Estimating the size of the population of persons who inject drugs in the island of Montréal, Canada, using a six-source capture-recapture model

BACKGROUND: To plan and implement services to persons who inject drugs (PWID), knowing their number is essential. For the island of Montréal, Canada, the only estimate, of 11,700 PWID, was obtained in 1996 through a capture-recapture method. Thirteen years later, this study was undertaken to produce a new estimate. METHODS: PWID were defined as individuals aged 14-65 years, having injected recently and living on the island of Montréal. The study period was 07/01/2009 to 06/30/2010. An estimate was produced using a six-source capture-recapture log-linear regression method. The data sources were two epidemiological studies and four drug dependence treatment centres. Model selection was conducted in two steps, the first focusing on interactions between sources and the second, on age group and gender as covariates and as modulators of interactions. RESULTS: A total of 1480 PWID were identified in the six capture sources. They corresponded to 1132 different individuals. Based on the best-fitting model, which included age group and sex as covariates and six two-source interactions (some modulated by age), the estimated population was 3910 PWID (95% confidence intervals (CI): 3180-4900) which represents a prevalence of 2.8 (95% CI: 2.3-3.5) PWID per 1000 persons aged 14-65 years. CONCLUSIONS: The 2009-2010 estimate represents a two-third reduction compared to the one for 1996. The multisource capture-recapture method is useful to produce estimates of the size of the PWID population. It is of particular interest when conducted at regular intervals thus allowing for close monitoring of the injection phenomenon.

Remolding a company through a compliance program : the case of Siemens

Abstract : Since at least the 1980's, a growing number of companies have set up an ethics or a compliance program within their organization. However, in the field of study of business management, there is a paucity of research studies concerning these management systems. This observation warranted the present investigation of one company's compliance program. Compliance programs are set up so that individuals working within an organization observe the laws and regulations which pertain to their work. This study used a constructivist grounded theory methodology to examine the process by which a specific compliance program, that of Siemens Canada Limited, was implemented throughout its organization. In conformity with this methodology, instead of proceeding with the investigation in accordance to a particular theoretical framework, the study established a number of theoretical constructs used strictly as reference points. The study's research question was stated as: what are the characteristics of the process by which Siemens' compliance program integrated itself into the existing organizational structure and gained employee acceptance? Data consisted of documents produced by the company and of interviews done with twenty-four managers working for Siemens Canada Limited. The researcher used QSR-Nvivo computer assisted software to code transcripts and to help with analyzing interviews and documents. Triangulation was done by using a number of analysis techniques and by constantly comparing findings with extant theory. A descriptive model of the implementation process grounded in the experience of participants and in the contents of the documents emerged from the data. The process was called "Remolding"; remolding being the core category having emerged. This main process consisted of two sub-processes identified as "embedding" and "appraising." The investigation was able to provide a detailed account of the appraising process. It identified that employees appraised the compliance program according to three facets: the impact of the program on the employee's daily activities, the relationship employees have with the local compliance organization, and the relationship employees have with the corporate ethics identity. The study suggests that a company who is entertaining the idea of implementing a compliance program should consider all three facets. In particular, it suggests that any company interested in designing and implementing a compliance program should pay particular attention to its corporate ethics identity. This is because employee's acceptance of the program is influenced by their comparison of the company's ethics identity to their local ethics identity. Implications of the study suggest that personnel responsible for the development and organizational support of a compliance program should understand the appraisal process by which employees build their relationship with the program. The originality of this study is that it points emphatically that companies must pay special attention in developing a corporate ethics identify which is coherent, well documented and well explained.

Les facteurs affectant les taux de réussite des cours d’anglais et de sciences humaines des étudiants dans les programmes de formation technique

A large percentage of Vanier College's technology students do not attain their College degrees within the scheduled three years of their program. A closer investigation of the problem revealed that in many of these cases these students had completed all of their program professional courses but they had not completed all of the required English and/or Humanities courses. Fortunately, most of these students do extend their stay at the college for the one or more semesters required for graduation, although some choose to go on into the workforce without returning to complete the missing English and/or Humanities and without their College Degrees. The purpose of this research was to discover if there was any significant measure of association between a student's family linguistic background, family cultural background, high school average, and/or College English Placement Test results and his or her likelihood of succeeding in his or her English and/or Humanities courses within the scheduled three years of the program. Because of both demographic differences between 'hard' and 'soft' technologies, including student population, more specifically gender ratios and student average ages in specific programs; and program differences, including program writing requirements and types of practical skill activities required; in order to have a more uniform sample, the research was limited to the hard technologies where students work hands-on with hardware and/or computers and tend to have overall low research and writing requirements. Based on a review of current literature and observations made in one of the hard technology programs at Vanier College, eight research questions were developed. These questions were designed to examine different aspects of success in the English and Humanities courses such as failure and completion rates and the number of courses remaining after the end of the fifth semester and as well examine how the students assessed their ability to communicate in English. The eight research questions were broken down into a total of 54 hypotheses. The high number of hypotheses was required to address a total of seven independent variables: primary home language, high school language of instruction, student's place of birth (Canada, Not-Canada), student's parents' place of birth (Both-born-in-Canada, Not-both-born-in-Canada), high school averages and English placement level (as a result of the College English Entry Test); and eleven dependent variables: number of English completed, number of English failed, whether all English were completed by the end of the 5th semester (yes, no), number of Humanities courses completed, number of Humanities courses failed, whether all the Humanities courses were completed by the end of the 5th semester (yes, no), the total number of English and Humanities courses left, and the students' assessments of their ability to speak, read and write in English. The data required to address the hypotheses were collected from two sources, from the students themselves and from the College. Fifth and sixth semester students from Building Engineering Systems, Computer and Digital Systems, Computer Science and Industrial Electronics Technology Programs were surveyed to collect personal information including family cultural and linguistic history and current language usages, high school language of instruction, perceived fluency in speaking, reading and writing in English and perceived difficulty in completing English and Humanities courses. The College was able to provide current academic information on each of the students, including copies of college program planners and transcripts, and high school transcripts for students who attended a high school in Quebec. Quantitative analyses were done on the data using the SPSS statistical analysis program. Of the fifty-four hypotheses analysed, in fourteen cases the results supported the research hypotheses, in the forty other cases the null hypotheses had to be accepted. One of the findings was that there was a strong significant association between a student's primary home language and place of birth and his or her perception of his or her ability to communicate in English (speak, read, and write) signifying that both students whose primary home language was not English and students who were not born in Canada, considered themselves, on average, to be weaker in these skills than did students whose primary home language was English. Although this finding was noteworthy, the two most significant findings were the association found between a student's English entry placement level and the number of English courses failed and the association between the parents' place of birth and the student's likelihood of succeeding in both his or her English and Humanities courses. According to the research results, the mean number of English courses failed, on average, by students placed in the lowest entry level of College English was significantly different from the number of English courses failed by students placed in any of the other entry level English courses. In this sample students who were placed in the lowest entry level of College English failed, on average, at least three times as many English courses as those placed in any of the other English entry level courses. These results are significant enough that they will be brought to the attention of the appropriate College administration. The results of this research also appeared to indicate that the most significant determining factor in a student's likelihood of completing his or her English and Humanities courses is his or her parents' place of birth (both-born-in-Canada or not-both-born-in-Canada). Students who had at least one parent who was not born in Canada, would, on average, fail a significantly higher number of English courses, be significantly more likely to still have at least one English course left to complete by the end of the 5th semester, fail a significantly higher number of Humanities courses, be significantly more likely to still have at least one Humanities course to complete by the end of the 5th semester and have significantly more combined English and Humanities courses to complete at the end of their 5th semester than students with both parents born in Canada. This strong association between students' parents' place of birth and their likelihood of succeeding in their English and Humanities courses within the three years of their program appears to indicate that acculturation may be a more significant factor than either language or high school averages, for which no significant association was found for any of the English and Humanities related dependent variables. Although the sample size for this research was only 60 students and more research needs to be conducted in this area, to see if these results are supported with other groups within the College, these results are still significant. If the College can identify, at admission, the students who will be more likely to have difficulty in completing their English and Humanities courses, the College will now have the opportunity to intercede during or before the first semester, and offer these students the support they require in order to increase their chances of success in their education, whether it be classes or courses designed to meet their specific needs, special mentoring, tutoring or other forms of support. With the necessary support, the identified students will have a greater opportunity of successfully completing their programs within the scheduled three years, while at the same time the College will have improved its capacity to meeting the needs of its students.

L’infirmière en GMF : vers une meilleure connaissance des activités réalisées auprès des personnes atteintes de maladies chroniques

Résumé : Contexte : Depuis la création des Groupes de médecine de famille (GMF), les infirmières peuvent assurer le suivi des personnes atteintes de maladies chroniques (MC). Il existe des écarts entre la littérature et la pratique. Un constat provincial permettra une compréhension des enjeux d’optimisation de la pratique infirmière auprès de cette clientèle grandissante. Objectifs : 1) décrire les activités de l’infirmière en GMF auprès des personnes atteintes de MC; 2) décrire les éléments contextuels déterminants de ces activités; 3) dresser un portrait provincial des activités des infirmières de GMF auprès des personnes atteintes de MC. Méthode : Un devis mixte séquentiel exploratoire en trois volets a été effectué. Volet 1 : Une étude de cas multiple a été réalisée auprès de dix infirmières de GMF. Cinq sources de données ont été utilisées : 1) observation des rencontres infirmière-patient (n=10); 2) entrevues individuelles avec chaque infirmière (n=10); 3) entrevues individuelles avec chaque patient (n=10); 4) audit des notes infirmières au dossier des patients participant (n=10) et; 5) documents administratifs décrivant la pratique des infirmières à l’intérieur des GMF. L’analyse qualitative a permis de générer une liste d’activités et de décrire les éléments contextuels qui déterminent les activités. Volet 2 : Un questionnaire électronique a été créé à l’aide de la liste d’activités produite lors du Volet 1 et de la recension des écrits. Il a été validé et prétesté. Volet 3 : Une enquête provinciale a été réalisée auprès de 322 infirmières de GMF. Des analyses descriptives telles que des fréquences, moyennes, étendues et écarts types ont été effectuées. Résultats : Volet 1 : les activités des infirmières de GMF auprès des personnes atteintes de MC sont regroupées en cinq domaines. Des éléments liés à l’organisation, aux infirmières et aux personnes atteintes de MC peuvent influencer les activités. Volet 3 : 266 infirmières ont complété le questionnaire. Les résultats démontrent que leurs activités se situent principalement dans les domaines de la Promotion de la santé et de l’Évaluation globale de la condition de la personne. Les activités en lien avec la Collaboration infirmière-médecin et l’Organisation de l’offre de services sont réalisées de façon occasionnelle. Conclusion : Cette étude a permis une description en profondeur des activités des infirmières de GMF auprès des personnes atteintes de MC. Il s’agissait d’un jalon important en vue d’optimiser les interventions liées à la prise en charge des MC en soins de première ligne.

Involvement of Beta-arrestin 1 and Beta-arrestin 2 in store operated calcium entry

Résumé : La variation de la [Ca2+] intracellulaire participe à nombreux de processus biologiques. Les cellules eucaryotes expriment à la membrane plasmique une variété de canaux par lesquelles le calcium peut entrer. Dans les cellules non excitables, deux mécanismes principaux permettent l'entrée calcique; l'entrée capacitative de Ca2+ via Orai1 (SOCE) et l'entrée calcique activé par un récepteur (ROCE). Plusieurs protéines clés sont impliquées dans la régulation de ces voies d'entrée calcique, ainsi que dans l'homéostasie calcique. TRPC6 est un canal calcique impliquée dans l'entrée calcique dans les cellules à la suite d’une stimulation d’un récepteur hormonal. TRPC6 transloque à la membrane cellulaire et il y demeure jusqu'à ce que le stimulus soit retiré. Les mécanismes qui régulent le trafic et l'activation de TRPC6 sont cependant encore peu connus. Des découvertes récentes ont démontré qu'il y a un rôle potentiel de Rho kinase dans l'activité de TRPC6. Rho kinase est activée par la petite protéine G RhoA qui peut être activée par les protéines G hétérotrimériques Gα12 et Gα13. En plus de Gα12 et Gα13, les protéines de désensibilisation des GPCR β -arrestin 1 et / ou β-arrestin 2 peuvent aussi activer RhoA. Le but de notre étude est d'examiner la participation des protéines Gα12/13 et β-arrestin 1/ β-arrestin 2 dans l'activation de TRPC6 et de la protéine Orai1. Nous avons utilisé des ARN interférant (siRNA) spécifiques pour induire une réduction de l'expression de Gα12/13 ou β-arrestin 1/β-arrestin 2. La conséquence sur l’entrée de Ca2+ dans les cellules a été ensuite déterminée par imagerie calcique en temps réel suite à une stimulation par la vasopressine (AVP), thapsigargin ou carbachol. Nous avons donc identifié que dans des cellules A7r5, une lignée cellulaire de musculaires lisses vasculaires où le canal TRPC6 exprimé de manière endogène, la diminution de l’expression des protéines Gα12 ou Gα13 ne semble pas modifier l’entrée Ca2+ induit par l’AVP par rapport aux cellules témoins. D'autre part, la diminution de l’expression β-arrestin 1 ou β-arrestin 2 dans des cellules HEK 293 ainsi que des cellules HEK 293 exprimant de façon stable TRPC6 (cellules T6.11) ont augmenté l’entrée de Ca2+ induite par thapsigargin, un activateur pharmacologique de SOCE. Des études de co-immunoprécipitation démontrent une interaction entre la β-arrestin 1 et STIM1, alors qu'aucune interaction n'a été observée entre les β-arrestin 1 et Orai1. Nous avons de plus montré à l'aide d'analyse en microscopie confocale que la diminution de l’expression β-arrestin 1 ou β-arrestin 2 n’influence pas la quantité d’Orai1 à la périphérie cellulaire. Cependant, des résultats préliminaires indiquent que la diminution de l’expression β-arrestin 1 ou β-arrestin 2 augmente la quantité de STIM1-YFP dans l'espace intracellulaire et diminue sa quantité à la périphérie cellulaire. En conclusion, nous avons montré que les β-arrestin 1 ou β-arrestin 2 sont impliquées dans l'entrée capacitative de Ca2+ (SOCE) et contrôlent la quantité de STIM1 dans le réticulum endoplasmique.