Physical activity, sedentary behaviour and fetal macrosomia in uncomplicated pregnancies: A prospective cohort study

Objective: to explore maternal energy balance, incorporating free living physical activity and sedentary behaviour, in uncomplicated pregnancies at risk of macrosomia.

Methods: a parallel-group cross-sectional analysis was conducted in healthy pregnant women predicted to deliver infants weighing Z4000 g (study group) or o4000 g (control group). Women were recruited in a 1:1 ratio from antenatal clinics in Northern Ireland. Women wore a SenseWears Body Media Pro3 physical activity armband and completed a food diary for four consecutive days in the third trimester. Physical activity was measured in Metabolic Equivalent of Tasks (METs) where 1 MET¼1 kcal per kilogram of body weight per hour. Analysis of covariance (ANCOVA) was employed using the General Linear Model to adjust for potential confounders.

Findings: of the 112 women recruited, 100 complete datasets were available for analysis. There was no significant difference in energy balance between the two groups. Intensity of free living physical activity (average METs) of women predicted to deliver macrosomic infants (n¼50) was significantly lower than that of women in the control group (n¼50) (1.3 (0.2) METs (mean, standard deviation) versus 1.2 (0.2) METs; difference in means 0.1 METs (95% confidence interval: 0.19, 0.01); p¼0.021). Women predicted to deliver macrosomic infants also spent significantly more time in sedentary behaviour (r1 MET) than the control group (16.1 (2.8) hours versus 13.8 (4.3) hours; 2.0 hours (0.3, 3.7), p¼0.020).

Key conclusions and implications for practice: although there was no association between predicted fetal macrosomia and energy balance, those women predicted to deliver a macrosomic infant exhibited increased sedentary behaviour and reduced physical activity in the third trimester of pregnancy. Professionals caring for women during pregnancy have an important role in promoting and supporting more active lifestyles amongst women who are predicted to deliver a macrosomic infant given the known associated risks.

Dietary patterns and cardiovascular risk factors in adolescents and young adults: the Northern Ireland Young Hearts Project

Dietary pattern (DP) analysis allows examination of the combined effects of nutrients and foods on the markers of CVD. Very few studies have examined these relationships during adolescence or young adulthood. Traditional CVD risk biomarkers were analysed in 12-15-year-olds (n 487; Young Hearts (YH)1) and again in the same individuals at 20-25 years of age (n 487; YH3). Based on 7 d diet histories, in the present study, DP analysis was performed using a posteriori principal component analysis for the YH3 cohort and the a priori Mediterranean Diet Score (MDS) was calculated for both YH1 and YH3 cohorts. In the a posteriori DP analysis, YH3 participants adhering most closely to the 'healthy' DP were found to have lower pulse wave velocity (PWV) and homocysteine concentrations, the 'sweet tooth' DP were found to have increased LDL concentrations, systolic blood pressure, and diastolic blood pressure and decreased HDL concentrations, the 'drinker/social' DP were found to have lower LDL and homocysteine concentrations, but exhibited a trend towards a higher TAG concentration, and finally the 'Western' DP were found to have elevated homocysteine and HDL concentrations. In the a priori dietary score analysis, YH3 participants adhering most closely to the Mediterranean diet were found to exhibit a trend towards a lower PWV. MDS did not track between YH1 and YH3, and nor was there a longitudinal relationship between the change in the MDS and the change in CVD risk biomarkers. In conclusion, cross-sectional analysis revealed that some associations between DP and CVD risk biomarkers were already evident in the young adult population, namely the association between the healthy DP (and the MDS) and PWV; however, no longitudinal associations were observed between these relatively short time periods.

Realistic evaluation of EWS and ALERT: factors enabling and constraining implementation.

Realistic Evaluation of EWS and ALERT: factors enabling and constraining implementation Background The implementation of EWS and ALERT in practice is essential to the success of Rapid Response Systems but is dependent upon nurses utilising EWS protocols and applying ALERT best practice guidelines. To date there is limited evidence on the effectiveness of EWS or ALERT as research has primarily focused on measuring patient outcomes (cardiac arrests, ICU admissions) following the implementation of a Rapid Response Team. Complex interventions in healthcare aimed at changing service delivery and related behaviour of health professionals require a different research approach to evaluate the evidence. To understand how and why EWS and ALERT work, or might not work, research needs to consider the social, cultural and organisational influences that will impact on successful implementation in practice. This requires a research approach that considers both the processes and outcomes of complex interventions, such as EWS and ALERT, implemented in practice. Realistic Evaluation is such an approach and was used to explain the factors that enable and constrain the implementation of EWS and ALERT in practice [1]. Aim The aim of this study was to evaluate factors that enabled and constrained the implementation and service delivery of early warnings systems (EWS) and ALERT in practice in order to provide direction for enabling their success and sustainability. Methods The research design was a multiple case study approach of four wards in two hospitals in Northern Ireland. It followed the principles of realist evaluation research which allowed empirical data to be gathered to test and refine RRS programme theory. This approach used a variety of mixed methods to test the programme theories including individual and focus group interviews, observation and documentary analysis in a two stage process. A purposive sample of 75 key informants participated in individual and focus group interviews. Observation and documentary analysis of EWS compliance data and ALERT training records provided further evidence to support or refute the interview findings. Data was analysed using NVIVO8 to categorise interview findings and SPSS for ALERT documentary data. These findings were further synthesised by undertaking a within and cross case comparison to explain the factors enabling and constraining EWS and ALERT. Results A cross case analysis highlighted similarities, differences and factors enabling or constraining successful implementation across the case study sites. Findings showed that personal (confidence; clinical judgement; personality), social (ward leadership; communication), organisational (workload and staffing issues; pressure from managers to complete EWS audit and targets), educational (constraints on training; no clinical educator on ward) and cultural (routine task delegated) influences impact on EWS and acute care training outcomes. There were also differences noted between medical and surgical wards across both case sites. Conclusions Realist Evaluation allows refinement and development of the RRS programme theory to explain the realities of practice. These refined RRS programme theories are capable of informing the planning of future service provision and provide direction for enabling their success and sustainability. References: 1. McGaughey J, Blackwood B, O’Halloran P, Trinder T. J. & Porter S. (2010) A realistic evaluation of Track and Trigger systems and acute care training for early recognition and management of deteriorating ward–based patients. Journal of Advanced Nursing 66 (4), 923-932. Type of submission: Concurrent session Source of funding: Sandra Ryan Fellowship funded by the School of Nursing & Midwifery, Queen’s University of Belfast

Technology-related strategies in labour-intensive industries from Southern European Regions: consequences for local employment

Tese dout., Economia, Universidade do Algarve, 2010

Muslims in Public and Media Discourse in Western Europe: The Reproduction of Aporia and Exclusion

This chapter scrutinizes the dominant public discourse in Western Europe. Drawing on examples from the UK, Germany, and France but also from the Netherlands, Denmark and Spain it illustrates the gradual transformation of discourse from an “exotic Islam” to a “threatening Islam” that endangers European values and safety and suggests that the combination of this “securitization” of Islam and the monopoly of the “Muslim voice” by radical Muslim activists leads to a vicious circle of misrecognition and enhancing the aporia of Europe's Muslims.

Business micro-location: factors, preferences and indicators to assess the influence factors

The paper presents a study on business micro-location behaviour as well as corresponding factors of influence, conducted in two metropolitan areas, Bucharest-Ilfov (Romania) and Greater Porto (Portugal). By business micro-location we refer to a specific site such as a building or facility, accommodating a business within a small, compact geographical area (e.g. metropolitan area). At this geographical scale, the macroeconomic layer factors were excluded, applicable when discern between regions or countries. The factors derived from location theory and previous empirical studies were surveyed, completing a cross-sectional analysis in order to find out the specific weights of the location factors and preferences, by region and by industry. Based on already established firms’ feedback on location, the specific weights were granted by each industry to the main location factors, types of areas, and types of accommodation facilities. The authors also suggested a model to integrate these results into a Geographical Information System (GIS).

Exposição de profissionais de saúde a radiações ionizantes : confiança dos profissionais nas leituras de dosimetria individual

Resumo - O avanço tecnológico e científico no campo da Medicina tem favorecido a aplicação das radiações ionizantes nas áreas da Medicina Nuclear, Radiologia, Radioterapia e noutras especialidades relacionadas com a medicina de intervenção, como a Cardiologia. As Organizações de Saúde, com profissionais com risco de exposição a radiações ionizantes, são responsáveis, legislativamente, por assegurar a sua vigilância. Certificando a observação controlada das doses de exposição, os profissionais são monitorizados com dosímetros individuais e submetidos a vigilância médica. As leituras de dosímetria individual destes profissionais, originam por vezes, nos próprios, desconfianças e incertezas quanto aos valores medidos. Objectivo: avaliar o grau de confiança dos profissionais de saúde, expostos a radiações ionizantes, no sistema de monitorização individual. Metodologia: estudo observacional do tipo analítico- transversal, por questionário. Amostra de 190 Técnicos de Diagnóstico e Terapêutica de Cardiopneumologia, Medicina Nuclear, Radiologia, Radioterapia, expostos a radiações ionizantes, que exercem a sua actividade profissional em hospitais do concelho de Lisboa. Resultados: 51,1% dos Técnicos de Diagnóstico e Terapêutica não confiam nas leituras dos dosímetros, não se determinou uma relação estatisticamente significativa entre essa confiança, o tipo de dosímetro e a empresa que realiza as leituras. A confiança é maior nos que exercem em Organizações de Saúde públicas. 40,2% das Organizações de Saúde apresentam plano de vigilância médica, constatando-se uma falta de conformidade entre os Técnicos de Diagnóstico e Terapêutica, nalguns hospitais, relativamente à existência desse plano no respectivo hospital. A margem de erro associado ao estudo é de 5,09%, com um nível de confiança de 95%. -----------Abstract - The technological and scientific advances in the field of medicine has encouraged the application of ionizing radiation with a considerable positive contribution in the areas of Nuclear Medicine, Radiology, Radiotherapy and other specialties related to medical intervention like Cardiology. The Health Organizations that arise the risk of occupational exposure to ionizing radiation and is their responsibility to ensure monitoring, according the law. To ensure the monitoring of controlled doses of exposure, the exposed works use an individual dosimeter and undergo medical supervision. The individual dosimetry readings of health-care professionals, is sometimes questionable for themselves, arising distrust and uncertainty about the values measured. Objective: evaluate the degree of confidence of health professionals, exposed to radiation, on the system of individual monitoring. Methods: Observational study of cross-type analysis by questionnaire. Sample of 190 of technologists of Cardiopneumology, Nuclear Medicine, Radiology, Radiotherapy, exposed to ionizing radiation, which work in hospitals on the region of Lisbon. Results: 51.1% of technologists does not rely on the readings of their dosimeters, and wasn’t determined a statistically significant relationship between this trust, the type of dosimeter and the company that makes the readings(s) of their(s) dosimeter(s). The confidence in the readings is higher in public Health Organizations. 40.2% of the Health Organizations have medical monitoring plan and there is a disagreement between technologists, in some hospitals, relatively to the existence of this plan in their hospital. It was estimated that the u

A technology diffusion perspective of Enterprise Resource Planning across European Small and Medium Enterprises: from determinants to Use to Value

Tese apresentada como requisito parcial para obtenção do grau de Doutor em Gestão de Informação

Alimentação e estado nutricional de grupos da população do concelho de Lisboa

RESUMO - Objectivo: descrever o estado nutricional e o padrão alimentar de grupos da população de Lisboa. Delineamento, locais e participantes: estudo transversal do estado nutricional e do padrão alimentar de homens com 38 anos e mulheres e homens com 50-65 anos que vivem na freguesia do Lumiar, do concelho de Lisboa; estudo transversal dos hábitos alimentares e do estado nutricional de adolescentes com 12 a 19 anos estudantes de escolas secundárias de Lisboa; estudo transversal da excreção de sódio em urina de 24 horas de rapazes de 7 a 8 anos de escolas primárias do Lumiar. Métodos: o estado nutricional foi avaliado com metodologias padronizadas tal como propostas pela OMS. A ingestão alimentar foi medida pelo método das 24 horas anteriores no primeiro estudo e pelo método da história alimentar no segundo estudo. Resultados: nas crianças, a excreção urinária de sódio foi uma das mais altas da Europa. Nos adolescentes, a prevalência de excesso de peso/obesidade foi de 19% nos rapazes e 16% nas raparigas. 16% dos adolescentes não tomam pequeno-almoço, mas mais de 30% comem bolos a meio da manhã. A proporção de adolescentes com uma ingestão diária de certos alimentos é de 44% para guloseimas, 43% para bolos, 29% para refrigerantes e 16% para chocolates e gelados. Por outro lado, a frequência de ingestão diária de fruta e produtos hortícolas é baixa, principalmente nos adolescentes de menor nível sócio-económico. Nos adultos, 57% dos homens com 38 anos e 80% e 74% dos homens e mulheres com 50-65 anos, respectivamente, têm excesso de peso ou obesidade. A hipertensão arterial foi detectada em mais de 20% dos homens jovens e a sua prevalência aumenta com a idade. Foi observado um colesterol sérico superior a 200 mg/dL em perto de metade dos adultos e maior do que 240 mg/dL em 28% dos homens com 38 anos, em 24% dos homens com 50-65 anos e 44% das mulheres do mesmo grupo etário. 20% dos adultos jovens têm colesterol HDL inferior a 35 mg/dL, mais do que um terço são fumadores e a ingestão de álcool representa 13% da sua ingestão calórica total. Conclusões: foram observados estilos de vida não saudáveis, nomeadamente padrões alimentares não equilibrados, uma elevada prevalência de obesidade, hipertensão e dislipidemias, e, por isso, uma percentagem relativamente elevada da população de Lisboa tem um risco elevado de doenças cárdio-vasculares e outras doenças crónicas, bem como de morte prematura.

Creation of an Age-Adjusted, Dual-Energy X-ray Absorptiometry-Derived Trabecular Bone Score Curve for the Lumbar Spine in Non-Hispanic US White Women.

The trabecular bone score (TBS, Med-Imaps, Pessac, France) is an index of bone microarchitecture texture extracted from anteroposterior dual-energy X-ray absorptiometry images of the spine. Previous studies have documented the ability of TBS of the spine to differentiate between women with and without fractures among age- and areal bone mineral density (aBMD)-matched controls, as well as to predict future fractures. In this cross-sectional analysis of data collected from 3 geographically dispersed facilities in the United States, we investigated age-related changes in the microarchitecture of lumbar vertebrae as assessed by TBS in a cohort of non-Hispanic US white American women. All subjects were 30 yr of age and older and had an L1-L4aBMDZ-score within ±2 SD of the population mean. Individuals were excluded if they had fractures, were on any osteoporosis treatment, or had any illness that would be expected to impact bone metabolism. All data were extracted from Prodigy dual-energy X-ray absorptiometry devices (GE-Lunar, Madison, WI). Cross-calibrations between the 3 participating centers were performed for TBS and aBMD. aBMD and TBS were evaluated for spine L1-L4 but also for all other possible vertebral combinations. To validate the cohort, a comparison between the aBMD normative data of our cohort and US non-Hispanic white Lunar data provided by the manufacturer was performed. A database of 619 non-Hispanic US white women, ages 30-90 yr, was created. aBMD normative data obtained from this cohort were not statistically different from the non-Hispanic US white Lunar normative data provided by the manufacturer (p = 0.30). This outcome thereby indirectly validates our cohort. TBS values at L1-L4 were weakly inversely correlated with body mass index (r = -0.17) and weight (r = -0.16) and not correlated with height. TBS values for all lumbar vertebral combinations decreased significantly with age. There was a linear decrease of 16.0% (-2.47 T-score) in TBS at L1-L4 between 45 and 90 yr of age (vs. -2.34 for aBMD). Microarchitectural loss rate increased after age 65 by 50% (-0.004 to -0.006). Similar results were obtained for other combinations of lumbar vertebra. TBS, an index of bone microarchitectural texture, decreases with advancing age in non-Hispanic US white women. Little change in TBS is observed between ages 30 and 45. Thereafter, a progressive decrease is observed with advancing age. The changes we observed in these American women are similar to that previously reported for a French population of white women (r(2) > 0.99). This reference database will facilitate the use of TBS to assess bone microarchitectural deterioration in clinical practice.

Selected polymorphisms in sex hormone-related genes, circulating sex hormones and risk of endometrial cancer.

BACKGROUND: The role of estrogen and progesterone in the development of endometrial cancer is well documented. Few studies have examined the association of genetic variants in sex hormone-related genes with endometrial cancer risk. METHODS: We conducted a case-control study nested within three cohorts to examine the association of endometrial cancer risk with polymorphisms in hormone-related genes among 391 cases (92% postmenopausal at diagnosis) and 712 individually-matched controls. We also examined the association of these polymorphisms with circulating levels of sex hormones and SHBG in a cross-sectional analysis including 596 healthy postmenopausal women at blood donation (controls from this nested case-control study and from a nested case-control study of breast cancer in one of the three cohorts). RESULTS: Adjusting for endometrial cancer risk factors, the A allele of rs4775936 in CYP19 was significantly associated (OR(per allele)=1.22, 95% CI=1.01-1.47, p(trend)=0.04), while the T allele of rs10046 was marginally associated with increased risk of endometrial cancer (OR(per allele)=1.20, 95% CI=0.99-1.45, p(trend)=0.06). PGR rs1042838 was also marginally associated with risk (OR(per allele)=1.25, 95% CI=0.96-1.61, p(trend)=0.09). No significant association was found for the other polymorphisms, i.e. CYP1B1 rs1800440 and rs1056836, UGT1A1 rs8175347, SHBG rs6259 and ESR1 rs2234693. Rs8175347 was significantly associated with postmenopausal levels of estradiol, free estradiol and estrone and rs6259 with SHBG and estradiol. CONCLUSION: Our findings support an association between genetic variants in CYP19, and possibly PGR, and risk of endometrial cancer.

Association of smoking and nicotine dependence with pre-diabetes in young and healthy adults.

INTRODUCTION: Several studies have shown an increased risk of type 2 diabetes among smokers. Therefore, the aim of this analysis was to assess the relationship between smoking, cumulative smoking exposure and nicotine dependence with pre-diabetes. METHODS: We performed a cross-sectional analysis of healthy adults aged 25-41 in the Principality of Liechtenstein. Individuals with known diabetes, Body Mass Index (BMI) >35 kg/m² and prevalent cardiovascular disease were excluded. Smoking behaviour was assessed by self-report. Pre-diabetes was defined as glycosylated haemoglobin between 5.7% and 6.4%. Multivariable logistic regression models were done. RESULTS: Of the 2142 participants (median age 37 years), 499 (23.3%) had pre-diabetes. There were 1,168 (55%) never smokers, 503 (23%) past smokers and 471 (22%) current smokers, with a prevalence of pre-diabetes of 21.2%, 20.9% and 31.2%, respectively (p <0.0001). In multivariable regression models, current smokers had an odds ratio (OR) of pre-diabetes of 1.82 (95% confidential interval (CI) 1.39; 2.38, p <0.0001). Individuals with a smoking exposure of <5, 5-10 and >10 pack-years had an OR (95% CI) for pre-diabetes of 1.34 (0.90; 2.00), 1.80 (1.07; 3.01) and 2.51 (1.80; 3.59) (p linear trend <0.0001) compared with never smokers. A Fagerström score of 2, 3-5 and >5 among current smokers was associated with an OR (95% CI) for pre-diabetes of 1.27 (0.89; 1.82), 2.15 (1.48; 3.13) and 3.35 (1.73; 6.48) (p linear trend <0.0001). DISCUSSION: Smoking is strongly associated with pre-diabetes in young adults with a low burden of smoking exposure. Nicotine dependence could be a potential mechanism of this relationship.

The carbon disclosure project, an evolution in international environmental corporate governance : motivations and determinants of market response to voluntary disclosures

This paper examines the factors associated with Canadian firms voluntarily disclosing climate change information through the Carbon Disclosure Project. Five hypotheses are presented to explain the factors influencing management's decision to disclose this information. These hypotheses include a response to shareholder activism, domestic institutional investor shareholder activism, signalling, litigation risk, and low cost publicity. Both binary logistic regressions as well as a cross-sectional analysis of the equity market's response to the environmental disclosures being made were used to test these hypotheses. Support was found for shareholder activism, low cost publicity, and litigation risk. However, the equity market's response was not found to be statistically significant.

Étude de la sensibilité baroréceptive en sommeil et à l’éveil dans l’insomnie primaire chronique

L’insomnie, une condition fréquemment retrouvée dans la population, se caractérise d’abord par une difficulté à initier ou à maintenir le sommeil et/ou par des éveils précoces le matin ou encore par un sommeil non-réparateur. Lorsqu’elle n’est pas accompagnée par des troubles psychiatriques ou médicaux ou un autre trouble de sommeil et qu’elle perdure plus de 6 mois on parle alors d’insomnie primaire chronique. Selon certains, cette condition serait associée à un état d’hyperéveil caractérisé par une augmentation de l’activité autonome sympathique durant le sommeil et l’éveil. Le baroréflexe est un important mécanisme de contrôle à court terme des fluctuations de la tension artérielle (TA) et de la fréquence cardiaque agissant sur le cœur et les vaisseaux sanguins par l’entremise du système nerveux autonome. On appelle sensibilité baroréceptive (SBR) la capacité du baroréflexe de réagir et de contrôler les fluctuations de TA en modulant le rythme cardiaque. De manière générale, la SBR serait augmentée durant la nuit par rapport à la journée. Aussi, il semblerait que le baroréflexe soit impliqué dans le phénomène de baisse physiologique de la TA pendant la nuit. Or, des données de notre laboratoire ont démontré une augmentation de la TA systolique au cours de la nuit ainsi qu’une atténuation de la baisse nocturne de TA systolique chez des sujets avec insomnie primaire chronique comparé à des témoins bons dormeurs. De plus, il a été démontré que le baroréflexe était altéré de façon précoce dans plusieurs troubles cardiovasculaires et dans l’hypertension artérielle. Or, il semblerait que l’insomnie soit accompagnée d’un risque accru de développement de l’hypertension artérielle. Ces études semblent aller dans le sens d’une altération des mécanismes de régulation de la TA dans l’insomnie. Par ailleurs, une réduction de la SBR serait aussi impliquée dans des états associés à une augmentation de l’activité autonome sympathique. Ainsi, nous nous sommes demandé si le baroréflexe pouvait constituer un des mécanismes de contrôle de la TA qui serait altéré dans l’insomnie et pourrait être impliqué dans l’augmentation de l’activité sympathique qui semble accompagner l’insomnie. Jusqu’à présent, le baroréflexe reste inexploré dans l’insomnie. L’objectif principal de ce mémoire était d’évaluer de façon non-invasive la SBR à l’éveil et en sommeil chez 11 sujets atteints d’insomnie primaire chronique comparé à 11 témoins bons dormeurs. L’évaluation du baroréflexe a été effectuée de façon spontanée par la méthode de l’analyse en séquence et par le calcul du coefficient alpha obtenu par l’analyse spectrale croisée de l’intervalle RR et de la TA systolique. De façon concomitante, les paramètres de la variabilité de l’intervalle RR en sommeil et à l’éveil ont aussi été comparés chez ces mêmes sujets. Aucune différence significative n’a été notée au niveau des index de la SBR entre le groupe d’insomniaques et celui des bons dormeurs, à l’éveil ou en sommeil. Cependant, on observe des valeurs légèrement plus faibles de la SBR chez les insomniaques ayant mal dormi (efficacité de sommeil (ES) < 85%) comparés aux insomniaques ayant bien dormi (ES≥ 85%) à la nuit expérimentale durant l’éveil et en sommeil. Par ailleurs, aucune différence n’a été notée entre le groupe d’insomniaques et celui des bons dormeurs au niveau des paramètres de la variabilité RR considérés (intervalle RR, PNN50, LF et HF en valeurs normalisées). En effet, les insomniaques tout comme les bons dormeurs semblent présenter une variation normale de l’activité autonome en sommeil, telle que représentée par les paramètres de la variabilité RR. Ces résultats préliminaires semblent suggérer que les mécanismes du baroréflexe sont préservés chez les sujets atteints d’insomnie primaire chronique tels que diagnostiqués de manière subjective. Cependant, il est possible qu’une altération des mécanismes du baroréflexe ne se révèle chez les insomniaques que lorsque les critères objectifs d’une mauvaise nuit de sommeil sont présents.

Les missions des bibliothèques publiques autonomes du point de vue des élus municipaux québécois

La légitimité d’une organisation est fondée sur sa mission, c’est-à-dire sur sa raison d’être. Des responsables des bibliothèques et de nombreux chercheurs craignent que la légitimité des bibliothèques publiques soit contestée dans la société de l’information. De plus, les textes officiels présentant les missions des bibliothèques publiques sont divers et les missions y sont délibérément non définies. Au Québec, où une grande majorité des bibliothèques publiques autonomes sont placées directement sous la tutelle des municipalités, les bibliothèques publiques doivent définir et légitimer leurs missions avec les élus municipaux. L’objectif principal de cette recherche est de comprendre, via les discours, le point de vue des élus municipaux québécois sur les missions des bibliothèques publiques autonomes, en comparaison avec les pratiques et les ressources des bibliothèques au plan local. Basé sur la théorie de la construction sociale de la réalité, un cadre conceptuel est proposé de manière à étudier non seulement les discours dans leur dimension textuelle, mais aussi à contextualiser ces discours et analyser l’écart entre ces discours et les pratiques des bibliothèques.La stratégie de recherche adoptée est une étude de cas multiples. L’objectif est de développer une analyse en profondeur de chaque cas et une analyse inter cas. Les douze cas (municipalités) ont été sélectionnés en fonction de deux critères de variation (la taille de la municipalité et le budget annuel alloué par la municipalité à la bibliothèque) et un critère discriminant (la distance par rapport à l’Université de Montréal). Des entrevues ont été menées auprès des élus municipaux présidant la commission ou le comité dont dépendent les bibliothèques publiques. Ces entrevues et les politiques culturelles ont fait l’objet d’une analyse de discours. Les entrevues auprès des responsables des bibliothèques et la documentation ont fait l’objet d’une analyse de contenu. Ces analyses ont permis la triangulation des méthodes et des sources de données.Les élus municipaux québécois, comme les professionnels, n’offrent pas un discours homogène sur les missions des bibliothèques publiques. Toutefois, un modèle de discours émerge. Il montre un discours « limité » par rapport à la littérature, dans lequel une image passive de la bibliothèque est présentée et dans lequel la tradition perdure malgré le contexte de la société de l’information. Mais l’analyse révèle aussi que les élus municipaux construisent leurs points de vue sur leurs propres convictions en tant qu’individus, sur leur rôle dans la gestion de la municipalité en tant qu’élus et sur l’image qu’ils ont des usagers des bibliothèques publiques. Enfin, l’analyse a révélé un axe de différenciation des points de vue selon que le discours s’appuie sur des valeurs fondamentales ou sur les usages (réels ou supposés) de la bibliothèque.