Utilisation des médecines complémentaires par les enfants atteints d'arthrite juvénile idiopathique et d'incapacités physiques

Contexte : Les enfants atteints de maladies chroniques utilisent souvent des médecines complémentaires. Plusieurs études traitent de l’utilisation de ces traitements et des facteurs qui y sont associés chez les enfants atteints d’arthrite juvénile mais aucune étude n’est longitudinale. De plus, aucune n’a documenté l’utilisation de ces traitements chez les enfants ayant des incapacités physiques en attente de services publics de réadaptation. Objectifs : Les objectifs de cette étude étaient de déterminer la fréquence d’utilisation des médecines complémentaires chez les enfants atteints d’arthrite juvénile et d’incapacités physiques, d’évaluer leur efficacité telle que perçue par les parents et d’explorer les facteurs associés à leur utilisation. Méthodes : Une cohorte d’enfants atteints d’arthrite juvénile idiopathique (n=182, âge moyen : 10,2 ans) qui fréquentent des cliniques d’arthrite et une cohorte d’enfants ayant des incapacités physiques en attente de services de réadaptation publics (n=224, âge moyen : 2,6 ans) ont été suivis durant une période d’un an. L’utilisation des médecines complémentaires et la perception de leur efficacité d’après les parents ont été évaluées à l’aide de statistiques descriptives à chaque trois mois pour la cohorte d’enfants atteints d’arthrite et au début de l’étude pour la cohorte d’enfants ayant des incapacités physiques. Les facteurs associés à l’utilisation de ces traitements ont été explorés par des analyses de type GEE (« Generalized estimating equations ») et des régressions polytomique et logistique. Résultats : L’utilisation antérieure de ces médecines était de 51,1% pour les enfants atteints d’arthrite et de 15% pour les enfants ayant des incapacités physiques. Les médecines complémentaires étaient considérées comme étant efficaces dans 72% des cas par les parents d’enfants atteints d’arthrite et dans 83% des cas par les parents d’enfants ayant des incapacités physiques. Les facteurs associés à l’utilisation des médecines complémentaires chez les enfants atteints d’arthrite étaient l’utilisation antérieure des médecines complémentaires par les parents et la perception des parents que les médicaments prescrits ne sont pas utiles pour leur enfant. Chez les enfants ayant des incapacités physiques, les facteurs associés à l’utilisation des médecines complémentaires étaient l’origine culturelle canadienne, un niveau de scolarité plus élevé que le diplôme d’études secondaires et une moins bonne qualité de vie reliée à la santé. Finalement, l’utilisation des médecines complémentaires semblait associée à de moins bons résultats chez les enfants atteints d’arthrite. Conclusion: Une proportion non-négligeable des enfants participant à la présente étude ont utilisé des médecines complémentaires. Leur utilisation était plus fréquente chez les enfants atteints d’arthrite juvénile idiopathique, surtout chez ceux dont les parents avaient déjà utilisé les médecines complémentaires par le passé et chez ceux qui trouvaient la médication peu efficace. Chez les enfants ayant des incapacités physiques, l’utilisation des médecines complémentaires était associée à des facteurs socio-démographiques et à des besoins plus élevés en matière de santé. Les médecines complémentaires étaient considérées comme étant efficaces dans les deux cohortes mais leur utilisation était associée à de faibles résultats chez les enfants atteints d’arthrite. Ces résultats démontrent l’importance d’évaluer l’utilisation des médecines complémentaires afin de mieux renseigner les parents et de les aider à prendre les meilleures décisions possibles concernant le traitement de leur enfant.

2D, 3D and 4D active compound delivery in tissue engineering and regenerative medicine

Recent advances in tissue engineering and regenerative medicine have shown that controlling cells microenvironment during growth is a key element to the development of successful therapeutic system. To achieve such control, researchers have first proposed the use of polymeric scaffolds that were able to support cellular growth and, to a certain extent, favor cell organization and tissue structure. With nowadays availability of a large pool of stem cell lines, such approach has appeared to be rather limited since it does not offer the fine control of the cell micro-environment in space and time (4D). Therefore, researchers are currently focusing their efforts on developing strategies that include active compound delivery systems in order to add a fourth dimension to the design of 3D scaffolds. This review will focus on recent concepts and applications of 2D and 3D techniques that have been used to control the load and release of active compounds used to promote cell differentiation and proliferation in or out of a scaffold. We will first present recent advances in the design of 2D polymeric scaffolds and the different techniques that have been used to deposit molecular cues and cells in a controlled fashion. We will continue presenting the recent advances made in the design of 3D scaffolds based on hydrogels as well as polymeric fibers and we will finish by presenting some of the research avenues that are still to be explored.

Agri-environmental evaluation of traditional and alternative corn production systems in Chiapas, Mexico

This study evaluates the effects of environmental variables on traditional and alternative agroecosystems in three Ejidos (communal lands) in the Chiapas rainforest in Mexico. The tests occurred within two seasonal agricultural cycles. In spring-summer, experiments were performed with the traditional slash, fell and burn (S-F-B) system, no-burn systems and rotating systems with Mucuna deeringiana Bort., and in the autumn-winter agricultural cycle, three no-burn systems were compared to evaluate the effect of alternative sowing with corn (no-burn and topological modification of sowing). The results show a high floristic diversity in the study area (S_S = 4 - 23%), with no significant differences among the systems evaluated. In the first cycle, the analysis of the agronomical variables of the corn indicated better properties in the fallowing systems, with an average yield of 1950 kg ha^‑1, but there was variation related to the number of years left fallow. In the second cycle, the yields were positive for the alternative technology (average yield 3100 kg ha^‑1). The traditional S-F-B systems had reduced pests and increased organic matter and soil phosphorous content. These results are the consequence of fallow periods and adaptation to the environment; thus, this practice in the Chiapas rainforest constitutes an ethnocultural reality, which is unlikely to change in the near future if the agrosystems are managed based on historical principles.

Conversations about self-identity in Alzheimer disease : Argumentative and Alternative Communication memory books as an aid

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Becoming skilled: The cultural and corporeal geographies of teaching and learning Thai Yoga massage

This paper explores the process of learning an embodied knowledge using the work of Dreyfus and Deleuze. Although geographers have begun to acknowledge the role of embodied knowledges in social life, there have been few in-depth case studies of how these skills are learned. This paper offers a case study of Thai Yoga massage (TYM), a ‘complementary and alternative therapy’ which is growing in popularity in the United Kingdom. Having outlined the case study, the paper explores the cultural geographies of the formalisation, documentation and contestation of the set of techniques that have come to cohere in the UK as TYM. The paper then interrogates the messy corporeal geographies of learning a skill, and briefly considers how more advanced practitioners experience their skilled practice.

Economic assessment of bovine tuberculosis and alternative policies

Break-even analyses of the costs and benefits of six alternative bovine tuberculosis (bTB) control strategies were undertaken. The results show that some strategies, such as zoning, would require relatively small reductions in bTB incidence as a result to be cost effective, whilst for others, such as proactive badger removal, the costs would require a substantial and relatively rapid reduction in bTB incidence to be worthwhile.

Conditional male dimorphism and alternative reproductive tactics in a Neotropical arachnid (Opiliones)

In arthropods, most cases of morphological dimorphism within males are the result of a conditional evolutionarily stable strategy (ESS) with status-dependent tactics. In conditionally male-dimorphic species, the status` distributions of male morphs often overlap, and the environmentally cued threshold model (ET) states that the degree of overlap depends on the genetic variation in the distribution of the switchpoints that determine which morph is expressed in each value of status. Here we describe male dimorphism and alternative mating behaviors in the harvestman Serracutisoma proximum. Majors express elongated second legs and use them in territorial fights; minors possess short second legs and do not fight, but rather sneak into majors` territories and copulate with egg-guarding females. The static allometry of second legs reveals that major phenotype expression depends on body size (status), and that the switchpoint underlying the dimorphism presents a large amount of genetic variation in the population, which probably results from weak selective pressure on this trait. With a mark-recapture study, we show that major phenotype expression does not result in survival costs, which is consistent with our hypothesis that there is weak selection on the switchpoint. Finally, we demonstrate that switchpoint is independent of status distribution. In conclusion, our data support the ET model prediction that the genetic correlation between status and switchpoint is low, allowing the status distribution to evolve or to fluctuate seasonally, without any effect on the position of the mean switchpoint.

Commutative Moufang loops and alternative algebras

We describe bases of free commutative Moufang loop with seven generators and calculate the order of this loop. (c) 2011 Published by Elsevier Inc.

Economic stagnation and alternative development strategies

The focus of my paper is the presentation of some thoughts on overcoming economic stagnation, with reference to the case of Mexico. In Section 2, I will describe the reasons why the policies of financial opening based on the Washington Consensus create endogenous tendencies toward economic stagnation and overvaluation of currencies. Section 3 offers a concise outline of a possible alternative development project for Mexico. Section 4 presents some proposals regarding monetary, foreign exchange, and fiscal policy oriented toward reviving economic growth. Finally, in Section 5, I present some conclusions.

Responses of chlorophyll fluorescence parameters of the facultative halophyte and C-3-CAM intermediate species Mesembryanthemum crystallinum to salinity and high irradiance stress

Mesembryanthemum crystallinum L. (Aizoaceae) is a facultative annual halophyte and a C-3-photosynthesis/crassulacean acid metabolism intermediate species currently used as a model plant in stress physiology. Both salinity and high light irradiance stress are known to induce CAM in this species. The present study was performed to provide a diagnosis of alterations at the photosystem 11 level during salinity and irradiance stress. Plants were subjected for up to 13 days to either 0.4M NaCl salinity or high irradiance of 1000 mu mol m(-2) s(-1), as well as to both stress factors combined (LLSA = low light plus salt; HLCO = high light of 1000 mu mol m(-2)s(-1), no salt; HLSA = high light plus salt). A control of LLCO = low light of 200 mu mol m(-2) s(-1), no salt was used. Parameters of chlorophyll a fluorescence of photosystem 11 (PSII) were measured with a pulse amplitude modulated fluorometer. HLCO and LLSA conditions induced a weak degree of CAM with day/night changes of malate levels (Delta malate) of similar to 12 mM in the course of the experiment, while HLSA induced stronger CAM of Delta malate similar to 20mM. Effective quantum yield of PSII, Delta F/F'(m), was only slightly affected by LLSA, somewhat reduced during the course of the experiment by HLCO and clearly reduced by HLSA. Potential quantum efficiency of PSII, F-v/F-m, at predawn times was not affected by any of the conditions, always remaining at >= 0.8, showing that there was no acute photoinhibition. During the course of the days HL alone (HLCO) also did not elicit photoinhibition; salt alone (LLSA) caused acute photoinhibition which was amplified by the combination of the two stresses (HLSA). Non-photochemical, NPQ, quenching remained low (< 0.5) under LLCO, LLSA and HLCO and increased during the course of the experiment under HLSA to 1-2. Maximum apparent photosynthetic electron transport rates, ETRmax, declined during the daily courses and were reduced by LLSA and to a similar extent by HLSA. It is concluded that A crystallinum expresses effective stress tolerance mechanisms but photosynthetic capacity is reduced by the synergistic effects of salinity and tight irradiance stress combined. (c) 2006 Elsevier GmbH. All rights reserved.

The plant energy-dissipating mitochondrial systems: Depicting the genomic structure and the expression profiles of the gene families of uncoupling protein and alternative oxidase in monocots and dicots

The simultaneous existence of alternative oxidases and uncoupling proteins in plants has raised the question as to why plants need two energy-dissipating systems with apparently similar physiological functions. A probably complete plant uncoupling protein gene family is described and the expression profiles of this family compared with the multigene family of alternative oxidases in Arabidopsis thaliana and sugarcane (Saccharum sp.) employed as dicot and monocot models, respectively. In total, six uncoupling protein genes, AtPUMP1-6, were recognized within the Arabidopsis genome and five (SsPUMP1-5) in a sugarcane EST database. The recombinant AtPUMP5 protein displayed similar biochemical properties as AtPUMP1. Sugarcane possessed four Arabidopsis AOx1-type orthologues (SsAOx1a-1d); no sugarcane orthologue corresponding to Arabidopsis AOx2-type genes was identified. Phylogenetic and expression analyses suggested that AtAOx1d does not belong to the AOx1-type family but forms a new (AOx3-type) family. Tissue-enriched expression profiling revealed that uncoupling protein genes were expressed more ubiquitously than the alternative oxidase genes. Distinct expression patterns among gene family members were observed between monocots and dicots and during chilling stress. These findings suggest that the members of each energy-dissipating system are subject to different cell or tissue/organ transcriptional regulation. As a result, plants may respond more flexibly to adverse biotic and abiotic conditions, in which oxidative stress is involved. © The Author [2006]. Published by Oxford University Press [on behalf of the Society for Experimental Biology]. All rights reserved.

Tourism for whom?: Different paths to development and alternative experiments in Brazil

The tourism policies pursued by the Brazilian government since the 1990s have not produced the benefits that were expected from mass tourism. The example of two very successful cases of community-based tourism, stressing paths rooted in a development model that is fair and environmentally responsible, shows that tourism development can improve the quality of life in communities that receive an influx of tourists provided that the local community is taken into account and the planning and implementation of such development focus on creating opportunities and benefits for its members. © 2008 Latin American Perpectives.