Innovations dans les traitements des troubles de la personnalité: une lecture integrative

L'interaction thérapeutique avec les patients présentant un trouble de la personnalité a été décrite comme difficile et volatile. Récemment, les thérapies cognitivo-comportementales (TCC) s'approchent de ces difficultés par des traitements manualisés et des modélisations complexes, ce qui tend à laisser dans l'ombre l'acteur principal du changement en psychothérapie : le patient. La présente lecture intégrative discute plusieurs mécanismes de changement actifs chez les patients avec trouble de la personnalité. Premièrement, il est décrit que les problèmes d'interaction, résumés sous le terme des jeux interactionnels, posent des défis spécifiques. Le thérapeute est ainsi amené à favoriser une interaction thérapeutique authentique, en utilisant notamment une forme individualisée d'intervention, la relation thérapeutique centrée sur les motifs. Deuxièmement, il est décrit que les problèmes de conscience et de différenciation émotionnelles entravent la qualité du traitement des troubles de la personnalité. Le thérapeute est ainsi conseillé d'utiliser des techniques empruntées aux thérapies néo-humanistes, notamment la directivité de processus, afin d'approfondir l'affect émergeant en séance. Troisièmement, il a été décrit qu'une identité sociale affirmée fait souvent défaut chez les patients avec trouble de la personnalité. Les thérapeutes avisés peuvent favoriser ce processus avec des interventions ciblées. En conclusion, une focalisation sur les comportements observables du patient - les processus réels en séance -, est productive, et elle permet au thérapeute d'affiner, de préciser et d'approfondir son intervention, au plus près du patient.

Preliminary epidemiological study of latent tuberculosis in Mexican agricultural workers in the Niagara region, Canada

It is well documented that the majority of Tuberculosis (TB) cases diagnosed in Canada are related to foreign-bom persons from TB high-burden countries. The Canadian seasonal agricultural workers program (SAWP) operating with Mexico allows migrant workers to enter the country with a temporary work permit for up to 8 months. Preiimnigration screening of these workers by both clinical examination and chest X-ray (CXR) reduces the risk of introducing cases of active pulmonary TB to Canada, but screening for latent TB (LTBI) is not routinely done. Studies carried out in industrialized nations with high immigration from TBendemic countries provide data of lifetime LTBI reactivation of around 10% but little is known about reactivation rates within TB-endemic countries where new infections (or reinfections) may be impossible to distinguish from reactivation. Migrant populations like the SAWP workers who spend considerable amounts of time in both Canada and TBendemic rural areas in Mexico are a unique population in terms of TB epidemiology. However, to our knowledge no studies have been undertaken to explore either the existence of LTBI among Mexican workers, the probability of reactivation or the workers' exposure to TB cases while back in their communities before returning the following season. Being aware of their LTBI status may help workers to exercise healthy behaviours to avoid TB reactivation and therefore continue to access the SAWP. In order to assess the prevalence of LTBI and associated risk factors among Mexican migrant workers a preliminary cross sectional study was designed to involve a convenience sample of the Niagara Region's Mexican workers in 2007. Research ethics clearance was granted by Brock University. Individual questionnaires were administered to collect socio-demographic and TB-related epidemiological data as well as TB knowledge and awareness levels. Cellular immunity to M tuberculosis was assessed by both an Interferon-y release assay (lGRA), QuantiFERON -TB Gold In-Tube (QFf™) and by the tuberculin skin test (TSn using Mantoux. A total of 82 Mexican workers (out of 125 invited) completed the study. Most participants were male (80%) and their age ranged from 22 to 65 years (mean 38.5). The prevalence of LTBI was 34% using TST and 18% using QFTTM. As previously reported, TST (using ~lOmm cut-off) showed a sensitivity of 93.3% and a specificity of 79.1 %. These findings at the moment cannot predict the probability of progression to active TB; only longitudinal cohort studies of this population can ascertain this outcome. However, based on recent publications, lORA positive individuals may have up to 14% probability of reactivation within the next two years. Although according to the SA WP guidelines, all workers undergo TB screening before entering or re-entering Canada, CXR examination requirements showed to be inconsistent for this population: whereas 100% of the workers coming to Canada for the first time reported having the procedure done, only 31 % of returning participants reported having had a CXR in the past year. None of the participants reported ever having a CXR compatible with TB which was consistent with the fact that none had ever been diagnosed with active pulmonary TB and with only 3.6% reporting close contact with a person with active TB in their lifetime. Although Mexico reports that 99% of popUlation is fully immunized against TB within the first year of age, only 85.3% of participants reported receiving BOC vaccine in childhood. Conversely, even when TST is not part of the routine TB screening in endemic countries, a suqDrisingly high 25.6% reported receiving a TST in the past. In regards to TB knowledge and awareness, 74% of the studied population had previous knowledge about (active) TB, 42% correctly identified active TB symptomatology, 4.8% identified the correct route of transmission, 4.8% knew about the existence of LTBI, 3.6% knew that latent TB could reactivate and 48% recognized TB as treatable and curable. Of all variables explored as potential risk factors for LTBI, age was the only one which showed statistical significance. Significant associations could not be proven for other known variables (such as sex, TB contact, history of TB) probably because of the small sample size and the homogeneity of the sample. Screening for LTBI by TST (high sensitivity) followed by confirmation with QFT''"'^ (high specificity) suggests to be a good strategy especially for immigrants from TB high-burden countries. After educational sessions, workers positive for LTBI gained greater knowledge about the signs and symptoms of TB reactivation as well as the risk factors commonly associated with reactivation. Additionally, they were more likely to attend their annual health check up and request a CXR exam to monitor for TB reactivation.

A survey of attitudes of agricultural society leaders toward leadership development education

It was the purpose of this study to investigate attitudes toward leadership development education of one client group served by the ontario Ministry of Agriculture and Food. The survey, answered by 175 participants, attempted to answer the following questions: (a) What is a common definition of leadership?, (b) What leadership concepts are important to leadership development education? and, (c) What are client attitudes toward leadership development education? A descriptive research approach was used and the data were analyzed according to a model developed by Colaizzi. Concept maps were developed under the broad areas of: (a) Developing leader qualities; (b) Past experiences that developed leadership skills that worked on the jOb; (c) Leadership skills developed from present day positions; and (d) How leadership skills may be developed in future situations. A description of the dynamics of leadership development was written and the essential dynamics of leadership skill development in one volunteer organization was described. This study supports the linkages perspective of leadership within voluntary organizations developed by Vandenberg, Thullen and Fear (1987). The linkages perspective consists of three major components: perception, property and process. As a perception, leadership is the set of beliefs each group member holds regarding the behaviours and qualities characteristic of effective leaders. As a property, leadership represents the qualities attributed by group members to persons perceived as effectively (or potentially) influencing the goal achievement process. As a process, leadership involves the use of non-coercive influence to facilitate group accomplishment of valued goals. Leadership concepts important for development in a leadership development education program related to personal, organizational and societal development. The top five concepts in terms of rank order are communicating effectively, forming and working with groups, working creatively (tie), developing followers, managing meetings, directing projects or activities, understanding financial matters, managing negotiations (tie), developing resources and understanding and developing oneself (tie). Several recommendations are relevant for extension personnel as educators. Theoretical concepts on leadership need to be shared to extension practitioners involved in leadership development. currently used teaching materials for leadership development should be evaluated to see if they include concepts from preferrred theoretical leadership perceptions.

Vitamin D status and latent tuberculosis infection : a preliminary study in a group of healthy Mexican agricultural workers

Vitamin D metabolites are important in the regulation of bone and calcium homeostasis, but also have a more ubiquitous role in the regulation of cell differentiation and immune function. Severely low circulating 25-dihydroxyvitamin D [25(OH)D] concentrations have been associated with the onset of active tuberculosis (TB) in immigrant populations, although the association with latent TB infection (LTBI) has not received much attention. A previous study identified the prevalence of LTBI among a sample of Mexican migrant workers enrolled in Canada's Seasonal Agricultural Workers Program (SA WP) in the Niagara Region of Ontario. The aim of the present study was to determine the vitamin D status of the same sample, and identify if a relationship existed with LTBI. Studies of vitamin D deficiency and active TB are most commonly carried out among immigrant populations to non-endemic regions, in which reactivation of LTBI has occurred. Currently, there is limited knowledge of the association between vitamin D deficiency and LTBI. Entry into Canada ensured that these individuals did not have active TB, and L TBI status was established previously by an interferon-gamma release assay (IGRA) (QuantiFERON-TB Gold In-Tube®, Cellestis Ltd., Australia). Awareness of vitamin D status may enable individuals at risk of deficiency to improve their nutritional health, and those with LTBI to be aware of this risk factor for disease. Prevalence of vitamin D insufficiency among the Mexican migrant workers was determined from serum samples collected in the summer of 2007 as part of the cross sectional LTBI study. Samples were measured for concentrations of the main circulating vitamin D metabolite, 25(OH)D, with a widely used 1251 250HD RIA (DiaSorin Inc.®, Stillwater, MN), and were categorized as deficient «37.5 nmoI/L), insufficient (>37.5 nmollL, < 80 nmol/L) or sufficient (2::80 nmoI/L). Fisher's exact tests and t tests were used to determine if vitamin D status (sufficiency or insufficiency) or 25(OH)D concentrations significantly differed by sex or age categories. Predictors of vitamin D insufficiency and 25(OH)D concentrations were taken from questionnaires carried out during the previous study, and analyzed in the present study using multiple regression prediction models. Fisher's exact test and t test was used to determine if vitamin D status or 25(OH)D concentration differed by LTBI status. Strength of the relationship between interferongamma (IFN-y) concentration (released by peripheral T cells in response to TB antigens) and 25(OH)D concentration was analyzed using a Spearman correlation. Out of 87 participants included in the study (78% male; mean age 38 years), 14 were identified as LTBI positive but none had any signs or symptoms of TB reactivation. Only 30% of the participants were vitamin D sufficient, whereas 68% were insufficient and 2% were deficient. Significant independent predictors of lower 25(OH)D concentrations were sex, number of years enrolled in the SA WP and length of stay in Canada. No significant differences were found between 25(OH)D concentrations and LTBI status. There was a significant moderate correlation between IFN-y and 25(OH)D concentrations ofLTBI-positive individuals. The majority of participants presented with Vitamin D insufficiency but none were severely deficient, indicating that 25(OH)D concentrations do not decrease dramatically in populations who temporarily reside in Canada but go back to their countries of origin during the Canadian winter. This study did not find a statistical relationship between low levels of vitamin D and LTBI which suggests that in the presence of overall good health, lower than ideal levels of 2S(OH)D, may still be exerting a protective immunological effect against LTBI reactivation. The challenge remains to determine a critical 2S(OH)D concentration at which reactivation is more likely to occur.

Competing and Conflicting Land Uses at the Rural-Urban Interface: Understanding the Impacts of Residential Development on Agricultural Landscapes

Rural communities are currently undergoing rapid restructuring as globalization impacts the future viability of many small towns. Agricultural regions throughout Canada, in particular, Niagara-on-the-Lake, are forced to adapt to changes within the industry. In addition to these challenges, sprawling residential developments from nearby urban centres are changing the dynamic of this town, resulting in conflicts between the residential and agricultural land uses. This thesis explores these conflicts from the perspective of the residents and the farmers. It was found that the initial sources of conflict related to noise-generating farm activities are no longer a concern, while the use of pesticide have become a source of contention among the residents. The farmers, alternately, were found to be proactive and strived to limit the potential for conflict with adjacent residents. Lastly, it was determined that planning legislation aggravates land use conflicts within Niagara-on-the-Lake and need to better address these land use conflicts.

Preservation of Agricultural Lands Society (PALS) fonds, 1954-2015, n.d.

Preservation of Agricultural Lands Society [PALS] held its first meeting at Brock University on June 21, 1976. Its first executive consisted of Robert Hoover, Rick Teather, Debbie Kehler and Bill Forster. Some objectives of the organization were "to seek the preservation of valuable farm areas from non-agricultural expansion and development and to foster development and support of federal, provinicial and local policy which will provide a secure financial future for farming." Gracia Janes and John Bacher are some of the organizations' well known advocates. The organization was active in raising public awareness of the issues surrounding encroaching development onto existing agricultural lands. The organization is still active today [2016] in educating the public and attempting to influence governments at all levels to protect valuable agricultural lands.

Letter to A.K. Boomer of the Niagara District Agricultural Society, 1845

Mr. Graham of the Bertie Agricultural Society is writing to obtain information from A.K. Boomer of the Niagara District Agricultural Society. The Niagara District Agricultural Society was established in 1793. Regular meetings and annual fairs were held by the society.

Outlines of a System of polítical Economy; written with a view to prove to government and the country, that the cause of the present agricultural distress is entirely artificial..

UANL

The Effect of Agricultural Zoning on Land Prices, Quebec, 1975-1981

Dans Ce Texte Nous Examinons les Effets de la Loi du Zonage Agricole du Quebec, Proclame En Decembre 1978 Sur le Prix du Sol Dans une Banlieu de Montreal. a L'aide de Donnees Sur les Transactions Normales Faites a Carignan et Saint-Mathias de 1975 a 1981, Nous Estimons, a L'aide des Moindres Carrees Ordinaires, une Equation de Determination du Prix Par Acre Avec Comme Variables Independantes la Dimension du Lot, la Distance de Montreal, les Services Disponibles (Egouts,...) et le Zonage Agricole (Ou Non) du Sol. Nos Resultats Nous Indiquent Que le Zonage Agricole Reduit le Prix D'un Acre de Sol.

Land Ownership, Working Capital, and the Agricultural Output: Egypt, 1913-1958.

A simple model is constructed in which short-term credit is needed to finance the purchase of inputs, in which there is bankruptcy risk, and in which we argue were important characteristics of Egyptian agriculture during the first half of this century, result in aggregate agricultural output being dependant on the distribution of land ownership. The main theorical insight is that aggregate agricultural output will be increased by a decrease in the inequality of the distribution of land ownership when returns to scale are decreasing. Testable short- and long-run empirical propositions are formulated and carefully tested on Egyptian data for the 1913-1958 period. We find that, controlling for factor inputs, there is no tradeoff between equity and efficiency for Egyptian agriculture - they go hand in hand in the short run.

The Alberta Dilemma: Optimal Sharing of a Water Resource by an Agricultural and an Oil Sector

The purpose of this paper is to characterize the optimal time paths of production and water usage by an agricultural and an oil sector that have to share a limited water resource. We show that for any given water stock, if the oil stock is sufficiently large, it will become optimal to have a phase during which the agricultural sector is inactive. This may mean having an initial phase during which the two sectors are active, then a phase during which the water is reserved for the oil sector and the agricultural sector is inactive, followed by a phase during which both sectors are active again. The agricultural sector will always be active in the end as the oil stock is depleted and the demand for water from the oil sector decreases. In the case where agriculture is not constrained by the given natural inflow of water once there is no more oil, we show that oil extraction will always end with a phase during which oil production follows a pure Hotelling path, with the implicit price of oil net of extraction cost growing at the rate of interest. If the natural inflow of water does constitute a constraint for agriculture, then oil production never follows a pure Hotelling path, because its full marginal cost must always reflect not only the imputed rent on the finite oil stock, but also the positive opportunity cost of water.

Land Ownership, Working Capital, and the Agricultural Output: Egypt, 1913-1958.

A simple model is constructed in which short-term credit is needed to finance the purchase of inputs, in which there is bankruptcy risk, and in which we argue were important characteristics of Egyptian agriculture during the first half of this century, result in aggregate agricultural output being dependant on the distribution of land ownership. The main theorical insight is that aggregate agricultural output will be increased by a decrease in the inequality of the distribution of land ownership when returns to scale are decreasing. Testable short- and long-run empirical propositions are formulated and carefully tested on Egyptian data for the 1913-1958 period. We find that, controlling for factor inputs, there is no tradeoff between equity and efficiency for Egyptian agriculture - they go hand in hand in the short run.

Débat public sur la valeur sociale des innovations médicales : l'expérience d'un Café scientifique

Les innovations médicales ont un impact considérable sur les pratiques cliniques, sur la formulation des politiques et sur les attentes du public envers le système de santé. Dans un contexte de système de santé public, les conséquences économiques importantes des innovations médicales freinent grandement leur adoption alors qu’elles sont souvent représentées dans les médias comme étant hautement désirables. Une telle définition de la problématique limite le débat sur ce qui rend les innovations sociales et technologiques en santé pertinentes d’un point de vue de santé des populations. Il apparaît donc intéressant de tirer profit d’une pratique communicationnelle innovante, le Café scientifique. Ce projet de recherche analyse un Café scientifique ayant mis en scène en mars 2007 un échange entre quatre experts et environ 80 membres du public autour des enjeux relatifs aux innovations en santé. Les objectifs sont : 1) analyser l’application d’une intervention de type Café scientifique; et 2) analyser ses retombées sur les participants. Cette étude de cas unique s’appuie sur des données qualitatives et quantitatives: 1) observation semi-participative; 2) enregistrement audiovisuel de l’activité; 3) questionnaires distribués à la fin de l’activité; et 4) entrevues semi-dirigées (n=11) avec des participants. L’analyse intégrée de ces données permet de mieux comprendre comment le contexte est structurant pour le débat, décrit les principaux rôles adoptés par les participants lors des échanges, identifie les principaux enjeux relatifs aux innovations médicales qui ont été débattus et dégage les dynamiques qui favorisent ou nuisent à un dialogue entre des scientifiques et le public. Le Café scientifique est une pratique encore peu répandue, mais qui suscite un intérêt à la fois chez les chercheurs et les participants.