Accounting for residential and non-residential environments to measure contextual effects on health behavior : the case of recreational walking behavior

Thèse réalisée en cotutelle entre l'Université de Montréal et l'Université Pierre et Marie Curie, Paris 06, Sorbonne Universités.

A Framework to Support the Sharing and Reuse of Computable Phenotype Definitions Across Health Care Delivery and Clinical Research Applications.

INTRODUCTION: The ability to reproducibly identify clinically equivalent patient populations is critical to the vision of learning health care systems that implement and evaluate evidence-based treatments. The use of common or semantically equivalent phenotype definitions across research and health care use cases will support this aim. Currently, there is no single consolidated repository for computable phenotype definitions, making it difficult to find all definitions that already exist, and also hindering the sharing of definitions between user groups. METHOD: Drawing from our experience in an academic medical center that supports a number of multisite research projects and quality improvement studies, we articulate a framework that will support the sharing of phenotype definitions across research and health care use cases, and highlight gaps and areas that need attention and collaborative solutions. FRAMEWORK: An infrastructure for re-using computable phenotype definitions and sharing experience across health care delivery and clinical research applications includes: access to a collection of existing phenotype definitions, information to evaluate their appropriateness for particular applications, a knowledge base of implementation guidance, supporting tools that are user-friendly and intuitive, and a willingness to use them. NEXT STEPS: We encourage prospective researchers and health administrators to re-use existing EHR-based condition definitions where appropriate and share their results with others to support a national culture of learning health care. There are a number of federally funded resources to support these activities, and research sponsors should encourage their use.

Institutional entrepreneurship and techniques of inclusiveness in the creation of the Intergovernmental Platform on Biodiversity and Ecosystem Services

This article contributes to understanding the conditions of social-ecological change by focusing on the agency of individuals in the pathways to institutionalization. Drawing on the case of the Intergovernmental Platform on Biodiversity and Ecosystem Services (IPBES), it addresses institutional entrepreneurship in an emerging environmental science-policy institution (ESPI) at a global scale. Drawing on ethnographic observations, semistructured interviews, and document analysis, we propose a detailed chronology of the genesis of the IPBES before focusing on the final phase of the negotiations toward the creation of the institution. We analyze the techniques and skills deployed by the chairman during the conference to handle the tensions at play both to prevent participants from deserting the negotiations arena and to prevent a lack of inclusiveness from discrediting the future institution. We stress that creating a new global environmental institution requires the situated exercise of an art of “having everybody on board” through techniques of inclusiveness that we characterize. Our results emphazise the major challenge of handling the fragmentation and plasticity of the groups of interest involved in the institutionalization process, thus adding to the theory of transformative agency of institutional entrepreneurs. Although inclusiveness might remain partly unattainable, such techniques of inclusiveness appear to be a major condition of the legitimacy and success of the institutionalization of a new global ESPI. Our results also add to the literature on boundary making within ESPIs by emphasizing the multiplicity and plasticity of the groups actually at stake.

Is land condition a useful indicator of soil organic carbon stock in Australia?

The grazing lands of northern Australia contain a substantial soil organic carbon (SOC) stock due to the large land area. Manipulating SOC stocks through grazing management has been presented as an option to offset national greenhouse gas emissions from agriculture and other industries. However, research into the response of SOC stocks to a range of management activities has variously shown positive, negative or negligible change. This uncertainty in predicting change in SOC stocks represents high project risk for government and industry in relation to SOC sequestration programs. In this paper, we seek to address the uncertainty in SOC stock prediction by assessing relationships between SOC stocks and grazing land condition indicators. We reviewed the literature to identify land condition indicators for analysis and tested relationships between identified land condition indicators and SOC stock using data from a paired-site sampling experiment (10 sites). We subsequently collated SOC stock datasets at two scales (quadrat and paddock) from across northern Australia (329 sites) to compare with the findings of the paired-site sampling experiment with the aim of identifying the land condition indicators that had the strongest relationship with SOC stock. The land condition indicators most closely correlated with SOC stocks across datasets and analysis scales were tree basal area, tree canopy cover, ground cover, pasture biomass and the density of perennial grass tussocks. In combination with soil type, these indicators accounted for up to 42% of the variation in the residuals after climate effects were removed. However, we found that responses often interacted with soil type, adding complexity and increasing the uncertainty associated with predicting SOC stock change at any particular location. We recommend that caution be exercised when considering SOC offset projects in northern Australian grazing lands due to the risk of incorrectly predicting changes in SOC stocks with change in land condition indicators and management activities for a particular paddock or property. Despite the uncertainty for generating SOC sequestration income, undertaking management activities to improve land condition is likely to have desirable complementary benefits such as improving productivity and profitability as well as reducing adverse environmental impact.

Investigation of multisensory processing and structural brain differences in Autism Spectrum Disorder

This thesis is an investigation of structural brain abnormalities, as well as multisensory and unisensory processing deficits in autistic traits and Autism Spectrum Disorder (ASD). To achieve this, structural and functional magnetic resonance imaging (fMRI) and psychophysical techniques were employed. ASD is a neurodevelopmental condition which is characterised by the social communication and interaction deficits, as well as repetitive patterns of behaviour, interests and activities. These traits are thought to be present in a typical population. The Autism Spectrum Quotient questionnaire (AQ) was developed to assess the prevalence of autistic traits in the general population. Von dem Hagen et al. (2011) revealed a link between AQ with white matter (WM) and grey matter (GM) volume (using voxel-based-morphometry). However, their findings revealed no difference in GM in areas associated with social cognition. Cortical thickness (CT) measurements are known to be a more direct measure of cortical morphology than GM volume. Therefore, Chapter 2 investigated the relationship between AQ scores and CT in the same sample of participants. This study showed that AQ scores correlated with CT in the left temporo-occipital junction, left posterior cingulate, right precentral gyrus and bilateral precentral sulcus, in a typical population. These areas were previously associated with structural and functional differences in ASD. Thus the findings suggest, to some extent, autistic traits are reflected in brain structure - in the general population. The ability to integrate auditory and visual information is crucial to everyday life, and results are mixed regarding how ASD influences audiovisual integration. To investigate this question, Chapter 3 examined the Temporal Integration Window (TIW), which indicates how precisely sight and sound need to be temporally aligned so that a unitary audiovisual event can be perceived. 26 adult males with ASD and 26 age and IQ-matched typically developed males were presented with flash-beep (BF), point-light drummer, and face-voice (FV) displays with varying degrees of asynchrony and asked to make Synchrony Judgements (SJ) and Temporal Order Judgements (TOJ). Analysis of the data included fitting Gaussian functions as well as using an Independent Channels Model (ICM) to fit the data (Garcia-Perez & Alcala-Quintana, 2012). Gaussian curve fitting for SJs showed that the ASD group had a wider TIW, but for TOJ no group effect was found. The ICM supported these results and model parameters indicated that the wider TIW for SJs in the ASD group was not due to sensory processing at the unisensory level, but rather due to decreased temporal resolution at a decisional level of combining sensory information. Furthermore, when performing TOJ, the ICM revealed a smaller Point of Subjective Simultaneity (PSS; closer to physical synchrony) in the ASD group than in the TD group. Finding that audiovisual temporal processing is different in ASD encouraged us to investigate the neural correlates of multisensory as well as unisensory processing using functional magnetic resonance imaging fMRI. Therefore, Chapter 4 investigated audiovisual, auditory and visual processing in ASD of simple BF displays and complex, social FV displays. During a block design experiment, we measured the BOLD signal when 13 adults with ASD and 13 typically developed (TD) age-sex- and IQ- matched adults were presented with audiovisual, audio and visual information of BF and FV displays. Our analyses revealed that processing of audiovisual as well as unisensory auditory and visual stimulus conditions in both the BF and FV displays was associated with reduced activation in ASD. Audiovisual, auditory and visual conditions of FV stimuli revealed reduced activation in ASD in regions of the frontal cortex, while BF stimuli revealed reduced activation the lingual gyri. The inferior parietal gyrus revealed an interaction between stimulus sensory condition of BF stimuli and group. Conjunction analyses revealed smaller regions of the superior temporal cortex (STC) in ASD to be audiovisual sensitive. Against our predictions, the STC did not reveal any activation differences, per se, between the two groups. However, a superior frontal area was shown to be sensitive to audiovisual face-voice stimuli in the TD group, but not in the ASD group. Overall this study indicated differences in brain activity for audiovisual, auditory and visual processing of social and non-social stimuli in individuals with ASD compared to TD individuals. These results contrast previous behavioural findings, suggesting different audiovisual integration, yet intact auditory and visual processing in ASD. Our behavioural findings revealed audiovisual temporal processing deficits in ASD during SJ tasks, therefore we investigated the neural correlates of SJ in ASD and TD controls. Similar to Chapter 4, we used fMRI in Chapter 5 to investigate audiovisual temporal processing in ASD in the same participants as recruited in Chapter 4. BOLD signals were measured while the ASD and TD participants were asked to make SJ on audiovisual displays of different levels of asynchrony: the participants’ PSS, audio leading visual information (audio first), visual leading audio information (visual first). Whereas no effect of group was found with BF displays, increased putamen activation was observed in ASD participants compared to TD participants when making SJs on FV displays. Investigating SJ on audiovisual displays in the bilateral superior temporal gyrus (STG), an area involved in audiovisual integration (see Chapter 4), we found no group differences or interaction between group and levels of audiovisual asynchrony. The investigation of different levels of asynchrony revealed a complex pattern of results indicating a network of areas more involved in processing PSS than audio first and visual first, as well as areas responding differently to audio first compared to video first. These activation differences between audio first and video first in different brain areas are constant with the view that audio leading and visual leading stimuli are processed differently.

From Hill to Harbor: Serving Water and People on Baltimore's Civic Waterfront

People and cities alike derive their life from water. Water is consequently influenced by the actions of people and cities. This crucial relationship deserves to be commemorated, and also analyzed as further human development, sea level rise, and ecological remediation efforts influence its form. This thesis seeks to remember the past condition, recognize the current, and positively influence the future of this relationship in Baltimore’s Inner Harbor through a waterfront park and harbor history museum. How can a building and a site work together to improve the health of local hydrology while still effectively serving its human community? This thesis weaves these opportunities together to create a responsible redesign of Rash Field and Federal Hill on the south side of the Inner Harbor in Baltimore.

Biobanks: Experience of the School of Medicine and the “Dr. José Eleuterio González” University Hospital of the Universidad Autónoma de Nuevo León

Medical research has greatly beneited from molecular biology and increasingly relies on tools from the “omics” disciplines (mainly genomics, transcriptomics, proteomics and metabolomics). The availability of biological samples preserved with high quality standards is a sine qua non condition for such studies and their repositories are referred to as biobanks. Biobanks support the transportation, storage, preservation, and initial pathological and analytical examinations of biospecimens, as well as the protection of relevant information and the comparison of clinical and laboratory findings. A biobank facility is one of the most valuable tools the academic medicine organizations can offer to their researchers to improve the competitiveness of their current and future medical research. it acts as an essential bridge and an effective catalyst for research synergies between basic and clinical sciences, and it can be potentiated with efforts to raise funds for acquiring and maintaining cutting-edge analytical infrastructure to better serve its clinical, pharmaceutical and biotech clients.

Seasonal variations in chemical composition and stable isotopes of farmed and wild Brazilian freshwater fish

This study examined variations in the Fulton condition factor, chemical composition, and stable isotopes of carbon and nitrogen in the Brazilian freshwater fish cachara (Pseudoplatystoma fasciatum), comparing farmed and wild fish in different seasons. Values for energy, protein, moisture, and Fulton's condition factor were higher for farmed than for wild fish in the rainy season, indicating better nutritional quality; however, these differences were not observed in the dry season. Likewise, we found significant enhancement of delta(15)N in farmed fish in the rainy season but not in the dry season, whereas enhancement of delta(13)C was observed in both seasons. The combined measurement of delta(13)C and delta(15)N provided traceability under all conditions. Our findings show that stable isotope analysis of C and N can be used to trace cachara origin, and that seasonal variations need to be considered when applying chemical and isotopic authentication of fish and fish products. (C) 2010 Elsevier Ltd. All rights reserved.

Protocolos de investigação de variáveis psicológicas na epilepsia infantil

Epilepsy is a common chronic condition in the childhood and its diagnosis reveals psychological, social and family difficulties, that seem to be related with beliefs and quality of parents-children interaction. The purpose of this paper is to schematize investigation strategies for the psychological variables: beliefs, impact of the disease, family relationship, identification of changes. Based upon collected reports of epileptic children's parents and upon surveyed aspects of the literature, psychological questionnaires were elaborated to identify important variables that affect the child's epilepsy life and his family. The use of more appropriate investigation procedures facilitates the psychological evaluation and ensures the collection of data.

Coma mixedematoso em paciente com neurofibromatose tipo 1: associação rara

Myxedema coma, a rare but fatal emergency, is an extreme expression of hypothyroidism. We describe a 51-year-old male patient who has discontinued hypothyroidism treatment 10 months earlier and developed lethargy, edema, and cold intolerance symptoms. He also had a previous diagnosis of neurofibromatosis. After admission, he progressed to respiratory insufficiency and coma. The prompt recognition of the condition, thyroid hormone replacement, and management of the complications (hypoventilation, cardiogenic shock associated with swinging heart, adrenal and renal insufficiency and sepsis), resulted in a favorable evolution.

Mensuração da potência mecânica em esforços de alta intensidade na condição laboratorial de corrida atada e na condição de campo em corrida semi-atada e livre

Universidade Estadual de Campinas . Faculdade de Educação Física

Efeitos da administração de monensina por meio de cápsulas de liberação controlada no desempenho de vacas Holandesas no início da lactação

Com o objetivo de estudar o efeito da monensina sobre a produção e composição de leite, a contagem de células somáticas, a condição corporal e os parâmetros sangüíneos e reprodutivos de vacas da raça Holandesa de alta produção no início de lactação, foram utilizadas 44 vacas com produção diária de 33,44 ± 4,93 litros de leite, em delineamento inteiramente casualizado, com dois tratamentos: um controle (C) e outro com cápsulas de liberação controlada de monensina com eficácia de 100 dias (300 mg/vaca/dia). A administração individual de monensina foi realizada 30 dias antes da data provável do parto. A monensina não alterou a produção, a composição do leite e a contagem de células somáticas do leite nem a condição corporal e a concentração de glicose e BHBA (beta-hidroxibutirato) no soro das vacas, no entanto, diminuiu a concentração de AGNE (ácidos graxos não-esterificados) no soro das vacas com 60 dias de lactação. O período de serviço e o número de serviços por concepção não diferiram entre os tratamentos, porém, a administração de monensina diminuiu o número de animais que apresentaram retenção de placenta e laminite. A administração de monensina para vacas Holandesas de alta produção no início de lactação não modifica a produção e a composição do leite, contudo, diminui a concentração de AGNE 60 dias após o parto e a incidência de laminite e retenção de placenta nas vacas no pós-parto.

Morfoanatomia da flor de cinco espécies de Galipea Aubl. e seu significado na evolução de flores tubulosas entre as Rutaceae neotropicais

A maioria dos gêneros da subtribo neotropical Galipeinae (tribo Galipeeae, Rutoideae) tem flores tubulosas, com várias formas e graus de conação e adnação. Galipea e outros gêneros na subtribo apresentam apenas duas anteras férteis mais cinco ou mais estaminódios, o que é intrigante porque na tribo predominam flores pentâmeras isostêmones. Visando elucidar a condição anatômica dessas características e estabelecer estados acurados para caracteres em análises filogenéticas, um estudo morfoanatômico de flores de cinco espécies de Galipea foi realizado, buscando os padrões de vascularização, posição, e união dos segmentos da flor. Destacam-se os resultados: 1) um tubo floral genuíno se forma no terço basal da flor por conação dos filetes e adnação desse tubo estaminal às pétalas; 2) as pétalas são distalmente coerentes umas às outras e aderentes aos filetes por meio de entrelaçamento de tricomas densos - um caso de pseudossimpetalia; 3) dentre as cinco (às vezes seis) estruturas tratadas como estaminódios, apenas as três externas são de fato homólogas a estames esterilizados, as demais surgem como ramificações adaxiais das pétalas; 4) os carpelos são peltados, congenitalmente conatos axial e lateralmente da base do ovário até o nível das placentas, e no estilete e estigma; na zona mediana e superior do ovário eles são unidos apenas posgenitalmente, com a epiderme diferenciada de carpelos contíguos e suturas evidentes na região ventral de cada carpelo; 5) a vascularização do disco sugere origem receptacular. As implicações desses dados para o entendimento da evolução das flores tubulosas em Galipea e grupos relacionados são discutidas.

Desigualdades no uso e acesso aos serviços de saúde entre idosos do município de São Paulo

OBJETIVO: Analisar os fatores relacionados à determinação e às desigualdades no acesso e uso dos serviços de saúde por idosos. MÉTODOS: Estudo integrante do Projeto Saúde, Bem-estar e Envelhecimento (SABE), no qual foram entrevistados 2.143 indivíduos com 60 anos ou mais no município de São Paulo, SP, em 2000. A amostra foi obtida em dois estágios, utilizando-se setores censitários com reposição, probabilidade proporcional à população e complementação da amostra de pessoas de 75 anos. Foi mensurado o uso de serviços hospitalares e ambulatoriais nos quatro meses anteriores à entrevista, relacionando-os com fatores de capacidade, necessidade e predisposição (renda total, escolaridade, seguro saúde, morbidade referida, auto-percepção, sexo e idade). O método estatístico utilizado foi regressão logística multivariada. RESULTADOS: Dos entrevistados, 4,7% referiram ter utilizado a internação hospitalar e 64,4% o atendimento ambulatorial. Dos atendimentos ambulatoriais em serviço público, 24,7% ocorreram em hospital e 24,1% em serviço ambulatorial; dentre os que ocorreram em serviços privados, 14,5% foram em hospital e 33,7% em clínicas. Pela análise multivariada, observou-se associação entre a utilização de serviços e sexo, presença de doenças, auto-percepção de saúde, interação da renda e escolaridade e posse de seguro saúde. A análise isolada com escolaridade apresentou efeito inverso. CONCLUSÕES: Foram observadas desigualdades no uso e acesso aos serviços de saúde e inadequação do modelo de atenção, indicando necessidade de políticas públicas que levem em conta as especificidades dessa população, facilitem o acesso e possam reduzir essas desigualdades.

Avaliação tecnológica de painéis MDF de madeira de Eucalyptus grandis confeccionados em laboratório e em linha de produção industrial

MDF panels of Eucalyptus grandis wood fibers were made in either experimentally in a laboratory or on an industrial production line. In order to analyze the influence of the production condition, the anatomical, physical and mechanical properties of the panels were determined. The wood refining induced the transversal rupture of the transversal fiber wall. The MDF panels obtained from the industrial production line presented less swelling in thickness and absorption values and improved mechanical properties in the requirements of bending strength, module of elasticity and surface resistance. For laboratory MDF panels, it was possible to verify a statistically significant correlation between bending strength and module of elasticity, medium density and internal bond and swelling in thickness and absorption. This tendency was also true for the MDF panels obtained in real conditions of production, however without statistical significance. By comparing the quality properties of MDF panels produced in the laboratory with those obtained in real conditions of production, it was sought to standardize the established variables for obtaining panels on a small scale, as well to make possible the safe transfer and divulgation of information obtained in the laboratory.