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

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

Analyse des stratégies d’évaluation des technologies des corps policiers canadiens : le cas de l’Identité Judiciaire

Les innovations technologiques pullulent dans le milieu policier depuis quelques années. Devant cette abondance de choix technologiques, et dans une conjoncture de ralentissement économique, la police doit s’assurer de faire une sélection favorisant le meilleur retour sur investissement. L’évaluation des technologies est la meilleure méthode permettant d’atteindre cet objectif. Ce projet de recherche analyse les différentes stratégies d’évaluation des technologies des corps policiers fédéraux et provinciaux du Canada en se basant sur le domaine baromètre de l’identité judiciaire. Cette étude s’appuie sur plusieurs données qualitatives : 1) observation participative à la Sûreté du Québec; 2) entrevues semi-directives (n=11) avec des membres de l’Ontario Provincial Police et de la Gendarmerie Royale du Canada. L’analyse intégrée des données colligées permet de mieux comprendre la dynamique de l’évaluation technologique dans la police. Même si une évolution est perceptible, certaines améliorations pourraient accroître l’efficacité du mini-PTA (Police Technology Assessment) dans un contexte où l’opérationnel et le théorique doivent cohabiter en parfaite harmonie afin de faciliter le travail des utilisateurs. Le mini-PTA est un outil facilitant l’adaptation de l’évaluation des technologies aux réalités régionales, mais ne peut en aucun cas remplacer unilatéralement le PTA fait par les grosses organisations d’évaluation des technologies policières.

Dynamiques d’intimidation contre la force publique : enjeux pour les policiers et les agents correctionnels

Une des caractéristiques fondamentales des policiers et des agents correctionnels est le recours légitime à la coercition pour imposer leur autorité. Cette force publique doit donc, en théorie, avoir le dessus sur toute forme de force privée. Dans l’étude des phénomènes de violence, cette caractéristique rend leur victimisation singulière. À ce jour, les formes d’influence, de pressions indues et d’intimidation vécus par les agents de la force publique demeurent relativement peu étudiées. Les objectifs de cette thèse sont d’améliorer notre compréhension des dynamiques d’intimidation, de soulever les différents enjeux pour la force publique et de proposer une théorie de l’intimidation criminelle. La force publique étant, avant toute chose, une émanation de l’État, nous avons commencé par analyser la problématique de l’intimidation criminelle de manière plus globale. En testant la théorie de l’action de sécurité (Cusson, 2010), nous avons constaté qu’une force publique intimidée et corrompue entraîne une perte de légitimité et une inefficacité du système judiciaire dans sa lutte contre la criminalité. Nous avons ensuite adopté une perspective interactionniste pour comprendre les dynamiques d’intimidation au quotidien. Nous nous sommes demandés quels étaient les éléments qui rendaient une intimidation crédible et grave pour les policiers. En identifiant leur monde d’objets (Blumer, 1986), nous avons constaté que les actes d’intimidation qui survenaient en dehors du cadre professionnel étaient jugés plus graves par les policiers et que l’appartenance de l’intimidateur à une organisation criminelle entraînait une augmentation de la gravité de la menace. Ensuite, nous nous sommes interrogés sur la notion d’identité sociale des agents correctionnels victimes d’intimidation (Tedeschi et Felson, 1994). Nous avons constaté que les intimidations mineures mais répétées avaient tendance à modifier les pratiques professionnelles des surveillants. Une analyse intégrée de ces perspectives met en lumière l’existence de deux formes d’intimidation : une intimidation réactive et peu sévère en nature et une intimidation planifiée et grave. Elle soulève également trois enjeux pour la force publique : son aspect symbolique, la transformation de son action et sa légitimité. En intégrant ces enjeux, une théorie de l’intimidation criminelle est proposée. En dernier lieu, des solutions préventives et répressives sont avancées pour lutter contre ce phénomène.

Hallazgos radiológicos de la enfermedad pulmonar en pacientes Colombianos con esclerodermia

La esclerosis sistémica (ES) es una enfermedad autoinmune multisistémica que afecta principalmente la piel, los pulmones, el tracto gastrointestinal, el corazón y los riñones. La enfermedad pulmonar, presente en casi el 100% de los casos, es el factor con mayor influencia en la mortalidad. El propósito de este estudio es realizar un análisis detallado de la enfermedad pulmonar por tomografía computarizada de alta resolución(TCAR) en pacientes Colombianos con ES, para lo cual se realizó un estudio de prevalencia analítica en 44 pacientes con ES valorados en el Hospital Universitario Mayor Méderi en los últimos 7 años. Los resultados mostraron características demográficas y clínicas similares a las previamente descritas. La prevalencia de enfermedad pulmonar intersticial fue alta, y los hallazgos de fibrosis pulmonar como vidrio esmerilado y panal de abejas se asociaron con la presencia del autoanticuerpo antiSCL70. La medida del diámetro esofágico por TCAR fue mayor en los pacientes con disfagia, antiSCL 70 y linfopenia, los cuales son marcadores de mal pronóstico.

Experiences with sustainability indicators and stakeholder participation: A case study relating to a 'Blue Plan' project in Malta

The practical application of systemic sustainability analysis (SSA; Bell and Morse, 1999) as applied in-a project instigated and managed by 'Blue Plan', one of the regional activity centres of the Mediterranean Action Plan, is set out and explained in this paper. The context in which SSA was applied and adapted to SPSA (systemic and prospective sustainability analysis). is described in the Mediterranean, primarily in Malta. The SSA process is summarized, its extension and linkage to the prospective approach is described and the comments of stakeholders in the context are added. Some preliminary outcomes are suggested. The pauticular focus of the paper is on the lessons learned from doing SSA/SPSA within a classic blueprint project framework. It is-not assumed that SSA/SPSA is 'finished' or 'definitive'. Rather, we suggest that it is a developing and changing approach that practitioners can adapt and change to meet the specific needs of the circumstances that confront them. Copyright (C) 2004 John Wiley & Sons, Ltd and ERP Environment.

Mining gene networks with application to GAW15 problem 1

The genetic analysis workshop 15 (GAW15) problem 1 contained baseline expression levels of 8793 genes in immortalised B cells from 194 individuals in 14 Centre d’Etude du Polymorphisme Humane (CEPH) Utah pedigrees. Previous analysis of the data showed linkage and association and evidence of substantial individual variations. In particular, correlation was examined on expression levels of 31 genes and 25 target genes corresponding to two master regulatory regions. In this analysis, we apply Bayesian network analysis to gain further insight into these findings. We identify strong dependences and therefore provide additional insight into the underlying relationships between the genes involved. More generally, the approach is expected to be applicable for integrated analysis of genes on biological pathways.

Processes controlling DOC in pore water during simulated drought cycles in six different UK peats

The effect of episodic drought on dissolved organic carbon (DOC) dynamics in peatlands has been the subject of considerable debate, as decomposition and DOC production is thought to increase under aerobic conditions, yet decreased DOC concentrations have been observed during drought periods. Decreased DOC solubility due to drought-induced acidification driven by sulphur (S) redox reactions has been proposed as a causal mechanism; however evidence is based on a limited number of studies carried out at a few sites. To test this hypothesis on a range of different peats, we carried out controlled drought simulation experiments on peat cores collected from six sites across Great Britain. Our data show a concurrent increase in sulphate (SO4) and a decrease in DOC across all sites during simulated water table draw-down, although the magnitude of the relationship between SO4 and DOC differed between sites. Instead, we found a consistent relationship across all sites between DOC decrease and acidification measured by the pore water acid neutralising capacity (ANC). ANC provided a more consistent measure of drought-induced acidification than SO4 alone because it accounts for differences in base cation and acid anions concentrations between sites. Rewetting resulted in rapid DOC increases without a concurrent increase in soil respiration, suggesting DOC changes were primarily controlled by soil acidity not soil biota. These results highlight the need for an integrated analysis of hydrologically driven chemical and biological processes in peatlands to improve our understanding and ability to predict the interaction between atmospheric pollution and changing climatic conditions from plot to regional and global scales.

The economic theory of international supply chains: a systems view

This paper offers an integrated analysis of out-sourcing, off-shoring and foreign direct investment within a systems view of international business. This view takes the supply chain rather than the firm as the basic unit of analysis. It argues that competition in the global economy selects supply chains that maximise the joint profit of all the firms in the chain. The systems view is compared with the firm-centred view commonly used in strategy literature. The paper shows that a firm’s strategy must be embedded within an efficient supply chain strategy, and that this strategy must be negotiated with, rather than imposed upon, other firms. The paper analyses the conditions under which various supply chain strategies - and by implication various firm-level strategies - are efficient. Only by adopting a systems view of supply chains is it possible to determine which firm-level strategies will succeed in a volatile global economy.

GNSS occultation sounding for climate monitoring

Considerable efforts are currently invested into the setup of a Global Climate Observing System (GCOS) for monitoring climate change over the coming decades, which is of high relevance given concerns on increasing human influences. A promising potential contribution to the GCOS is a suite of spaceborne Global Navigation Satellite System (GNSS) occultation sensors for global long-term monitoring of atmospheric change in temperature and other variables with high vertical resolution and accuracy. Besides the great importance with respect to climate change, the provision of high quality data is essential for the improvement of numerical weather prediction and for reanalysis efforts. We review the significance of GNSS radio occultation sounding in the climate observations context. In order to investigate the climate change detection capability of GNSS occultation sensors, we are currently performing an end-to-end GNSS occultation observing system simulation experiment over the 25-year period 2001 to 2025. We report on this integrated analysis, which involves in a realistic manner all aspects from modeling the atmosphere via generating a significant set of stimulated measurements to an objective statistical analysis and assessment of 2001–2025 temporal trends.

Genetic dissection of vitamin E biosynthesis in tomato

Vegetables are critical for human health as they are a source of multiple vitamins including vitamin E (VTE). In plants, the synthesis of VTE compounds, tocopherol and tocotrienol, derives from precursors of the shikimate and methylerythritol phosphate pathways. Quantitative trait loci (QTL) for alpha-tocopherol content in ripe fruit have previously been determined in an Solanum pennellii tomato introgression line population. In this work, variations of tocopherol isoforms (alpha, beta, gamma, and delta) in ripe fruits of these lines were studied. In parallel all tomato genes structurally associated with VTE biosynthesis were identified and mapped. Previously identified VTE QTL on chromosomes 6 and 9 were confirmed whilst novel ones were identified on chromosomes 7 and 8. Integrated analysis at the metabolic, genetic and genomic levels allowed us to propose 16 candidate loci putatively affecting tocopherol content in tomato. A comparative analysis revealed polymorphisms at nucleotide and amino acid levels between Solanum lycopersicum and S. pennellii candidate alleles. Moreover, evolutionary analyses showed the presence of codons evolving under both neutral and positive selection, which may explain the phenotypic differences between species. These data represent an important step in understanding the genetic determinants of VTE natural variation in tomato fruit and as such in the ability to improve the content of this important nutriceutical.

Cell death and lumen formation in spheroids of MCF-7 cells

3D (three-dimensional) cell culture permits a more integrated analysis of the relationship between cells, inserting them into a structure more closely resembling the cellular microenvironment in vivo. The development of in vitro parameters to approximate in vivo 3D cellular environments makes a less reductionist interpretation of cell biology possible. For breast cells, in vitro 3D culture has proven to be an important tool for the analysis of luminal morphogenesis. A greater understanding of this process is necessary because alterations in the lumen arrangement are associated with carcinogenesis. Following lumen formation in 3D cell culture using laser scanning confocal microscopy, we observed alterations in the arrangement of cytoskeletal components (F-actin and microtubules) and increasing levels of cell death associated with lumen formation. The formation of a polarized monolayer facing the lumen was characterized through 3D reconstructions and the use of TEM (transmission electron microscopy), and this process was found to occur through the gradual clearing of cells from the medullary region of the spheroids. This process was associated with different types of cell death, such as apoptosis, autophagy and entosis. The present study showed that changes in the extracellular matrix associated with long periods of time in 3D cell culture lead to the formation of a lumen in MCF-7 cell spheroids and that features of differentiation such as lumen and budding formation occur after long periods in 3D culture, even in the absence of exogenous extracellular compounds.

The Aedes aegypti larval transcriptome: a comparative perspective with emphasis on trypsins and the domain structure of peritrophins

The genome sequence of Aedes aegypti was recently reported. A significant amount of Expressed Sequence Tags (ESTs) were sequenced to aid in the gene prediction process. In the present work we describe an integrated analysis of the genomic and EST data, focusing on genes with preferential expression in larvae (LG), adults (AG) and in both stages (SG). A total of 913 genes (5.4% of the transcript complement) are LG, including ion transporters and cuticle proteins that are important for ion homeostasis and defense. From a starting set of 245 genes encoding the trypsin domain, we identified 66 putative LG, AG, and SG trypsins by manual curation. Phylogenetic analyses showed that AG trypsins are divergent from their larval counterparts (LG), grouping with blood-induced trypsins from Anopheles gambiae and Simulium vittatum. These results support the hypothesis that blood-feeding arose only once, in the ancestral Culicomorpha. Peritrophins are proteins that interlock chitin fibrils to form the peritrophic membrane (PM) that compartmentalizes the food in the midgut. These proteins are recognized by having chitin-binding domains with 6 conserved Cys and may also present mucin-like domains (regions expected to be highly O-glycosylated). PM may be formed by a ring of cells (type 2, seen in Ae. aegypti larvae and Drosophila melanogaster) or by most midgut cells (type 1, found in Ae. aegypti adult and Tribolium castaneum). LG and D. melanogaster peritrophins have more complex domain structures than AG and T. castaneum peritrophins. Furthermore, mucin-like domains of peritrophins from T. castaneum (feeding on rough food) are lengthier than those of adult Ae. aegypti (blood-feeding). This suggests, for the first time, that type 1 and type 2 PM may have variable molecular architectures determined by different peritrophins and/or ancillary proteins, which may be partly modulated by diet.

Short terms effects of air pollution from biomass burning in mucociliary clearance of Brazilian sugarcane cutters

Nasal mucociliary system is the first line of defense of the upper airways and may be affected acutely by exposure to particulate matter (PM) from biomass burning. Several epidemiologic studies have demonstrated a consistent association between levels of air pollution from biomass burning with increases in hospitalization for respiratory diseases and mortality. To determine the acute effects of exposure to particulate matter from biomass burning in nasal mucociliary transport by saccharin transit time (STT) test, we studied thirty-three non-smokers and twelve light smokers sugarcane cutters in two periods: pre-harvest season and 4 h after harvest at the first day after biomass burning. Lung function, exhaled carbon monoxide (CO), nasal symptoms questionnaire and mucociliary clearance (MC) were assessed. Exhaled CO was increased in smokers compared to non-smokers but did not change significantly after harvest. In contrast, SIT was similar between smokers and non-smokers and decreased significantly after harvest in both groups (p < 0.001). Exposure to PM from biomass burning did not influence nasal symptoms. Our results suggest that acute exposure to particulate matter from sugarcane burned affects mucociliary clearance in smokers and non-smokers workers in the absence of symptoms. (C) 2011 Elsevier Ltd. All rights reserved.