Un pilote avec groupe témoin : effets de la méditation de pleine conscience sur la qualité de vie, le sommeil et l’humeur chez des adolescents atteints de cancer

L’annonce d’un diagnostic de cancer provoque souvent une forte réaction émotionnelle et un stress important tant chez les adultes que chez les adolescents et leurs parents. Certains d’entre eux cherchant à soulager cette détresse se tournent vers des méthodes alternatives positives de gestion de stress, dans le but d’atténuer les effets psychologiques indésirables du cancer. Les thérapies ciblant à la fois le corps et l’esprit gagnent en popularité dans ces populations. Une avenue prometteuse est la méditation de pleine conscience (MPC), inspirée de la philosophie bouddhiste et adaptée dans le cadre d’interventions thérapeutiques pour améliorer la qualité de vie des patients souffrant de maladies chroniques. À ce jour, des études dans le domaine de la santé ont suggéré que la MPC pouvait avoir des effets bénéfiques sur les symptômes et la gestion de plusieurs maladies chroniques dont le cancer, faisant d’elle une avenue thérapeutique intéressante dans le traitement des effets psychologiques indésirables liés à ces maladies. La recherche émergente en pédiatrie suggère des effets comparables chez les enfants et adolescents. L’objectif de la présente thèse a été de développer un essai clinique randomisé visant à évaluer les effets de la MPC sur la qualité de vie, le sommeil et l’humeur chez des adolescents atteints de cancer, en documentant les étapes d’implantation du projet, les embuches qui ont été rencontrées durant son implantation et les résultats obtenus. La thèse est présentée sous la forme de deux articles scientifiques. Le premier article présente la méthodologie qui avait été planifiée pour ce projet mais qui n’a pu être réalisée en raison d’embuches rencontrées dans la complétion de ce pilote. Ainsi, les étapes préliminaires du développement de ce projet de recherche, en accordant une place prépondérante au manuel d’intervention rédigé à cette fin. La mise en place et la structure de ce projet, nommément le devis méthodologique employé, la taille d’échantillon visée, les méthodes de recrutement mises en place et les stratégies de randomisation prévues, sont décrites en détail dans cet article. Pour les fins de ce projet, un manuel d’intervention de MPC a été rédigé. L’intervention en MPC, menée par deux instructeurs formés en MPC, s’est échelonnée sur une durée de huit semaines, à raison d’une séance d’une heure trente par semaine. Une description détaillée de chaque séance est incluse dans cet article, dans un but de dissémination du protocole de recherche. Des analyses intragroupe serviront à évaluer l’impact de l’intervention en méditation de pleine conscience sur la qualité de vie, le sommeil et l’humeur pré-à-post intervention et au suivi à six mois. Des analyses intergroupes prévues sont décrites afin de comparer les effets de l’intervention entre les participants du groupe contrôle et du groupe expérimental. Les limites potentielles de ce projet, notamment la participation volontaire, le risque d’attrition et la petite taille d’échantillon sont décrites en détail dans cet article. Le deuxième article présente, dans un premier temps, le déroulement du projet de recherche, en mettant en lumière les embuches rencontrées dans son implantation. Ainsi, les leçons à tirer de l’implantation d’un tel essai clinique en milieu hospitalier au Québec sont décrites selon trois axes : 1) les défis liés au recrutement et à la rétention des participants; 2) l’acceptabilité et la compréhensibilité de l’intervention en pleine conscience; et 3) le moment où l’intervention s’est déroulée (timing) et l’impact sur l’engagement requis des participants dans le projet. Durant une période de recrutement de neuf mois, 481 participants potentiels ont été filtrés. 418 (86,9 %) d’entre eux ont été exclus. 63 participants potentiels, vivant à moins d’une heure de Montréal, ont été approchés pour prendre part à ce projet. De ce nombre, seulement 7 participants (1,4%) ont accepté de participer aux rencontres de MPC et de compléter les mesures pré-post intervention. Un bassin d’éligibilité réduit, ainsi que des taux de refus élevés et des conflits d’horaire avec les activités scolaires ont eu un impact considérable sur la taille d’échantillon de ce projet et sur l’absentéisme des participants. Malgré l’intérêt manifeste des équipes médicales pour la recherche psychosociale, les ressources requises pour mener à terme de tels essais cliniques sont trop souvent sous- estimées. Les stratégies de recrutement et de rétention des participants méritent une attention spéciale des chercheurs dans ce domaine. Dans un deuxième temps, le deuxième article de cette thèse a pour objectif de présenter les résultats de l’intervention en MPC chez des jeunes ayant le cancer, en examinant spécifiquement l’impact de l’intervention sur la qualité de vie, le sommeil et l’humeur des jeunes pré-post intervention et lors du suivi à six mois. Faisant écho aux embuches décrites préalablement décrites, les analyses statistiques n’ont permis de déceler aucun effet statistiquement significatif de notre intervention. Aucune différence significative n’est notée entre les participants du groupe expérimental et les participants du groupe contrôle. Les difficultés rencontrées dans de la complétion des devoirs et de la pratique de techniques de méditation entre les séances, décrites en détail cet article, expliquent en partie ces résultats. Globalement, le contexte développemental spécifique à l’adolescence, ayant possiblement eu un impact sur l’adhérence des participants à la thérapie proposée et à leur motivation à prendre part aux rencontres, les scores sous-cliniques lors du premier temps de mesure, l’impact du soutien social inhérent au contexte de thérapie de groupe, ainsi que les caractéristiques personnelles des thérapeutes, pourraient avoir influencé les résultats de ce pilote. Les résultats de ce projet pilote nous laissent croire que la prudence est de mise dans la généralisation des bienfaits et de l’efficacité de la pleine conscience observés chez les adultes atteints de cancer dans son application aux adolescents en oncologie. En conclusion, la présente thèse contribue à enrichir la recherche dans le domaine de la MPC chez les jeunes en questionnant néanmoins la pertinence d’une telle intervention auprès d’une population d’adolescents souffrant de cancer. Ainsi, il convient d’analyser les résultats obtenus en tenant compte des limites méthodologiques de ce projet et de poser un regard critique sur la faisabilité et la reproductibilité d’un projet d’une telle envergure auprès d’une même population. Les leçons tirées de l’implantation d’un tel projet en milieu hospitalier pédiatrique se sont avérées d’une importance centrale dans sa complétion et feront partie intégrante de toute tentative de réplication. D’autres essais cliniques de cette nature seront inévitablement requis afin de statuer sur l’efficacité de la MPC chez des adolescents atteints cancer et sur la faisabilité de l’implantation de cette méthode d’intervention auprès d’une population pédiatrique hospitalière.

Study on tropical rain with special reference to rain Drop Size Distribution and integral rain parameters using ground-based and satellite measurements

Department of Physics, Cochin University of Science and Technology

OPTIMAL UTILIZATION OF SERVICE FACILITY FOR A k-OUT-OF-n SYSTEM WITH REPAIR BY EXTENDING SERVICE TO EXTERNAL CUSTOMERS IN A RETRIAL QUEUE

In this paper, we study a k-out-of-n system with single server who provides service to external customers also. The system consists of two parts:(i) a main queue consisting of customers (failed components of the k-out-of-n system) and (ii) a pool (of finite capacity M) of external customers together with an orbit for external customers who find the pool full. An external customer who finds the pool full on arrival, joins the orbit with probability and with probability 1− leaves the system forever. An orbital customer, who finds the pool full, at an epoch of repeated attempt, returns to orbit with probability (< 1) and with probability 1 − leaves the system forever. We compute the steady state system size probability. Several performance measures are computed, numerical illustrations are provided.

Factors Underlying Heterogeneous Individual Growth in Macrobrachium rosenbergii and the Effect of Size Heterogeneity on Economic Feasibility of Farming in Kuttanad ( Kerala )

School of Industrial Fisheries, Cochin University of Science and Technology

Effect of pore size on the catalytic activities of K-I 0 clay and H-zeolites for the acetalization of ketones with methanol

One-pot acetalizations of cyclohexanone. acetophenone and benzophenone were carried out using methanol over H-montmorillonite clay (a mesoporous material). silica, alumina, and different zeolites such as HFAU-Y.HBeta, H-ZSM-5, and H-mordenite. In all the cases a single product-the corresponding dimethylacetal-was obtained in high yields. Hemiacetal formation was not observed with any catalyst. A comparison of catalytic activity indicated that montmorillonite K-10 is the most active catalyst for the reaction. As evidenced by the reaction time studies, the catalyst decay is greater over the zeolite catalyst than over the clay.

Investigations on The Finite Size Effects of Some Inverse Spinels and Studies on Their Composites Based on Nitrile Rubber

Magnetism and magnetic materials have been an ever-attractive subject area for engineers and scientists alike because of its versatility in finding applications in useful devices. They find applications in a host of devices ranging from rudimentary devices like loud speakers to sophisticated gadgets like waveguides and Magnetic Random Access Memories (MRAM).The one and only material in the realm of magnetism that has been at the centre stage of applications is ferrites and in that spinel ferrites received the lions share as far as practical applications are concerned.It has been the endeavour of scientists and engineers to remove obsolescence and improve upon the existing so as to save energy and integrate in to various other systems. This has been the hallmark of material scientists and this has led to new materials and new technologies.In the field of ferrites too there has been considerable interest to devise new materials based on iron oxides and other compounds. This means synthesising ultra fine particles and tuning its properties to device new materials. There are various preparation techniques ranging from top- down to bottom-up approaches. This includes synthesising at molecular level, self assembling,gas based condensation. Iow temperature eo-precipitation, solgel process and high energy ball milling. Among these methods sol-gel process allows good control of the properties of ceramic materials. The advantage of this method includes processing at low temperature. mixing at the molecular level and fabrication of novel materials for various devices.Composites are materials. which combine the good qualities of one or more components. They can be prepared in situ or by mechanical means by the incorporation of fine particles in appropriate matrixes. The size of the magnetic powders as well as the nature of matrix affect the processability and other physical properties of the final product. These plastic/rubber magnets can in turn be useful for various applications in different devices. In applications involving ferrites at high frequencies, it is essential that the material possesses an appropriate dielectric permittivity and suitable magnetic permeability. This can be achieved by synthesizing rubber ferrite composites (RFC's). RFCs are very useful materials for microwave absorptions. Hence the synthesis of ferrites in the nanoregirne.investigations on their size effects on the structural, magnetic, and electrical properties and the incorporation of these ferrites into polymer matrixes assume significance.In the present study, nano particles of NiFe204, Li(!5Fe2S04 and Col-e-O, are prepared by sol gel method. By appropriate heat treatments, particles of different grain sizes are obtained. The structural, magnetic and electrical measurements are evaluated as a function of grain size and temperature. NiFel04 prepared in the ultrafine regime are then incorporated in nitrile rubber matrix. The incorporation was carried out according to a specific recipe and for various loadings of magnetic fillers. The cure characteristics, magnetic properties, electrical properties and mechanical properties of these elastomer blends are carried out. The electrical permittivity of all the rubber samples in the X - band are also conducted.

Size-dependent enhancement of nonlinear optical properties in nanocolloids of ZnO

We have investigated the third-order nonlinearity in ZnO nanocolloids with particle sizes in the range 6-18 nm by the z-scan technique. The third-order optical susceptibility χ(3) increases with increasing particle size (R) within the range of our investigations. In the weak confinement regime, an R2 dependence of χ(3) is obtained for ZnO nanocolloids. The optical limiting response is also studied against particle size.

Size dependent fluorescence spectroscopy of nanocolloids of ZnO

In this article we present size dependent spectroscopic observations of nanocolloids of ZnO. ZnO is reported to show two emission bands, an ultraviolet (UV) emission band and another in the green region. Apart from the known band gap 380 nm and impurity 530 nm emissions, we have found some peculiar features in the fluorescence spectra that are consistent with the nanoparticle size distribution. Results show that additional emissions at 420 and 490 nm are developed with particle size. The origin of the visible band emission is discussed. The mechanism of the luminescence suggests that UV luminescence of ZnO colloid is related to the transition from conduction band edge to valence band, and visible luminescence is caused by the transition from deep donor level to valence band due to oxygen vacancies and by the transition from conduction band to deep acceptor level due to impurities and defect states. A correlation analysis between the particle size and spectroscopic observations is also discussed.

Dynamics and Thermodynamics of the Arabian Sea Warm Pool

The present study examines the importance of low saline waters and resulting barrier layer in the dynamics of the ASWP using observational data.The oceanic general circulation models (OGCM) are very useful for exploring the processes responsible for the ASWP and their variability. The circulation and thermohaline structure stimulated by an OGCM changes a lot when the resolution is increased from mesoscale to macro scale. For a reasonable simulation of the ASWP, we must include the mesoscale turbulence in numerical models. Especially the SEAS is an eddy prominent region with a horizontal dimension of 100 to 500 km and vertical extent of hundred meters. These eddies may have an important role on the evolution of ASWP, which has not been explored so far.Most of the earlier studies in the SEAS showed that the heat buildup in the mixed layer during the pre-monsoon (March-May) is primarily driven by the surface heat flux through the ocean-atmosphere interface, while the 3-dimensional heat budget of the ML physical processes that are responsible for the formation of the ASWP are unknown. With this background the present thesis also examines the relative importance of mixed layer processes that lead to the formation of warm pool in the SEAS.

Contribution of size fractions of planktonic algae to primary organic productivity in the coastal waters of Cochin- south west coast of lndia

This thesis entitled “Contribution of size fractions of planktonic algae to primary organic productivity in the coastal waters of cochin,south west coast of india”. Marine ecosystems planktonic algae are the most important primary producers on wliich considerable attention is being given on account of their supreme status in the marine food chain.The study of primary production in the Indian Ocean started With DANA (I928-30),, John Murray t I933-34). Discovery ( I934) and Albatross (I947-48) expeditions which tried to evaluate productivity from nutrients and standing crop of phytoplankton .The bioproductivity of the marine environment is dependent on various primary producers. ranging in size from picoplankton to larger macro phytoplankton. The quantity and quality of various size fractions of planktonic algae at any locality depend mainly on the hydrographic conditions of the area .In the coastal waters of Cochin- south west coast of lndia. Planktonic algal community is composed mainly of the diatoms, the dinoflagellates, the blue-green algae and the silicoflagellates, the former two contributing the major flora and found distributed in the all size fractions. The maximum number of species of diatoms at station 1 and station 2 was found in the pre-monsoon season.. The size groups of planktonic algae greater than 53 um are dominated by filamentous- chain forming and colonial diatoms. The coastal waters of Cochin. planktonic algae less than 53 um in size contribute significantly to primary productivity and the biodiversity of the microflora, indicating the presence of rich fishery resources in the south west coast of india.The study of different size fractions of planktonic algae and their relative contribution to the primary organic production is a useful tool for the estimation of the quantity and quality of fisheries.A deeper investigation on the occurrence of these microalgae and proper identification of their species would be of immense help for the assessment of the specificity and magnitude of fishery resources.

Generic finite-size enhancement of pairing in mesoscopic Fermi systems

The finite-size-dependent enhancement of pairing in mesoscopic Fermi systems is studied under the assumption that the BCS approach is valid and that the two-body force is size independent. Different systems are investigated such as superconducting metallic grains and films as well as atomic nuclei. It is shown that the finite size enhancement of pairing in these systems is in part due to the presence of a surface which accounts quite well for the data of nuclei and explains a good fraction of the enhancement in Al grains.

Finite-size scaling analysis of the avalanches in the three-dimensional Gaussian random-field Ising model with metastable dynamics

A numerical study is presented of the third-dimensional Gaussian random-field Ising model at T=0 driven by an external field. Standard synchronous relaxation dynamics is employed to obtain the magnetization versus field hysteresis loops. The focus is on the analysis of the number and size distribution of the magnetization avalanches. They are classified as being nonspanning, one-dimensional-spanning, two-dimensional-spanning, or three-dimensional-spanning depending on whether or not they span the whole lattice in different space directions. Moreover, finite-size scaling analysis enables identification of two different types of nonspanning avalanches (critical and noncritical) and two different types of three-dimensional-spanning avalanches (critical and subcritical), whose numbers increase with L as a power law with different exponents. We conclude by giving a scenario for avalanche behavior in the thermodynamic limit.

Size effects in the magneto-optical response of Co nanoparticles

A study of the magneto-optical (MO) spectral response of Co nanoparticles embedded in MgO as a function of their size and concentration in the spectral range from 1.4 to 4.3 eV is presented. The nanoparticle layers were obtained by sputtering at different deposition temperatures. Transmission electron microscopy measurements show that the nanoparticles have a complex structure which consists of a crystalline core having a hexagonal close-packed structure and an amorphous crust. Using an effective-medium approximation we have obtained the MO constants of the Co nanoparticles. These MO constants are different from those of continuous Co layers and depend on the size of the crystalline core. We associate these changes with the size effect of the intraband contribution to the MO constants, related to a reduction of the relaxation time of the electrons into the nanoparticles.