Solutions to water problems in the bottom of the pyramid market

Solving the water crisis in the developing world is a critical issue. Four billion people in the globe, so called the Base of the Pyramid (BoP) population suffer from inadequate access to safe drinking water, while millions die daily from waterborne diseases and lack of clean water. The BoP people desperately need to obtain a satisfactory access to safe water sources. In order to address the issue, this research has been carried out. To provide holistic consideration to the matter, comprehensive exploration of various causes of the water crisis and its impacts in developing countries were discussed. Then, various viable and relevant solutions to the problem have been thoroughly scrutinized, including scientific, rational, practical and speculative approaches, examination of existing methods, technologies and products at the BoP water market. The role of clean water to the sustainable development was specifically featured. The paper also has studied social and economic factors, actors and circumstances which affect the market development of clean water technologies in the BoP. Possibilities and potentials of successful business between foreign water enterprises and BoP consumers were considered, while primary obstacles are deliberated on, with suggestion of the ways to tackle them. Technologies and products which are needed by the poor must be affordable, sustainable and of an appropriate quality. The crucial question of technology transfer was soundly discussed with pointing out main hindrances on the way of its implementation between the developed and developing world. The means to overcome these barriers were properly observed as well. To explore to some extent the possibility and feasibility of technology transfer from Finland to the BoP sector, 3 case study analyses have been implemented. Personal discussions in form of interviews were conducted at Kemira, Outotec and Fenno Water, Finnish water treatment and supply enterprises. The results of the interviews shed light on the specific practical matters, actual obstacles and potential solutions of the technology transfer from Finland to low-income countries.

Coopetition as a lead generating mechanism: design, modelling and simulation

The aim of this research is to develop a tool that could allow to organize coopetitional relationships between organizations on the basis of two-sided Internet platform. The main result of current master thesis is a detailed description of the concept of the lead generating internet platform-based coopetition. With the tools of agent-based modelling and simulation, there were obtained results that could be used as a base for suggestion that the developed concept is able to cause a positive effect on some particular industries (e.g. web-design studios market) and potentially can bring some benefits and extra profitability for most companies that operate on this particular industry. Also on the basis of the results it can be assumed that the developed instrument is also able to increase the degree of transparency of the market to which it is applied.

La thérapeutique suggestive et ses applications aux maladies nerveuses et mentales, à la chirurgie, à l'obstétrique et à la pédagogie / par le Dr A. Cullerre,...

Collection : Bibliothèque scientifique contemporaine

Nietzsche's eternal recurrence of the same : the effect of logic abridgement, contradictions and inconsistencies

I will argue that the doctrine of eternal recurrence of the same no better interprets cosmology than pink elephants interpret zoology. I will also argue that the eternal-reiurn-of-the-same doctrine as what Magnus calls "existential imperative" is without possibility of application and thus futile. To facilitate those arguments, the validity of the doctrine of the eternal recurrence of the same will be tested under distinct rubrics. Although each rubric will stand alone, one per chapter, as an evaluation of some specific aspect of eternal recurrence, the rubric sequence has been selected to accommodate the identification of what I shall be calling logic abridgments. The conclusions to be extracted from each rubric are grouped under the heading CONCLUSION and appear immediately following rubric ten. Then, or if, at the end of a rubric a reader is inclined to wonder which rubric or topic is next, and why, the answer can be found at the top of the following page. The question is usually answered in the very first sentence, but always answered in the first paragraph. The first rubric has been placed in order by chronological entitlement in that it deals with the evolution of the idea of eternal recurrence from the time of the ancient Greeks to Nietzsche's August, 1881 inspiration. This much-recommended technique is also known as starting at the beginning. Rubric 1 also deals with 20th. Century philosophers' assessments of the relationship between Nietzsche and ancient Greek thought. The only experience of E-R, Zarathustra's mountain vision, is second only because it sets the scene alluded to in following rubrics. The third rubric explores .ii?.ih T jc,i -I'w Nietzsche's evaluation of rationality so that his thought processes will be understood appropriately. The actual mechanism of E-R is tested in rubric four...The scientific proof Nietzsche assembled in support of E-R is assessed by contemporary philosophers in rubric five. E-R's function as an ethical imperative is debated in rubrics six and seven.. .The extent to which E-R fulfills its purpose in overcoming nihilism is measured against the comfort assured by major world religions in rubric eight. Whether E-R also serves as a redemption for revenge is questioned in rubric nine. Rubric ten assures that E-R refers to return of the identically same and not merely the similar. In addition to assemblage and evaluation of all ten rubrics, at the end of each rubric a brief recapitulation of its principal points concludes the chapter. In this essay I will assess the theoretical conditions under which the doctrine cannot be applicable and will show what contradictions and inconsistencies follow if the doctrine is taken to be operable. Harold Alderman in his book Nietzsche's Gift wrote, the "doctrine of eternal recurrence gives us a problem not in Platonic cosmology, but in Socratic selfreflection." ^ I will illustrate that the recurrence doctrine's cosmogony is unworkable and that if it were workable, it would negate self-reflection on the grounds that selfreflection cannot find its cause in eternal recurrence of the same. Thus, when the cosmology is shown to be impossible, any expected ensuing results or benefits will be rendered also impossible. The so-called "heaviest burden" will be exposed as complex, engrossing "what if speculations deserving no linkings to reality. To identify ^Alderman p. 84 abridgments of logic, contradictions and inconsistencies in Nietzsche's doctrine of eternal recurrence of the same, I. will examine the subject under the following schedule. In Chapter 1 the ancient origins of recurrence theories will be introduced. ..This chapter is intended to establish the boundaries within which the subsequent chapters, except Chapter 10, will be confined. Chapter 2, Zarathustra's vision of E-R, assesses the sections of Thus Spoke Zarathustra in which the phenomenon of recurrence of the same is reported. ..Nihilism as a psychological difficulty is introduced in this rubric, but that subject will be studied in detail in Chapter 8. In Chapter 2 the symbols of eternal recurrence of the same will be considered. Whether the recurrence image should be of a closed ring or as a coil will be of significance in many sections of my essay. I will argue that neither symbolic configuration can accommodate Nietzsche's supposed intention. Chapter 3 defends the description of E-R given by Zarathustra. Chapter 4, the cosmological mechanics of E-R, speculates on the seriousness with which Nietzsche might have intended the doctrine of eternal recurrence to be taken. My essay reports, and then assesses, the argument of those who suppose the doctrine to have been merely exploratory musings by Nietzsche on cosmological hypotheses...The cosmogony of E-R is examined. In Chapter 5, cosmological proofs tested, the proofs for Nietzsche's doctrine of return of the same are evaluated. This chapter features the position taken by Martin ' Heidegger. My essay suggests that while Heidegger's argument that recurrence of the same is a genuine cosmic agenda is admirable, it is not at all persuasive. Chapter 6, E-R is an ethical imperative, is in essence the reporting of a debate between two scholars regarding the possibility of an imperative in the doctrine of recurrence. Their debate polarizes the arguments I intend to develop. Chapter 7, does E-R of the same preclude alteration of attitudes, is a continuation of the debate presented in Chapter 6 with the focus shifted to the psychological from the cosmological aspects of eternal recurrence of the same. Chapter 8, Can E-R Overcome Nihilism?, is divided into two parts. In the first, nihilism as it applies to Nietzsche's theory is discussed. ..In part 2, the broader consequences, sources and definitions of nihilism are outlined. My essay argues that Nietzsche's doctrine is more nihilistic than are the world's major religions. Chapter 9, Is E-R a redemption for revenge?, examines the suggestion extracted from Thus Spoke Zarathustra that the doctrine of eternal recurrence is intended, among other purposes, as a redemption for mankind from the destructiveness of revenge. Chapter 10, E-R of the similar refuted, analyses a position that an element of chance can influence the doctrine of recurrence. This view appears to allow, not for recurrence of the same, but recurrence of the similar. A summary will recount briefly the various significant logic abridgments, contradictions, and inconsistencies associated with Nietzsche's doctrine of eternal recurrence of the same. In the 'conclusion' section of my essay my own opinions and observations will be assembled from the body of the essay.

Emergence of normative beliefs legitimizing antisocial behaviour in adolescents : the roles of monitoring, attachment, and temperament /

Beliefs about the rightness or wrongness of engaging in various antisocial acts, referred to here as nonnative beliefs legitimizing antisocial behaviour (nblab), have been shown to playa role in the emergence oflater antisocial behaviour. The current study represented an attempt to understand whether parental monitoring and parent-child attachment have differential relationships with these antisocial nonnative beliefs in adolescents of different temperaments. The participants, 7135 adolescents in 25 high schools (ages 10- 18 years, M = 15.7) completed a wide-ranging questionnaire as part of the broad Youth Lifestyle Choices - Community University Research Alliance project, whose goal is to identify and describe the major developmental pathways of risk behaviours and resilience in youth. Two aspects of monitoring (monitoring knowledge and surveillance/tracking), attachment security, and two measures of temperament (activity level and approach) were examined for main effects and in interactions as predictors of adolescent nonnative beliefs. All of these measures were based on adolescent self-ratings on either 3- or 4-point Likert-type scales. Several important results emerged from the study. Males were higher than females in nblab; parental monitoring knowledge and adolescent attachment security were negatively related to nblab; and temperamental activity level was positively related. Monitoring knowledge, the strongest of the predictors, was much more strongly related to nonnative beliefs than was parental surveillance/tracking, supporting the contention that it is how much parents actually know, and not their surveillance efforts, that predict adolescent nonnative beliefs. A surprising finding that is of the utmost importance was that, although several of the interactions tested were significant, none were considered to be of a meaningful magnitude (defined as sr^ > .01). The current study supported the suggestion that normative beliefs legitimizing antisocial behaviour are multiply determined, and the results were discussed with respect to the observed differential relations of parental monitoring, parent-child attachment, temperament, age, and gender to antisocial normative beliefs in adolescents. Also discussed were the need to test other parenting, temperament, and other variables that may be involved in the development of nblab; the need to directly test possible mechanisms explaining the links among the variables; and the usefulness of longitudinal research in determining possible directions of causality and developmental changes in the relationships.

An investigation of ethylene inhibition of growth in etiolated Avena sativa coleoptiles /

Growth rates of etiolated Avena sativa coleoptiles in pH 7.0 buffered medium are stimulated in a synergistic manner by IAA and 320 ~l/l carbon dioxide. The suggestion that carbon dioxide stimulated growth involves dark fixation is supported by the ability of 1 mM malate to replace carbon dioxide, with neither factor able to stimulate growth in the presence of the other (Bown, Dymock and Aung, 1974). The regulation of Avena coleoptile growth by ethylene has been investigated in the light of this data and the well documented antagonism between carbon dioxide and ethylene in the regulation of developmental processes. The influence of various permutations of ethylene, IAA, carbon dioxide and malate on the rates of growth, l4c-bicarbonate incorporation, l4C-bicarbonate fixation, and malate decarboxylation have been investigated. In the presence of 320 ~l/l carbon dioxide, 10.8 ~l/l ethylene inhibited growth both in the absence and presence of 20 ~M IAA with inhibition times, of 8-10 and 12-13 minutes respectively. In contrast ethylene inhibition of growth was not significant in the absence of growth stimulation by CO2 or 1 mM malate, and the normal growth increases in response to CO2 and malate were blocked by the simultaneous application of ethylene. The rates of incorporation and dark fixation of l4C-bicerbonate were not measurably. influenced by ethylene, IAA or malate, either prior to or during the changes in growth ,ates induced by these agents. The data does not support the hypothesis that ethylene inhibition of growth results from an inhibition of dark fixation, but suggests that ethylene may inhibit a process which is subsequent to fixation.

A comparative study of chitin synthase activity in two Mortierella species

An in vitro investigation of some important factors controlling the activity of chitin synthase in cell-free extracts of two Mortierella species has been carried out. Mixed membrane fractions from mycelial homogenates of Mortierella candelabrum and Mortierella pusilla were found to catalyse the transfer of N-acetylglucosamine from UDP-N-acetylglucosamine into an insoluble product characterized as chitin by its insolubility in weak acid and alkali, and the release of glucosamine and diacetylchitobiose on hydrolysis with a strong acid and chitinase, respectively. Apparent Km values for UDP-GlcNAc were 1.8 mM and 2.0 mM for M. pusilla and ~ candelabrum, respectively. Polyoxin D was found to be a very potent competitive inhibitor with values of the constant of inhibition, Ki' for both species about three orders of magnitude lower than theKm for UDP-GlcNAc. A divalent cation, Mg+2 , Mn+2 or Co+2 , was required for activity. N-acetylglucosamine, the monomer of chitin, stimulated the activity of the enzyme. The crude enzyme preparation of ~ candelabrum, unlike that of ~ pusilla, showed an absolute requirement for both Mg+2 and N-acetylglucosamine. Large differences in response to exogenous proteases were noted in the ratio of active to inactive chitin synthase of the two species. A fifteen fold or greater increase was obtained after treatment with acid protease (from Aspergillussaitoi) as compared to a two- to four-fold activation of the M. pusilla membrane preparation treated similarly. During storage at 4°C over 48 hours, an endogenous activation of chitin synthase of ~ pus ilIa was achieved, comparable to that obtained by exogenous protease treatment. The high speed supernatant of both species inhibited the chitin synthase activity of the mixed membrane fractions. The inhibitor of ~ pus ilIa was effective against the pre-activated enzyme whereas that of M. candelabrum inhibited the activated enzyme. Several possibilities are discussed as to the role of the different factors regulating the enzyme activity. The suggestion is made from the properties of chitin synthase in the two species that in vivo a delicate balance exists between the activation and inactivation of the enzyme which is responsible for the pattern of wall growth of each fungus.

A comparative study of in vitro chitin synthase activity in mucoraceous hosts of a mycoparasite

A comparative study of in vitro chitin synthase activity in mucoraceous hosts of a mycoparasite: Chitin synthase, the enzyme responsible for the synthesis of chitin in fungal cell wall was extracted from young hyphae of Choanephora cucurbitarum and Phascolomyces articulosus, susceptible and resistant hosts, respectively, to the mycoparasite, Piptocephalis virginiana. Crude enzyme was identified and characterized by measuring the incorporation of the substrate [14C]-UDP-N-acetylglucosamine, into chitin. Most activity occurred in mixed membrane fraction. Inhibition of activity with Polyoxin D and activation with proteases, N-acetyl-glucosamine and magnesium and other ions was observed. Properties of the crude enzyme preparation such as cofactor requirement, Vmax , apparent Km value for UDP-GlcNAc, inhibition by Polyoxin D, response to pH and to temperature, and stability at 4°C were determined. Enzyme activity from both fungi displayed basically the same features as the corresponding enzymes reported from other mucoraceous fungi. However, the two preparations from P. articulosus and C. cucurbitarum differed from each other in their expressed activity (i.e., the preparations from ~ articulosus exhibited higher latency and higher specific chitin synthase activity than the corresponding preparations from ~ cucurbitarum). Trypsin was effective in activation only over a narrow concentration range. Acid protease was the most effec.tive activator. En.dogenous protease estimation indicated higher protease activity in C. cucurbitarum than in P. articulosus. The suggestion is made that regulation of chitin synthase activities may be related to host resistance in the mycoparasitic system.

Localization of monoterpenoid indole alkaloid (MIA) biosynthesis by in situ hybridization (ISH)

Monoterpenoid indole alkaloids (MIA) are among the largest and most complex group of nitrogen containing secondary metabolites that are characteristic of the Apocynaceae plant family including the most notable Catharanthus roseus. These compounds have demonstrated activity as successful drugs for treating various cancers, neurological disorders and cardiovascular conditions. Due to the low yields of these compounds and high pharmacological value, their biosynthesis is a major topic of study. Previous work highlighting the leaf epidermis and leaf surface as a highly active area in MIA biosynthesis and MIA accumulation has made the epidermis a major focus of this thesis. This thesis provides an in-depth analysis of the valuable technique of RNA in situ hybridization (ISH) and demonstrates the application of the technique to analyze the location of the biosynthetic steps involved in the production of MIAs. The work presented in this thesis demonstrates that most of the MIAs of Eurasian Vinca minor, African Tabernaemontana e/egans and five Amsonia species, including North American Amsonia hubrichitii and Mediterranean A. orienta/is, accumulate in leaf wax exudates, while the rest of the leaf is almost devoid of alkaloids. Biochemical studies on Vinca minor displayed high tryptophan decarboxylase (TOe) enzyme activity and protein expression in the leaf epidermis compared to whole leaves. ISH studies aimed at localizing TOe and strictosidine synthase suggest the upper and lower epidermis of V. minor and T. e/egans as probable significant production sites for MIAs that will accumulate on the leaf surface, however the results don't eliminate the possibility of the involvement of other cell types. The monoterpenoid precursor to all MIAs, secologanin, is produced through the MEP pathway occurring in two cell types, the IPAP cells (Gl0H) and epidermal cells (LAMT and SLS). The work presented in this thesis, localizes a novel enzymatic step, UDPG-7-deoxyloganetic acid glucosyltransferase (UGT8) to the IPAP cells of Catharanthus longifolius. These results enable the suggestion that all steps from Gl0H up to and including UGT8 occur in the IPAP cells of the leaf, making the IPAP cells the main site for the majority of secologanin biosynthesis. It also makes the IPAP cells a likely cell type to begin searching for the gene of the uncharacterized steps between Gl0H and UGT8. It also narrows the compound to be transported from the IPAP cells to either 7-deoxyloganic acid or loganic acid, which aids in the identification of the transportation mechanism.

The Influence of Attentional Focus on the Self-Efficacy-Performance Relationship in a Continuous Running Task

The self-efficacy-performance relationship in continuous sport tasks has been shown to be significantly reciprocal yet unequal with stronger influences in the performance-to-self-efficacy pathway rather than self-efficacy-to-performance pathway (e.g., LaForge-MacKenzie & Sullivan, 2014b). Bandura (2012) suggested that sociocognitive variables may influence this relationship. Attention as a sociocognitve factor may bias the processing of performance and self-efficacy information (Bandura, 1982, 1997; Bandura & Jourden, 1991). As confidence and attention are important aspects of peak running performance (Brewer, Van Raalte, Linder, & VanRaalte, 1991), the primary purpose of the present study was to examine the self-efficacy-performance relationship under three conditions of attentional focus. The secondary purpose was to examine self-efficacy and performance as separate constructs under the same conditions of attention. Participants ran continuously for one kilometer in one of three randomly assigned attentional focus conditions: internal-focus (n = 51), external-focus (n = 50), and control (n = 49). Self-efficacy was assessed using a one-item measure every 200 meters. Path analyses examining the primary objective revealed significant self-efficacy-to-performance pathways in all conditions: external-focus (p < .05, βs ranging from -.17 to -.32), internal-focus (p < .05, βs ranging from -.26 to -.36), and control (p < .05, βs ranging from -.29 to -.42). Significant reciprocal relationships were absent in all conditions. ANOVAs examining the secondary objectives found significantly faster performance in the control condition at the start (F (2, 147) = 3.86, p < .05) and end of the task (F (2, 147) = 3.56, p < .05). Self-efficacy was significantly higher in the internal-focus condition at the end of the task (Self-Efficacy 4 (F (2, 147) = 3.21, p < .05) and Self-Efficacy 5 (F (2, 147) = 4.74, p < .05). In contrast to previous within-trial research (e.g., LaForge-MacKenzie & Sullivan, 2014b) self-efficacy-to-performance effects were more significant and robust than performance-to-self-efficacy effects. These results provided support for Bandura’s (2012) suggestion that sociocognitive factors may have the ability to alter the causal structure of the self-efficacy-performance relationship, proposing complexities in the self-efficacy-performance relationship (Sitzmann &Yeo, 2013). Results were discussed from both theoretical and applied perspectives.

Dynamic Measures of Individual Deprivation

We introduce and axiomatize a one-parameter class of individual deprivation measures. Motivated by a suggestion of Runciman, we modify Yitzhaki’s index by multiplying it by a function that is interpreted as measuring the part of deprivation generated by an agent’s observation that others in its reference group move on to a higher level of income than itself. The parameter reflects the relative weight given to these dynamic considerations, and the standard Yitzhaki index is obtained as a special case. In addition, we characterize more general classes of measures that pay attention to this important dynamic aspect of deprivation.

Deliberative Democracy and Precautionary Public Reasoning : Exploratory Thoughts

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Étude des interactions protéiques impliquant NPM-MLF1 dans la leucémie myéloïde aiguë.

Différentes translocations génomiques sont fréquemment associées à l'apparition de leucémies myéloïdes aiguës (LMA). Ces translocations génomiques résultent de l’assemblage de deux gènes conduisant à la production d'une protéine de fusion. C'est le cas de la translocation t (3; 5) (q25.1; q34) impliquant le suppresseur tumoral NPM et l'oncogène MLF1 donnant naissance à la protéine de fusion NPM-MLF1. Généralement, les gènes impliqués dans ces translocations contrôlent la croissance cellulaire, la différenciation ou la survie cellulaire. Cependant, pour NPM-MLF1 les causes du gain ou de la perte de fonction associée à la translocation demeurent inconnues car nous ne savons pas comment cette translocation peut favoriser ou participer à l'avènement de la LMA. Le but de ce travail est d’analyser le rôle de NPM-MLF1 dans le cancer et d’examiner comment son activité contribue à la leucémie en faisant des études d’interactions protéine/protéine. En effet, l’étude de la fonction d’une protéine implique souvent de connaître ses partenaires d’interactions. Pour ce faire, la technique de double hybride dans la souche de levure AH109 a été utilisée. Tout d’abord, les ADN complémentaires (ADNc) de MLF1, NPM1 et de NPM-MLF1, MLF1-Like (une partie de MLF1 de l’acide aminé 94 à 157) normaux et mutés du domaine MTG8-Like constitué des acides aminés (a.a.) 151 à 164 de MLF1 (excepté NPM) ont été clonés dans un vecteur d'expression de levure pGBKT7. Les ADNc de GFI-1, mSin3A, PLZF, HDAC1 et HDAC3 ont été clonés dans le plasmide pGADT7 de façon à créer des protéines de fusion synthétiques avec le domaine de liaison à l'ADN et de trans-activation de la protéine GAL4. Le plasmide pGBKT7 possède un gène TRP1 et pGADT7 un gène LEU2 qui permettent la sélection des clones insérés dans la levure. Aussi, le pGBKT7 a un épitope c-myc et pGADT7 un épitope HA qui permet de voir l’expression des protéines par buvardage de type Western. Après la transformation des levures les interactions protéine/protéine ont été observées en vérifiant l’expression des gènes rapporteurs HIS3, LacZ, MEL1, ADE2 de la levure en utilisant des milieux de sélection YPD/-Leu/-Trp, YPD/-Leu/-Trp/-His, YPD/-Leu/-Trp/-His/-Ade, YPD/-Leu/-Trp/+ X-Gal, YPD/-Leu/-Trp/ + X-α-Gal. Ensuite, les interactions trouvées par double-hybride ont été vérifiées dans les cellules érythroleucémiques K562 par immuno-précipitation (IP) de protéines suivies de buvardages Westerns avec les anticorps appropriés. NPM-MLF1, MLF1, MTG8, MLF1-Like surexprimés dans les cellules K562 ont été clonés dans le plasmide pOZ-FH-N. pOZ-FH-N possède un récepteur IL-2 qui permet de sélectionner les cellules qui l’expriment ainsi qu’un tag Flag-HA qui permet de voir l’expression des protéines par buvardage-Western. Les résultats du double-hybride suggèrent une interaction faible de NPM-MLF1 avec HDAC1, HDAC3 et mSin3A ainsi qu’une interaction qui semble plus évidente entre NPM-MLF1 et PLZF, GFI-1. NPM interagit avec GFI-1 et mSin3A. Aussi, MLF1 et MLF1-Like interagissent avec HDAC1, HDAC3, GFI-1, PLZF mais pas avec mSin3A. Les IP suggèrent que NPM-MLF1 interagit avec HDAC1, HDAC3, mSin3A et PLZF. MLF1 et MLF1-Like interagissent avec HDAC1, HDAC3 et mSin3A. L’interaction de NPM-MLF1 avec GFI-1, MLF1 et MLF1-Like avec PLZF et GFI-1 n’a pas encore été vérifiée par IP. Ainsi, nos observations permettent de suggérer que NPM-MF1, MLF1 et NPM pourraient jouer un rôle dans la transcription et la régulation de l’expression de certains gènes importants dans l’hématopoïèse et une variété de processus cellulaires parce qu’ils interagissent avec différents corépresseurs. En déterminant les partenaires protéiques de MLF1, NPM et NPM-MLF1, leurs fonctions et comment NPM-MLF1 influence et modifie le fonctionnement cellulaire normal; il sera possible de renverser le processus de LMA favorisé par la t (3; 5) NPM-MLF1 par la technologie d’interférence à l’ARN.

Relations sociales et troubles dépressifs chez les personnes âgées au Québec : interactions avec le genre et la région de résidence

Chez les personnes âgées, la dépression est un problème important en santé publique, à cause de sa prévalence élevée et de son association avec les incapacités fonctionnelles, la mortalité et l’utilisation des services. La plupart des études ont montré que le manque de relations sociales était associé à la dépression, mais les résultats ne sont pas clairs. Au Québec et au Canada, on possède peu de données sur la prévalence de la dépression chez les personnes âgées et de son association avec les relations sociales. Peu d’études ont examiné le rôle des relations sociales sur l’utilisation des services de santé par les personnes âgées déprimées. Le but de cette recherche était d’examiner le rôle des relations sociales dans la présence de la dépression et dans la consultation chez un professionnel de la santé des personnes âgées déprimées, au Québec. Plus spécifiquement, ce travail visait à : 1) examiner les associations entre les relations sociales et les troubles dépressifs selon la région de résidence; 2) examiner les associations différentielles des relations sociales sur la dépression des femmes et des hommes âgés; 3) examiner le rôle des relations sociales dans la consultation auprès d’un professionnel de la santé des personnes âgées déprimées. Pour répondre à ces objectifs, nous avons utilisé les données de l’enquête ESA (Enquête sur la Santé des Aînés), réalisée en 2005 -2006 auprès d’un échantillon de 2670 personnes âgées résidant à domicile au Québec, qui nous ont permis de rédiger trois articles. Les troubles dépressifs (incluant la dépression majeure et mineure) ont été mesurés, selon les critères du DSM-IV, en excluant le critère de l’altération du fonctionnement social, professionnel ou dans d’autres domaines importants, à l’aide du questionnaire ESA développé par l’équipe de recherche. Les relations sociales ont été mesurées à l’aide de cinq variables : (1) le réseau social; (2) l’intégration sociale; (3) le soutien social, (4) la perception d’utilité auprès des proches et (5) la présence de relations conflictuelles avec le conjoint, les enfants, les frères et sœurs et les amis. Des modèles de régression logistique multiple ont été ajustés aux données pour estimer les rapports de cote et leur intervalle de confiance à 95 %. Nos résultats ont montré des prévalences de dépression plus élevées chez les personnes qui résident dans les régions rurales et urbaines, comparées à celles qui résident dans la région métropolitaine de Montréal. La pratique du bénévolat, le soutien social et les relations non conflictuelles avec le conjoint sont associés à une faible prévalence de dépression, indépendamment du type de résidence. Comparés aux hommes, les femmes ont une prévalence de dépression plus élevée. L’absence de confident est associée à une prévalence de dépression élevée, tant chez les hommes que chez les femmes. La probabilité de dépression est plus élevée chez les hommes veufs et chez ceux qui ne pratiquent pas d’activités de bénévolat, comparativement à ceux qui sont mariés et font du bénévolat. Chez les femmes, aucune association significative n’a été observée entre le statut marital, le bénévolat et la dépression. Cependant, la présence de relations conflictuelles avec le conjoint est associée avec la dépression, seulement chez les femmes. Les relations avec les enfants, les frères et sœurs et les amis ne sont pas associées avec la dépression dans cette population de personnes âgées du Quebec. En ce qui concerne la consultation chez un professionnel de la santé, nos résultats ont révélé que presque la moitié des personnes âgées dépressives n’ont pas consulté un professionnel de la santé, pour leurs symptômes de dépression, au cours des 12 derniers mois. Par ailleurs, notre étude a montré que les personnes âgées qui disposent de tous les types de soutien (confident, émotionnel et instrumental) consultent plus pour leurs symptômes de dépression que ceux qui ont moins de soutien. Comparativement aux hommes mariés, les femmes mariées consultent plus les professionnels de la santé, ce qui laisse supposer que le réseau de proches (épouse et enfants) semble agir comme un substitut en réduisant la fréquence de consultation chez les hommes. Vu la rareté des études canadiennes sur la prévalence de la dépression chez les personnes âgées et les facteurs psychosociaux qui y sont associés, les résultats de ce travail seront utiles pour les cliniciens et pour les responsables des politiques à l’échelle nationale, provinciale et locale. Ils pourront guider des interventions spécifiques, selon la région de résidence et pour les hommes et les femmes âgées, dans le domaine de la santé mentale.

Étude exploratoire et comparative du trouble bipolaire et du trouble de personnalité limite à l'adolescence

Actuellement, le diagnostic différentiel du trouble bipolaire (TB) et du trouble de personnalité limite (TPL) à l’adolescence s’avère difficile et complique le choix thérapeutique. Portant sur le TB et le TPL, ce mémoire fait le point sur la littérature scientifique adulte et adolescente, vérifie la faisabilité et présente les résultats d’une étude exploratoire portant sur les variables cliniques (instabilité émotionnelle, hostilité, impulsivité, tempraément) et le rythme veille-sommeil à l’adolescence. L’étude exploratoire comprend sept adolescents TB et huit TPL (12-17 ans), évalués par questionnaires autoadministrés pour les variables cliniques, et par actigraphie et agenda de sommeil pour le rythme veille-sommeil. Aucune différence significative n’existe entre les deux troubles pour les variables cliniques. En moyenne, les adolescents TB ont porté l'actigraphie pendant 9,9 jours et ont rempli un agenda de sommeil pendant 5,7 jours; chez les TPL, les chiffres sont respectivement 9,8 et 8,9 jours. Comparés aux TPL, les TB ont un plus grand intervalle d’éveil (p=0,035), ont un plus grand intervalle de sommeil (p>0,05), et ont une plus grand variabilité intrajournalière (p=0,04). Les données subjectives (agenda de sommeil) semblent refléter les données objectives (actigraphie) : aucune différence statistique n’est observée entre les deux mesures pour le délai d’endormissement, la durée du dernier réveil et le temps total de sommeil. La recension de la littérature montre un manque de données chez l’adolescent quant aux deux troubles. La faisabilité de l’étude est démontrée par la présence de résultats analysables. Ceci encourage la poursuite des recherches sur ces variables, afin de distinguer les deux psychopathologies à l’adolescence.