Instruments for investigating fitness to drive - needs and expectations in primary care: a qualitative study

Background: Primary care physicians are often requested to assess their patients' fitness to drive. Little is however known on their needs to help them in this task. Aims: The aim of this study is to develop theories on needs, expectations, and barriers for clinical instruments helping physicians assess fitness to drive in primary care. Methods: This qualitative study used semi-structured interviews to investigate needs and expectations for instruments used to assess fitness to drive. From August 2011 to April 2013, we recorded opinions from five experts in traffic medicine, five primary care physicians, and five senior drivers. All interviews were integrally transcribed. Two independent researchers extracted, coded, and stratified categories relying on multi-grounded theory. All participants validated the final scheme. Results: Our theory suggests that for an instruments assessing fitness to drive to be implemented in primary care, it need to contribute to the decisional process. This requires at least five conditions: 1) it needs to reduce the range of uncertainty, 2) it needs to be adapted to local resources and possibilities, 3) it needs to be accepted by patients, 4) choices of tasks need to adaptable to clinical conditions, 5) and interpretation of results need to remain dependant of each patient's context. Discussion and conclusions: Most existing instruments assessing fitness to drive are not designed for primary care settings. Future instruments should also aim to support patient-centred dialogue, help anticipate driving cessation, and offer patients the opportunity to freely take their own decision on driving cessation as often as possible.

Fc block treatment, dead cells exclusion, and cell aggregates discrimination concur to prevent phenotypical artifacts in the analysis of subpopulations of tumor-infiltrating CD11b(+) myelomonocytic cells.

It is well established that cancer cells can recruit CD11b(+) myeloid cells to promote tumor angiogenesis and tumor growth. Increasing interest has emerged on the identification of subpopulations of tumor-infiltrating CD11b(+) myeloid cells using flow cytometry techniques. In the literature, however, discrepancies exist on the phenotype of these cells (Coffelt et al., Am J Pathol 2010;176:1564-1576). Since flow cytometry analysis requires particular precautions for accurate sample preparation and trustable data acquisition, analysis, and interpretation, some discrepancies might be due to technical reasons rather than biological grounds. We used the syngenic orthotopic 4T1 mammary tumor model in immunocompetent BALB/c mice to analyze and compare the phenotype of CD11b(+) myeloid cells isolated from peripheral blood and from tumors, using six-color flow cytometry. We report here that the nonspecific antibody binding through Fc receptors, the presence of dead cells and cell doublets in tumor-derived samples concur to generate artifacts in the phenotype of tumor-infiltrating CD11b(+) subpopulations. We show that the heterogeneity of tumor-infiltrating CD11b(+) subpopulations analyzed without particular precautions was greatly reduced upon Fc block treatment, dead cells, and cell doublets exclusion. Phenotyping of tumor-infiltrating CD11b(+) cells was particularly sensitive to these parameters compared to circulating CD11b(+) cells. Taken together, our results identify Fc block treatment, dead cells, and cell doublets exclusion as simple but crucial steps for the proper analysis of tumor-infiltrating CD11b(+) cell populations.

Review. Precision viticulture. Research topics, challenges and opportunities in site-specific vineyard management

Precision Viticulture (PV) is a concept that is beginning to have an impact on the wine-growing sector. Its practical implementation is dependant on various technological developments: crop sensors and yield monitors, local and remote sensors, Global Positioning Systems (GPS), VRA (Variable-Rate Application) equipment and machinery, Geographic Information Systems (GIS) and systems for data analysis and interpretation. This paper reviews a number of research lines related to PV. These areas of research have focused on four very specific fields: 1) quantification and evaluation of within-field variability, 2) delineation of zones of differential treatment at parcel level, based on the analysis and interpretation of this variability, 3) development of Variable-Rate Technologies (VRT) and, finally, 4) evaluation of the opportunities for site-specific vineyard management. Research in these fields should allow winegrowers and enologists to know and understand why yield variability exists within the same parcel, what the causes of this variability are, how the yield and its quality are interrelated and, if spatial variability exists, whether site-specific vineyard management is justifiable on a technical and economic basis.

Role of immune and angiogenic markers in the pathology of endometriosis

Background: Endometriosis is an estrogen-dependent, pro-inflammatory, pro-angiogenic condition that affects 5 to 10% of women of reproductive age. Its defining feature is the presence of endometrium-like tissue in sites outside the uterine cavity, primarily on the pelvic peritoneum and ovaries. The main clinical features are chronic pain, pain during intercourse and infertility. In patients with endometriosis, inflammatory and immune responses, angiogenesis and apoptosis are altered in favour of the survival and replenishment of endometriotic tissue. These basic pathological processes depend on the excessive formation of estrogen and prostaglandins. Recently, new cellular and molecular mechanisms for the resolution of inflammation have been discovered, revealing key roles for lipid mediators such as lipoxins, resolvins and protectins. It is possible that disequilibrium in the expression of these molecules exists in endometriosis. Objective: To compare the expression of two proteins involved in the synthe sis and in the function of lipid mediators; the Arachidonate 15-lipoxygenase (ALOXI5), implicated in the synthesis of lipoxins A4 and B4 and the Formyl peptide receptor 1 (FPRLI), the specific receptor for Lipoxin A4 and B4, between women who suffer from endometriosis and a control group. We wish to demonstrate the cellular localisation of these two molecules and to investigate if their expression is alteted in this pathology. Methods and Materials Using immunohistochemistry we will compare ALOXI5 and FPRLI staining, in endometrium, normal peritoneum and endometriotic lesions. The samples are being collected in the department of Gynaecology and Obstetrics at the Centre Hospitalier Universitaire Lausanne (CHUV). Women attending the department for laparoscopic investigation of pain/infertility, suspected endometriosis or for a hysterectomy, are invited to participate. Approval of the ethics committee (Commission d'Ethique de la recherché clinique) was obtained in March 2009. Clinical samples will only be obtained from subjects having consented. Expected results and interpretation: No published studies investigating the expression of these two molecules in endometriotic lesions exist. A better understanding of the mechanisms underlying this disease will result in the development of new medical therapies and new diagnostic tests, with the aim of ameliorating the quality of life of endometriosis patients.

Thermal behaviour study of solid state compounds of manganese (II), zinc (II) and lead (II) with cinnamic acid

Compounds of cinnamic acid with manganese, zinc and lead have been prepared in aqueous solution. Thermogravimetry, derivative thermogravimetry (TG, DTG), differential scanning calorimetry (DSC), X-ray diffraction and complexometry have been used in the characterization as well as in the study of the thermal stability and interpretation concerning the thermal decomposition.

Strategic communication : practice, ideology and dissonance

This dissertation approaches the manifestations of ideology in U.S. Strategic Communication. The discussion approaches Strategic Communication by relating it to the Enlightenment narratives and suggesting these narratives maintain similar social and political functions. This dissertation aims to address the key contents and mechanisms of Strategic Communication by covering the perspectives of (i) communication as leadership as well as (ii) communication as discourse , i.e. practice and contents. Throughout the empirical part of the dissertation, the communication theoretical discussion is supported by a methodological framework that bridges Critical Discourse Analysis (CDA) and functional language theory. According to the principles of CDA, Strategic Communication is treated as ideological, hegemonic discourse that impacts social order. The primary method of analysis is transitivity analysis, which is concerned with how language and its patterns construe reality. This analysis is complemented with a discussion on the rituals of production and interpretation, which can be treated as visual extensions of textual transitivity. The concept of agency is the key object of analysis. From the perspective of leadership, Strategic Communication is essentially a leadership model through which the organization defines itself, its aims and legitimacy. This dissertation arrives to the conclusion that Strategic Communication is used not only as a concept for managing Public Relations and information operations. It is an esse ntial asset in the inter-organization management of its members. The current developments indicate that the concept is developing towards even heavier measures of control. From the perspective of language and discourse, the key narratives of Strategic Communication are advocated with the intrinsic values of democracy and technological progress as the prerequisites of ethics and justice. The transitivity patterns reveal highly polarized agency. The agency of the Self is typically outsourced to technology. Further, the transitivity pa tterns demonstrate how the effects-centric paradigm of warfare has created a lexicon that is ideologically exclusive. It has led to the development of two mutually exclusive sets of vocabulary, where the desc riptions of legitimate ac tion exclude Others by default. These ideological discourses have become naturalized in the official vocabulary of strategic planning and le adership. Finally, the analysis of the images of the captures and deaths of Saddam Hussein, Osama bin Laden and Muammar Gaddafi bring the discussion back to the themes of the Enlightenment by demonstrating how democracy is framed to serve political purposes. The images of democracy are essentially images of violence. Contrary to the official, instrumental and humanitari an narratives of Strategic Communication, it is the grammar of expressive, violent rituals that serve as the instrument of unity.

Effects of Cinnamon extract on biochemical enzymes, TNF-α and NF-κB gene expression levels in liver of broiler chickens inoculated with Escherichia coli

Abstract: Infection with Escherichia coli (E. coli) is a common disease in poultry industry. The use of antibiotics to treat diseases is facing serious criticism and concerns. The medicinal plants may be effective alternatives because of their multiplex activities. The aim of this study was to investigate the effects of cinnamon extract on the levels of liver enzymes, tumor necrosis factor-alpha (TNF-α) and nuclear factor-kappa B (NF-κB) gene expressions in liver of broiler chickens infected with E. coli. Ninety Ross-308 broilers were divided into healthy or E. coli-infected groups, receiving normal or cinnamon extract (in concentrations of 100 or 200mg/kg of food) supplemented diets. E. coli suspension (108cfu) was injected subcutaneously after 12 days cinnamon administration. Seventy-two hours after E. coli injection, the blood samples were taken for biochemical analysis of liver enzymes in serum (spectrophotometrically), and liver tissue samples were obtained for detection of gene expression of inflammatory markers TNF-α and NF-κB, using real-time PCR. Infection with E. coli significantly increased the levels of TNF-α and NF-κB gene expressions as well as some liver enzymes including creatine-kinase (CK), lactate-dehydrogenase (LDH), alanine-transferase (ALT) and aspartate-transferase (AST) as compared with control group (P<0.05). Pre-administration of cinnamon extract in broilers diet (in both concentrations) significantly reduced the tissue levels of TNF-α and NF-κB gene expressions and enzymes CK and ALT in serum of broiler chickens inoculated with E. coli in comparison with E. coli group (P<0.05 and P<0.01). The levels of LDH and AST were significantly decreased only by 200mg/kg cinnamon extract in infected broilers. The level of alkaline-phosphatase (ALP) was not affected in any groups. Pre-administration of cinnamon extract in diets of broiler chickens inoculated with E. coli could significantly reduce the gene expression levels of pro-inflammatory mediators and liver enzymes activities, thereby protecting the liver against this pathologic condition.

Effect of race, genetic population structure, and genetic models in two-locus association studies: clustering of functional renin-angiotensin system gene variants in hypertension association studies

Previous genetic association studies have overlooked the potential for biased results when analyzing different population structures in ethnically diverse populations. The purpose of the present study was to quantify this bias in two-locus association studies conducted on an admixtured urban population. We studied the genetic structure distribution of angiotensin-converting enzyme insertion/deletion (ACE I/D) and angiotensinogen methionine/threonine (M/T) polymorphisms in 382 subjects from three subgroups in a highly admixtured urban population. Group I included 150 white subjects; group II, 142 mulatto subjects, and group III, 90 black subjects. We conducted sample size simulation studies using these data in different genetic models of gene action and interaction and used genetic distance calculation algorithms to help determine the population structure for the studied loci. Our results showed a statistically different population structure distribution of both ACE I/D (P = 0.02, OR = 1.56, 95% CI = 1.05-2.33 for the D allele, white versus black subgroup) and angiotensinogen M/T polymorphism (P = 0.007, OR = 1.71, 95% CI = 1.14-2.58 for the T allele, white versus black subgroup). Different sample sizes are predicted to be determinant of the power to detect a given genotypic association with a particular phenotype when conducting two-locus association studies in admixtured populations. In addition, the postulated genetic model is also a major determinant of the power to detect any association in a given sample size. The present simulation study helped to demonstrate the complex interrelation among ethnicity, power of the association, and the postulated genetic model of action of a particular allele in the context of clustering studies. This information is essential for the correct planning and interpretation of future association studies conducted on this population.

Disabled legislators : disability and Irish colonial pathology in James Joyce's Ulysses

Why are there so many disabled characters in James Joyce's Ulysses? "Disabled Legislators" seeks to answer this question by exploring the variety and depth of disability's presence in Joyce's novel. This consideration also recognizes the unique place disability finds within what Lennard Davis calls "the roster of the disenfranchised" in order to define Joyce as possessing a "disability consciousness;" that is, an empathetic understanding (given his own eye troubles) of the damaged lives of the disabled, the stigmatization of the disabled condition, and the appropriation of disabled representations by literary works reinforcing normalcy. The analysis of four characters (Gerty MacDowell, the blind stripling, the onelegged sailor, and Stephen Dedalus) treats disability as a singular self-concept, while still making necessary associations to comparably created marginal identities-predominantly the colonial Other. This effort reevaluates how Ulysses operates in opposition to liberal Victorian paradigms, highlighting disability's connections to issues of gender, intolerance, self-identification and definition.

The Ontario Municipal Freedom of Information and Protection of Individual Privacy Act: an analysis of its application to school boards

In Canada freedom of information must be viewed in the context of governing -- how do you deal with an abundance of information while balancing a diversity of competing interests? How can you ensure people are informed enough to participate in crucial decision-making, yet willing enough to let some administrative matters be dealt with in camera without their involvement in every detail. In an age when taxpayers' coalition groups are on the rise, and the government is encouraging the establishment of Parent Council groups for schools, the issues and challenges presented by access to information and protection of privacy legislation are real ones. The province of Ontario's decision to extend freedom of information legislation to local governments does not ensure, or equate to, full public disclosure of all facts or necessarily guarantee complete public comprehension of an issue. The mere fact that local governments, like school boards, decide to collect, assemble or record some information and not to collect other information implies that a prior decision was made by "someone" on what was important to record or keep. That in itself means that not all the facts are going to be disclosed, regardless of the presence of legislation. The resulting lack of information can lead to public mistrust and lack of confidence in those who govern. This is completely contrary to the spirit of the legislation which was to provide interested members of the community with facts so that values like political accountability and trust could be ensured and meaningful criticism and input obtained on matters affecting the whole community. This thesis first reviews the historical reasons for adopting freedom of information legislation, reasons which are rooted in our parliamentary system of government. However, the same reasoning for enacting such legislation cannot be applied carte blanche to the municipal level of government in Ontario, or - ii - more specifially to the programs, policies or operations of a school board. The purpose of this thesis is to examine whether the Municipal Freedom of Information and Protection of Privacy Act, 1989 (MFIPPA) was a neccessary step to ensure greater openness from school boards. Based on a review of the Orders made by the Office of the Information and Privacy Commissioner/Ontario, it also assesses how successfully freedom of information legislation has been implemented at the municipal level of government. The Orders provide an opportunity to review what problems school boards have encountered, and what guidance the Commissioner has offered. Reference is made to a value framework as an administrative tool in critically analyzing the suitability of MFIPPA to school boards. The conclusion is drawn that MFIPPA appears to have inhibited rather than facilitated openness in local government. This may be attributed to several factors inclusive of the general uncertainty, confusion and discretion in interpreting various provisions and exemptions in the Act. Some of the uncertainty is due to the fact that an insufficient number of school board staff are familiar with the Act. The complexity of the Act and its legalistic procedures have over-formalized the processes of exchanging information. In addition there appears to be a concern among municipal officials that granting any access to information may be violating personal privacy rights of others. These concerns translate into indecision and extreme caution in responding to inquiries. The result is delay in responding to information requests and lack of uniformity in the responses given. However, the mandatory review of the legislation does afford an opportunity to address some of these problems and to make this complex Act more suitable for application to school boards. In order for the Act to function more efficiently and effectively legislative changes must be made to MFIPPA. It is important that the recommendations for improving the Act be adopted before the government extends this legislation to any other public entities.

Electrophysiological and behavioural correlates of facial identity and expression perception deficits following a closed head injury /

A large variety of social signals, such as facial expression and body language, are conveyed in everyday interactions and an accurate perception and interpretation of these social cues is necessary in order for reciprocal social interactions to take place successfully and efficiently. The present study was conducted to determine whether impairments in social functioning that are commonly observed following a closed head injury, could at least be partially attributable to disruption in the ability to appreciate social cues. More specifically, an attempt was made to determine whether face processing deficits following a closed head injury (CHI) coincide with changes in electrophysiological responsivity to the presentation of facial stimuli. A number of event-related potentials (ERPs) that have been linked specifically to various aspects of visual processing were examined. These included the N170, an index of structural encoding ability, the N400, an index of the ability to detect differences in serially presented stimuli, and the Late Positivity (LP), an index of the sensitivity to affective content in visually-presented stimuli. Electrophysiological responses were recorded while participants with and without a closed head injury were presented with pairs of faces delivered in a rapid sequence and asked to compare them on the basis of whether they matched with respect to identity or emotion. Other behavioural measures of identity and emotion recognition were also employed, along with a small battery of standard neuropsychological tests used to determine general levels of cognitive impairment. Participants in the CHI group were impaired in a number of cognitive domains that are commonly affected following a brain injury. These impairments included reduced efficiency in various aspects of encoding verbal information into memory, general slower rate of information processing, decreased sensitivity to smell, and greater difficulty in the regulation of emotion and a limited awareness of this impairment. Impairments in face and emotion processing were clearly evident in the CHI group. However, despite these impairments in face processing, there were no significant differences between groups in the electrophysiological components examined. The only exception was a trend indicating delayed N170 peak latencies in the CHI group (p = .09), which may reflect inefficient structural encoding processes. In addition, group differences were noted in the region of the N100, thought to reflect very early selective attention. It is possible, then, that facial expression and identity processing deficits following CHI are secondary to (or exacerbated by) an underlying disruption of very early attentional processes. Alternately the difficulty may arise in the later cognitive stages involved in the interpretation of the relevant visual information. However, the present data do not allow these alternatives to be distinguished. Nonetheless, it was clearly evident that individuals with CHI are more likely than controls to make face processing errors, particularly for the more difficult to discriminate negative emotions. Those working with individuals who have sustained a head injury should be alerted to this potential source of social monitoring difficulties which is often observed as part of the sequelae following a CHI.

Photograph - Julia Canby Cleveland with doll

Black and white photograph, 23 cm x 18 cm copy of Julia Canby Cleveland and her doll which has been reprinted from the daguerreotype. This is accompanied by notes (1970) from R. W. Band.

Adopter Tchekhov : étude sociolinguistique de trois traductions québécoises d'Oncle Vania (1983-2001)

Réalisé en codirection avec Hélène Buzelin

Multichannel Remote Data Acquisition and Analysing Systems For Fisheries / Environmental Investigations

Remote Data acquisition and analysing systems developed for fisheries and related environmental studies have been reported. It consists of three units. The first one namely multichannel remote data acquisition system is installed at the remote place powered by a rechargeable battery. It acquires and stores the 16 channel environmental data on a battery backed up RAM. The second unit called the Field data analyser is used for insitue display and analysis of the data stored in the backed up RAM. The third unit namely Laboratory data analyser is an IBM compatible PC based unit for detailed analysis and interpretation of the data after bringing the RAM unit to the laboratory. The data collected using the system has been analysed and presented in the form of a graph. The system timer operated at negligibly low current, switches on the power to the entire remote operated system at prefixed time interval of 2 hours.Data storage at remote site on low power battery backedupRAM and retrieval and analysis of data using PC are the special i ty of the system. The remote operated system takes about 7 seconds including the 5 second stabilization time to acquire and store data and is very ideal for remote operation on rechargeable bat tery. The system can store 16 channel data scanned at 2 hour interval for 10 days on 2K backed up RAM with memory expansion facility for 8K RAM.