estandarizada a nivel individual y familiar. Ademâs se ofrecen diferentes modalidades de tratamiento, segûn un enfoque individual (psicoeducaciôn, psicoterapia) y de grupo (intervenciôn psicolôgica a nivel cognoscitivo o Integrated psychological therapy, de Brenner). Igualmente se le ofrece a las fami-lias, la Intervenciôn psioeducativa familiar. Las estructuras y los pasos a seguir que se describen se armonizan a las que ya existian antes de la creation del programa, Io que ofrece una continuidad de tratamiento. Son presentados, el marco conceptual subyacente y las modalidades del fucionamiento des programa

A collaborative model to implement flexible, accessible and efficient oncogenetic services for hereditary breast and ovarian cancer : the C-MOnGene study

Medical genetic services are facing an unprecedented demand for counseling and testing for hereditary breast and ovarian cancer (HBOC) in a context of limited resources. To help resolve this issue, a collaborative oncogenetic model was recently developed and implemented at the CHU de Québec-Université Laval; Quebec; Canada. Here, we present the protocol of the C-MOnGene (Collaborative Model in OncoGenetics) study, funded to examine the context in which the model was implemented and document the lessons that can be learned to optimize the delivery of oncogenetic services. Within three years of implementation, the model allowed researchers to double the annual number of patients seen in genetic counseling. The average number of days between genetic counseling and disclosure of test results significantly decreased. Group counseling sessions improved participants' understanding of breast cancer risk and increased knowledge of breast cancer and genetics and a large majority of them reported to be overwhelmingly satisfied with the process. These quality and performance indicators suggest this oncogenetic model offers a flexible, patient-centered and efficient genetic counseling and testing for HBOC. By identifying the critical facilitating factors and barriers, our study will provide an evidence base for organizations interested in transitioning to an oncogenetic model integrated into oncology care; including teams that are not specialized but are trained in genetics

Molecular cloning, cDNA structure and predicted amino acid sequence of bovine 3β-hydroxy-5-ene steroid dehydrogenase/Δ5-Δ4 isomerase

AbstractWe have used our recently characterized human 3β-hydroxy-5-ene steroid dehydrogenase/Δ5-Δ4-isomerase (3β-HSD) cDNA as probe to isolate cDNAs encoding bovine 3β-HSD from a bovine ovary λgtll cDNA library. Nucleotide sequence analysis of two overlapping cDNA clones of 1362 bp and 1536 bp in length predicts a protein of 372 amino acids with a calculated molecular mass of 42093 (excluding the first Met). The deduced amino acid sequence of bovine 3β-HSD displays 79% homology with human 3β-HSD while the nucleotide sequence of the coding region shares 82% interspecies similarity. Hybridization of cloned cDNAs to bovine ovary poly(A)+ RNA shows the presence of an approximately 1.7 kb mRNA species

Inclusion criteria

Sources tackling access of physical activities or sport of people with physical or sensory deficiency through the means of digital platforms. Peer-reviewed empirical studies regardless of their methodologies (qualitative, quantitative or mixed-methods), thesis, governmental reports, not-for profit community organization websites, websites presenting mobile app. Only Sources published in English or French will be included to be understood by the entire research team

Data Extraction

The whole research team collaboratively identified the variables to be extracted from included papers. An Excel chart and a reading card template was developed to gather these variables. Data were extracted from papers included in the scoping review by two or more independent reviewers.  The draft of the data extraction tool will be modified and revised as necessary during the process of extracting data from each included evidence source. Modifications will be detailed in the scoping review. Authors of papers will be contacted to request missing or additional data, where required. The results of the search and the study inclusion process are presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flow diagram (Liberati et al., 2009). Charted data was then analyzed descriptively and presented in tables to synthesize information

Search strategy for scientific and grey literature

The search strategy will aim to locate both published and unpublished sources from the scientific and grey literature as well as relevant websites and reports. For the scientific literature, an initial search of Medline (Ovid) was undertaken to identify articles on the topic. The text words contained in the titles and abstracts of relevant articles, and the index terms used to describe the articles were used to develop a full search strategy for four electronic databases and information sources. Databases to be searched include Medline (Ovid), Web Of Science, Cinhal and Embase. The search was conducted in August 2022 with the three following concepts: 1) Adults with physical and/or sensory disability, 2) Digital platform, and 3) Sport or physical activity. The search strategy collaboratively developed by the research team based on the PICO framework (Richardson et al., 1995), including all identified keywords and index terms, will be adapted by the librarian for each included database and/or information source. The reference list of all included sources of evidence will be screened for additional studies.  For the grey literature, a search will be performed in Advanced Search - Google search engine. Google search requires creating several search strategies containing multiple combinations of search terms. Thirty-two unique search strategies were applied to Advanced Search - Google. Each search was repeated using a VPN with IP addresses based in the following countries: Canada, USA, France, Belgium, UK, and Australia. A comprehensive Internet search is impossible; thus, relying on the power of relevancy ranking within Google search engine, only the first five pages of each search’s hits (i.e., 50 results) will be reviewed, using the title and short descriptive text underneath. This number of pages was chosen to capture many of the most relevant hits while providing a volume feasible for screening. Potentially relevant records will be added to a file in Zotero© shared by the research team and then each source will be entered into an Excel spreadsheet for screening purposes

Source of Evidence selection

The study selection process included four steps (Levac et al., 2010): 1) identifying the relevant studies from the literature, 2) screening the studies by applying the selection criteria to the titles and abstracts, 3) defining the eligibility of the studies by applying criteria to the full papers, and 4) the inclusion of the studies by re-applying criteria to the full papers during data extraction. For the first step (identification), following the search, all identified citations will be collated and uploaded into Covidence version (Veritas Health Innovation, 2022) and duplicates removed. For the second, third and fourth steps (screening, eligibility and inclusion), two reviewers among CHF, NL, DL, EVB and CC independently completed the assessment against the inclusion criteria and documented the reasons for exclusion to report them in the scoping review. Any disagreements that arise between the reviewers at each stage of the selection process will be resolved through discussion, or with an additional, more experienced reviewer. Percentage of agreement was calculated for each of these steps (the target was a minimum of 70 %)

Methods

The proposed scoping review will be conducted in accordance with the JBI (Peters et al., 2020) and Levac et al. (2010) methodology for scoping reviews

Aim

Identify factors to consider in a development of the digital platform that aim to facilitate PWDs’ access to physical activities and sport