Adhésion thérapeutique en oncologie : persistance, qualité d'exécution et satisfaction des patients sous traitement oral et MEMS®

Introduction: en oncologie apparaissent sur le marché depuis quelques années de nouveaux traitements en formulation orale facilitant l'administration et améliorant la qualité de vie du patient mais augmentant le risque de non adhésion et d'erreurs de posologie. L'observation par MEMS® (Medication Event Monitoring System) permet le suivi et l'encadrement du traitement oral et par le biais d'entretiens semi structurés menés par le pharmacien, ouvre la discussion sur les problèmes révélés par cette prise en charge. Méthode: étude non randomisée prospective uni centrique regroupant 50 patients inclus dans 3 groupes de traitements oncologiques oraux courants (capecitabine, letrozole/exemestane, imatinib/sunitinib) bénéficiant d'un suivi oncologique classique et équipés d'un MEMS® pour un an maximum. La persistance et la qualité d'exécution sont les deux paramètres mesurés grâce aux données récoltées électroniquement. Les entretiens sont dédiés à la prévention de la non adhésion et à la gestion des effets secondaires médicamenteux. La satisfaction est évaluée par un questionnaire à la fin du suivi. Résultats: à ce jour 38 patients ont été inclus dans l'étude. Les données complètes sont disponibles pour les 19 premiers patients dont 10 sous capecitabine et 9 sous letrozole/exemestane. Dans ce collectif l'âge médian est de 66 ans avec une majorité de femmes (11:8). La persistance à 10 jours est de 85% et la qualité d'exécution de 99%. Les toxicités observées supérieures à grade 1 sont 1 syndrome mains-pieds (G3) et 1 syndrome coronarien aigu (G3). Le questionnaire de fin de suivi relève une satisfaction de 85% des patients pour les entretiens proposés (57% utiles, 28% très utiles, 15% inutiles) et le succès quant à l'intégration du MEMS® dans leur quotidien (57% très facile, 43% facile). Conclusion: la persistance et la qualité d'exécution observées dans notre collectif sont excellentes. La satisfaction retrouvée auprès des patients reflète le besoin d'un soutien complémentaire face à la complexité de la maladie oncologique. La gestion pluridisciplinaire profite tant aux patients qu'au binôme médecin-pharmacien par l'amélioration de la communication globale entre les divers acteurs et par l'identification précoce des risques de non adhésion. La poursuite de cette étude et l'analyse des futures données permettra de mesurer le réel impact de notre intervention et de justifier le bénéfice pour des patients sous traitement similaire.

Oral pregabalin as an add-on treatment for status epilepticus.

Oral antiepileptic drugs (AEDs) represent possible add-on options in refractory status epilepticus (SE). In this setting, pregabalin (PGB) has not been reported before. Over the last 42 months, we identified 11 SE episodes (10 patients) treated with PGB in our hospital. Its use was prompted by the favorable pharmacokinetic profile, devoid of drug-drug interactions. The patients mostly had refractory, partial SE. Only two patients were managed in the intensive care unit (ICU). We found a definite electroclinical response in 5 of 11, already evident 24 h after PGB introduction, and a possible response (concomitantly with other AEDs) in 3 of 11 of the episodes; 3/11 did not respond. The treatment was well tolerated. Partial SE appeared to better respond than generalized convulsive SE. PGB appears to be an interesting option as add-on treatment in refractory partial SE.

presentación escrita y oral del plan de empresa

Desarrollo empresarial y creación de empresa

Improving the oral health status of functionally independent and dependent seniors residing in long-term care facilities through dental hygiene education /

The purpose of this study was to evaluate the oral health status of residents residing in 2 long-term care facilities and determine if dental hygiene education was required in order to improve their current oral health. The oral health status of 6 independent and 4 dependent individuals residing in 2 long-term care facilities was evaluated. In addition, the current oral health and disease prevention practices employed by 4 caregivers who were responsible for providing oral care to dependent residents in the long-term care facilities were evaluated. Furthermore, an evaluation of the oral care practices of independent residents who were responsible for providing their own care was conducted. Finally, the challenges that caregivers and independent residents faced when performing oral care were determined, and methodological changes were proposed. Using a generic qualitative research methodology, data collection was comprised of semi structured interviews, field observations, and documentation. The oral health status of the residents was reevaluated 3 months later. The findings of this study demonstrated an increase in plaque accumulation, gingival inflammation, and unhealthy gingival tissue colour changes among the residents over the 3-month period. The study revealed that poor oral health among the residents was a result of inadequate oral hygiene care techniques, difficulties accessing oral health care, financial limitations, insufficient care staff, insufficient time for personal care duties, lack of professional development, minimal interprofessional collaboration of health disciplines, and lack of perseverance on the part of the caregivers and residents. Overall, oral health is essential, and maintaining optimal oral health requires increased collaboration and communication between health care providers.

Using dramatic activity to enhance Junior Core French students' motivation and oral communication skills /

Junior Core French students' motivation to learn a second language and students' French oral communication skills relating to drama instruction were investigated in this study. Students' increased and improved motivation and oral acquisition were measured by several forms of data collection including journals, questionnaires and surveys, interviews, outside observer and teacher observations, and anecdotal comments. The results indicated that as a result of drama integration in the Junior Core French classroom, grade 5 students, both male and female, were more motivated to participate in second language instruction, thereby increasing and improving their oral communication skills. The findings showed that more males than females reported that drama integration allowed them the opportunity to use their French speaking skills. Research shows that interactive approaches to teaching such as drama give students the motivation and enthusiasm to learn.

Deviance of syntax in oral languages and oral reading behavior

The major hypothesis of this paper is that any deviance in syntax present in oral language will be evident in oral r eading behaviour. Using Lee and Canter's Developmental i 1 Sentence Scoring technique (1971) and Y. Goodman and Burke's Reading Miscue Inventory (1972) linguistic competence was established in t hree male children. ages 10 to 11. patterns of strengths and weaknesses in reading were determined. and the relationships t hat were established, were examined. Results of the study i ndicate that oral language behaviour is closely tied to oral r eading behaviour. This type of approach can be used as a basis for a diagnosis of a reading difficulty and then a prescription for language and reading skills.

Astringency and other oral sensations : biological sources of individual variation and association with food and beverage behaviour

Orosensory perception strongly influences liking and consumption of foods and beverages. This thesis examines the influence of biological sources of individual variation on the perception of prototypical orosensory stimuli, food liking, self-reported alcohol liking and consumption, and indices of health. Two orosensory indices were examined: propylthiouracil (PROP) responsiveness, a genetically-mediated index of individual variation associated with enhanced responsiveness to orosensory stimuli often expressed as PROP taster status (PTS); and thermal taster status (TTS), a recently reported index of orosensory responsiveness. Taster status in PTS and/or TTS confers greater responsiveness to most orosensory stimuli. Gender, age, ethnicity, and fungiform papillae (FP) density were not associated with orosensory responsiveness to tastants, an astringent, and a flavour. Unlike PROP responsiveness, FP density was not associated with TTS. Both PROP responsiveness and TTS were associated with increased responsiveness to orosensory stimuli, including temperature and astringency. For PROP, this association did not hold when stimuli were presented at cold or warm temperatures, which are ecologically valid since most foods and beverages are not consumed at ambient temperature. Thermal tasters (TTs), who perceive 'phantom' taste sensations with lingual thermal stimulation, were more responsive to stimuli at both temperatures than thermal non-tasters (TnTs). While PTS, TIS, and gender affected self-reported liking and consumption of some alcoholic beverages, gender associated with the greatest number of beverage types and consumption parameters, with males generally liking and consuming alcoholic beverages more than females. Age and gender were the best predictors of alcoholic beverageAiking and consumption. As expected, .. liking of bitter and fatty foods and cream was inversely related to PROP responsiveness. TTS did not associate with body mass index or waist circumference, and contrary to previous studies, neither did PROP responsiveness. Taken together, TnTs' greater liking of cooked fruits and vegetables and high alcohol, and astringent alcoholic beverages than TTs suggests differences between TTS groups may be driven by perceived temperature and texture. Neither an interaction between PTS and TTS nor a TTS effect on PROP responsiveness was observed, suggesting these two indices of individual variation exert their influences on orosensory perception independently.

The Effects of Drama on Oral Fluency and Foreign Language Anxiety: An exploratory study

Previous research has suggested that drama has positive effects on learners' oral communication and anxiety; however, it is unclear which dimensions, or to what extent, they are affected by drama. This research narrows the investigation by examining how a drama-based EFL program impacts three dimensions of oral communication: fluency, comprehensibility, and accentedness, and one anxiety factor - foreign language speaking anxiety (FLSA) -, over time. Speech samples were collected from EFL learners in a treatment and a control group, and subsequently assessed by untrained Canadian-born raters. FLSA levels were measured through questionnaires and interviews. Pre- and post-test analysis indicate that learners in the treatment group made significant gains in oral fluency while oral fluency among learners in the control group remained unchanged. There was a significant reduction in FLSA levels among learners in both groups. Finally, qualitative analyses suggest that drama activities, among others, enhance learners' comfort levels in speaking English.

Oral French Communication in French Immersion Canadian and World Studies Classrooms: A Primer for Educators

This project presents a primer for secondary French Immersion teachers that facilitates the use of French oral communicative activities in secondary Canadian and World Studies courses. The primer supports collaborative and inclusive teaching strategies that invite students to speak and develop their oral French communication skills. The primer is divided into 2 main components: (a) Rationale for the Primer, and (b) the Strategies themselves, comprising succinct descriptions as well as potential uses and suggestions. A critical content analysis of various Ontario Ministry of Education documents was undertaken in order to explore the importance of oral communication in second-language learning in Ontario secondary schools. Furthermore, holistic and invitational education perspectives were examined in order to define the advantages of collaborative learning. Moreover, research in the stream of French Immersion studies was also referenced to frame the relevance of second-language learning and the significant role the French Immersion teacher plays. The aforementioned research contributes to the advancement of theory and practice regarding the importance of opportunities for oral French communication in secondary Canadian and World Studies courses.

Planeación, desarrollo y elaboración del programa analítico, libro de texto y curso de formación docente para la asignatura de comunicación oral y escrita

Tesis (Maestría en Planeación e Investigación de la Comunicación) UANL

Relación entre el diagnóstico clínico y el diagnóstico histopatológico de muestras recibidas por el Depto. de Patología Oral de la Facultad de Odontología de la U.A.N.L., 1991-1997

Tesis (Maestría en Salud Pública con Especialidad en Odontología Social) UANL

Cambios histoquímicos y ultraestructurales del nervio ciático de la rata con intoxicación crónica con fruto molido de Karwinskia humboldtiana por vía oral

Tesis (Maestría en Ciencias con Orientación en Morfología) UANL

Estrategias didácticas para el desarrollo de la comunicación y expresión oral en los alumnos de la Preparatoria No.9 de la U.A.N.L.

[Tesis] ( Maestría en Enseñanza Superior) U.A.N.L.