L'évaluation des difficultés et des besoins des patients psychiatriques. Les échelles lausannoises ELADEB.

Il existe de multiples instruments d'évaluation du fonctionnement social, de la qualité de vie ou des besoins des patients psychiatriques qui peuvent aider dans l'élaboration des stratégies de traitement. Néanmoins, nombre d'entre eux ne répondent pas toujours aux attentes des cliniciens ou des chercheurs. En réponse à ces limitations, nous avons élaboré une nouvelle échelle de mesure subjective des difficultés et du besoin d'aide, intitulée ELADEB. Sur la base d'une activité de tri de cartes, il est possible en quelques minutes de dresser le profil de difficultés des patients, et de mettre en évidence les domaines dans lesquels ils estiment avoir besoin d'une aide supplémentaire par rapport à celle qui existe peut-être déjà.

Algorithm optimization for solving crew scheduling problems

In this paper, we are proposing a methodology to determine the most efficient and least costly way of crew pairing optimization. We are developing a methodology based on algorithm optimization on Eclipse opensource IDE using the Java programming language to solve the crew scheduling problems.

Le romanesque africain sous le signe de la ruse : L'étrange destin de Wangrin d'Hampaté Bâ et Monnè, outrages et défis d'Ahmadou Kourouma in Ecrire en francophonie: une prise de pouvoir?, (ed. Ch. Le Quellec Cottier et D. Maggetti), Etudes de Lettres no... , 2008

Le motif de la ruse est une constante de l'imaginaire africain et ses figures, souvent animales dans les contes, attestent de la valeur symbolique de cet art du stratagème. Avec la complicité du roman d'H. Bâ, L'étrange destin de Wangrin, et celui d'A. Kourouma, Monnè, outrages et défis, nous allons montrer que la ruse et le rusé ont subi une métamorphose en devenant des pratiques textuelles. La ruse littéraire donne voix à « l'autre » et la langue construite sous ce signe-là est le lieu d'une prise de pouvoir, celle de sa propre énonciation.

Phase I/IIa study of cilengitide and temozolomide with concomitant radiotherapy followed by cilengitide and temozolomide maintenance therapy in patients with newly diagnosed glioblastoma.

Purpose: Invasion and migration are key processes of glioblastoma and are tightly linked to tumor recurrence. Integrin inhibition using cilengitide has shown synergy with chemotherapy and radiotherapy in vitro and promising activity in recurrent glioblastoma. This multicenter, phase I/IIa study investigated the efficacy and safety of cilengitide in combination with standard chemoradiotherapy in newly diagnosed glioblastoma. Patients and Methods: Patients (age >= 18 to >= 70 years) were treated with cilengitide (500 mg) administered twice weekly intravenously in addition to standard radiotherapy with concomitant and adjuvant temozolomide. Treatment was continued until disease progression or for up to 35 weeks. The primary end point was progression-free survival (PFS) at 6 months. Results: Fifty-two patients ( median age, 57 years; 62% male) were included. Six- and 12-month PFS rates were 69% (95% CI, 54% to 80%) and 33% ( 95% CI, 21% to 46%). Median PFS was 8 months ( 95% CI, 6.0 to 10.7 months). Twelve- and 24-month overall survival ( OS) rates were 68% ( 95% CI, 53% to 79%) and 35% ( 95% CI, 22% to 48%). Median OS was 16.1 months ( 95% CI, 13.1 to 23.2 months). PFS and OS were longer in patients with tumors with O-6-methylguanine-DNA methyltransferase (MGMT) promoter methylation (13.4 and 23.2 months) versus those without MGMT promoter methylation (3.4 and 13.1 months). The combination of cilengitide with temozolomide and radiotherapy was well tolerated, with no additional toxicity. No pharmacokinetic interactions between temozolomide and cilengitide were identified. Conclusion: Compared with historical controls, the addition of concomitant and adjuvant cilengitide to standard chemoradiotherapy demonstrated promising activity in patients with glioblastoma with MGMT promoter methylation. J Clin Oncol 28:2712-2718. (C) 2010 by American Society of Clinical Oncology

Avaliação de um Centro de Atenção Psicossocial: a realidade em Foz do Iguaçu

Trata-se de um recorte da pesquisa Avaliação dos Centros de Atenção Psicossocial da Região Sul do Brasil. Temos o objetivo de avaliar a ambiência enquanto espaço de conforto e subjetividade em um Centro de Atenção Psicossocial II (CAPS). Pesquisa qualitativa, tipo estudo de caso, que utilizou a Avaliação de Quarta Geração. Os instrumentos de coleta de dados foram: entrevistas com dez profissionais da equipe, 11 usuários e 11 familiares e 297 horas de observação de campo. A porta fechada e a equipe reduzida foram problematizadas, ocasionando repercussões no processo de trabalho do serviço. Esses nós críticos interferem diretamente na ambiência e consistem em tensão e antagonismo às proposições de um serviço como CAPS. Identificamos que as questões apresentadas são temas que demonstram o compromisso com um ambiente saudável, que considera o conforto e a subjetividade no trabalho do CAPS.

Effect of age on toxicokinetics among human volunteers exposed to propylene glycol methyl ether (PGME)

Aging adults represent the fastest growing population segment in many countries. Physiological and metabolic changes in the aging process may alter how aging adults biologically respond to pollutants. In a controlled human toxicokinetic study (exposure chamber; 12 m³), aging volunteers (n=10; >58 years) were exposed to propylene glycol monomethyl ether (PGME, CAS no. 107-98-2) at 50 ppm for 6 h. The dose-dependent renal excretion of oxidative metabolites, conjugated and free PGME could potentially be altered by age. AIMS: (1) Compare PGME toxicokinetic profiles between aging and young volunteers (20-25 years) and gender; (2) test the predictive power of a compartmental toxicokinetic (TK) model developed for aging persons against urinary PGME concentrations found in this study. METHODS: Urine samples were collected before, during, and after the exposure. Urinary PGME was quantified by capillary GC/FID. RESULTS: Differences in urinary PGME profiles were not noted between genders but between age groups. Metabolic parameters had to be changed to fit the age adjusted TK model to the experimental results, implying a slower enzymatic pathway in the aging volunteers. For an appropriate exposure assessment, urinary total PGME should be quantified. CONCLUSION: Age is a factor that should be considered when biological limit values are developed.

Islands of euchromatin-like sequence and expressed polymorphic sequences within the short arm of human chromosome 21

The goals of the human genome project did not include sequencing of the heterochromatic regions. We describe here an initial sequence of 1.1 Mb of the short arm of human chromosome 21 (HSA21p), estimated to be 10% of 21p. This region contains extensive euchromatic-like sequence and includes on average one transcript every 100 kb. These transcripts show multiple inter- and intrachromosomal copies, and extensive copy number and sequence variability. The sequencing of the "heterochromatic" regions of the human genome is likely to reveal many additional functional elements and provide important evolutionary information.

A short motif in Drosophila SECIS Binding Protein 2 provides differential binding affinity to SECIS RNA hairpins

Selenoproteins contain the amino acid selenocysteine which is encoded by a UGA Sec codon. Recoding UGA Sec requires a complex mechanism, comprising the cis-acting SECIS RNA hairpin in the 3′UTR of selenoprotein mRNAs, and trans-acting factors. Among these, the SECIS Binding Protein 2 (SBP2) is central to the mechanism. SBP2 has been so far functionally characterized only in rats and humans. In this work, we report the characterization of the Drosophila melanogaster SBP2 (dSBP2). Despite its shorter length, it retained the same selenoprotein synthesis-promoting capabilities as the mammalian counterpart. However, a major difference resides in the SECIS recognition pattern: while human SBP2 (hSBP2) binds the distinct form 1 and 2 SECIS RNAs with similar affinities, dSBP2 exhibits high affinity toward form 2 only. In addition, we report the identification of a K (lysine)-rich domain in all SBP2s, essential for SECIS and 60S ribosomal subunit binding, differing from the well-characterized L7Ae RNA-binding domain. Swapping only five amino acids between dSBP2 and hSBP2 in the K-rich domain conferred reversed SECIS-binding properties to the proteins, thus unveiling an important sequence for form 1 binding.

Social rationality and scales of action: inter-ethnic relations in cockfighting and game-fishing, Raiatea, French Polynesia

This article challenges the notion of economic rationality as a criterion for explaining ethnic boundary maintenance. It offers an ethnographic analysis of inter-ethnic relations in the context of games (cockfights and game-fishing contests) in the island of Raiatea (French Polynesia). Although all players engage in the same basic gambling practices, money is differentially scaled and mobilized by the Tahitian and Chinese participants. Building on recent pragmatic approaches to rationality, it is shown that the players' rationalities differ not from the point of view of economic maximization, but only in so far as they participate in social relations at different scales.

Chitosan-based nanogels for selective delivery of photosensitizers to macrophages and improved retention in and therapy of articular joints.

Macrophages play key roles in inflammatory disorders. Therefore, they are targets of treatments aiming at their local destruction in inflammation sites. However, injection of low molecular mass therapeutics, including photosensitizers, in inflamed joints results in their rapid efflux out of the joints, and poor therapeutic index. To improve selective uptake and increase retention of therapeutics in inflamed tissues, hydrophilic nanogels based on chitosan, of which surface was decorated with hyaluronate and which were loaded with one of three different anionic photosensitizers were developed. Optimal uptake of these functionalized nanogels by murine RAW 264.7 or human THP-1 macrophages as models was achieved after <4h incubation, whereas only negligible uptake by murine fibroblasts used as control cells was observed. The uptake by cells and the intracellular localization of the photosensitizers, of the fluorescein-tagged chitosan and of the rhodamine-tagged hyaluronate were confirmed by fluorescence microscopy. Photodynamic experiments revealed good cell photocytotoxicity of the photosensitizers entrapped in the nanogels. In a mouse model of rheumatoid arthritis, injection of free photosensitizers resulted in their rapid clearance from the joints, while nanogel-encapsulated photosensitizers were retained in the inflamed joints over a longer period of time. The photodynamic treatment of the inflamed joints resulted in a reduction of inflammation comparable to a standard corticoid treatment. Thus, hyaluronate-chitosan nanogels encapsulating therapeutic agents are promising materials for the targeted delivery to macrophages and long-term retention of therapeutics in leaky inflamed articular joints.

Technologies of birth and models of midwifery care

This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

Accidental intoxication of the infant-juvenile population in households: profiles of emergency care

OBJECTIVE Analyzing profiles of intoxication and accidental poisoning of infant-juvenile population (0-24 years) in the household, treated at a reference facility for Emergency and Primary Care, during the year 2013. METHOD A descriptive, cross-sectional study. Data were analyzed using Epi-Info, by way of simple and bivariate analyzes. The project was approved by the Research Ethics Committee (protocol 405.578). RESULTS There were 45 intoxications, with a prevalence of males (60.0%), aged 1-4 years (71.1%). Among children under one, there was a higher frequency of pesticide poisoning (66.6%), between the ages of 1-4 by cleaning products (34.4%), and between 5-9 years of age by pharmacological substances (66.6%). The primary assistance was provided only at health institutions, with hospital admissions in 24.4% of the cases. CONCLUSION The importance of prevention through legislation is evident, in order to ensure greater safety in packaging of various products, and community awareness to eliminate risks in the household environment.

25-hydroxyvitamin D concentration is inversely associated with serum MMP-9 in a cross-sectional study of African American ESRD patients.

BACKGROUND: Circulating 25-hydroxyvitamin D [25(OH)D] concentration is inversely associated with peripheral arterial disease and hypertension. Vascular remodeling may play a role in this association, however, data relating vitamin D level to specific remodeling biomarkers among ESRD patients is sparse. We tested whether 25(OH)D concentration is associated with markers of vascular remodeling and inflammation in African American ESRD patients.METHODS: We conducted a cross-sectional study among ESRD patients receiving maintenance hemodialysis within Emory University-affiliated outpatient hemodialysis units. Demographic, clinical and dialysis treatment data were collected via direct patient interview and review of patients records at the time of enrollment, and each patient gave blood samples. Associations between 25(OH)D and biomarker concentrations were estimated in univariate analyses using Pearson's correlation coefficients and in multivariate analyses using linear regression models. 25(OH) D concentration was entered in multivariate linear regression models as a continuous variable and binary variable (<15 ng/ml and =15 ng/ml). Adjusted estimate concentrations of biomarkers were compared between 25(OH) D groups using analysis of variance (ANOVA). Finally, results were stratified by vascular access type.RESULTS: Among 91 patients, mean (standard deviation) 25(OH)D concentration was 18.8 (9.6) ng/ml, and was low (<15 ng/ml) in 43% of patients. In univariate analyses, low 25(OH) D was associated with lower serum calcium, higher serum phosphorus, and higher LDL concentrations. 25(OH) D concentration was inversely correlated with MMP-9 concentration (r = -0.29, p = 0.004). In multivariate analyses, MMP-9 concentration remained negatively associated with 25(OH) D concentration (P = 0.03) and anti-inflammatory IL-10 concentration positively correlated with 25(OH) D concentration (P = 0.04).CONCLUSIONS: Plasma MMP-9 and circulating 25(OH) D concentrations are significantly and inversely associated among ESRD patients. This finding may suggest a potential mechanism by which low circulating 25(OH) D functions as a cardiovascular risk factor.