NCube/papyrus huggingface dataset:
Multisite Research Ethics Review: Problems and Potential Solutions

Large scale, multisite clinical research trials have been increasing in frequency. As it stands currently, a research project performed at multiple institutions requires ethics review at each institution. While local (institutional) review may be necessary in some instances, repetitive reviews may require unnecessary changes and not serve to further protect participants. Multiple ethics reviews of a single study have been shown to delay research and require, in some cases, significant resources in order to fulfill the requests of individual ethics boards. This literature review discusses the conceptual issues and outlines empirical research surrounding multisite ethics review from different jurisdictions, as well as alternative methods to streamline the ethics review process including reciprocal review, centralized review, and a proposed modification to the centralized review process.

Keyphrases: multisite research, human subject research, research ethics board, institutional review board, reciprocal review, centralized review, multisite ethics review
Activité antimicrobienne de peptides provenant d’hydrolysats de protéines de babeurre, de lactoferrine et de pois

Antibiotics are frequently used in poultry feed in order to prevent certain diseases, including necrotic enteritis, which causes the emergence of bacterial strains resistant to antibiotics. A promising alternative is the use of antimicrobial peptides (AMPs) as dietary supplements, such as AMPs from dairy products. The objective of this project was to develop a production method for the extraction peptides, from co-produced food processing (buttermilk, lactoferrin, pea protein isolates). These peptides were tested for the detection of antimicrobial activity on the following specific poultry pathogens; Salmonella Enteritidis, Salmonella Typhimurium, Escherichia coli and Staphylococcus aureus. Proteins were suspended in water (5% w/w) and pepsin hydrolyzed by pepsin for 6 hours at pH 2.5. Peptides were recovered by ultrafiltration (< 10 kDa) and fractionated based on the basis of their ionic charges: total, cationic, anionic and unbound peptides, to specifically target the fractions with antimicrobial activities. Bacterial survival was measured in contact with different peptides concentrations. Cationic buttermilk extracts were effective at a concentration less or equal to 5 mg / mL; loss of 3 log for Escherichia coli O78: H80, compared with lactoferrin which was effective at a concentration less than or equal to 0.6 mg / mL; loss of 6 log for E. coli O78: H80. The peptide extracts from pea showed low efficiency. The use of antimicrobial peptides, from buttermilk, lactoferrin and peas, is promising for the development of an alternative or a complement to reduce antimicrobial use.

Keyphrases: Antimicrobial peptide, Buttermilk, Lactoferrin, Pea, Avian pathogens, Absorptive membrane chromatography, Ionic charge
Les effets du vieillissement sur la pharmacodynamie et la pharmacocinétique de la kétamine et de la xylazine chez le rat Sprague-Dawley

In laboratory animals, even if inhalation anesthetics are generally safer than injecting, their usefulness is often restrained when an experimental design does not allow it. For this reason, ketamine combinations are considered the option of choice for injecting anesthesia in rats. Aging brings degenerative changes in the structure and function of the organs, often affecting the pharmacokinetics of drugs. This project focuses on the evaluation of physiological, pharmacokinetic, biochemical and histological changes during a ketamine-­‐xylazine anesthetic combination in aging Sprague-­‐Dawley rats. Anesthesia with ketamine-­‐xylazine was induced in Sprague-­‐Dawley rats of different ages. To assess the effect of aging on the metabolism of both drugs, periodic blood samples for pharmacokinetic analysis and measurements of physiological, biochemical and histological parameters were performed. Aging have made some changes for example a decrease in oxygen saturation, a sharp drop in heart and respiratory rate, hypoalbuminemia and an increase in the duration of anesthesia. The pharmacokinetic parameters of ketamine and xylazine were greatly affected in older animals, causing a significant increase in the area Under the curve (AUC) and the half-­‐life time, and a decrease in clearance. In the light of these results, dosage of ketamine and xylazine must be adapted in aging rats to allow a short anesthesia and an awakening without complications.

Keyphrases: Xylazine, Sprague-Dawley rat, Anesthesia, Ketamine, Xylazine, Aging, Pharmacokinetic
Perspectives de l'usage de poudre de jaunes d’oeuf comme additif alimentaire contre Campylobacter jejuni chez le poulet : mode d'immunisation et effet de l’encapsulation

Campylobacteriosis is a zoonosis caused by Campylobacter jejuni, a commensal bacterium of chicken. Chickens are considered the main identified source of human infection. C. jejuni is rarely found in the digestive tract of chickens before two or three weeks of age. Part of this may be caused by the transmission of maternal immunity (IgY antibodies) to the chicks via the egg yolk. At the Research Chair in Meat Safety (RCMS), a characterization of IgY antibody extracted from fresh egg yolks showed different production levels of antibodies, depending on the mode of immunization of the laying hens, and were proven, in vitro, to recognize  the pathogen. These findings suggest that, as a feed additive, a potentiated egg yolk powder could fight against C. jejuni colonization in broilers. In this work, the additive manufacturing process (dehydration by « Spray dry » and then encapsulation) is evaluated and the different methods used to immunize the corresponding laying hens were also compared. Antibodies were extracted from the egg powers or the final encapsulated product, and characterized in vitro (dosage/ELISA, mobility and bactericidal tests, Western blot). Then, an in vivo assessment of the ability of these encapsulated powders, incorporated at 5% in the feed, to reduce or block intestinal colonization by C. jejuni in birds was tested. In vitro results showed antibody concentrations and effectiveness were variable depending on the type of immunization. In this study, it was observed that the “spray drying” concentrated the antibodies in powders and that these antibodies remained functional against C. jejuni. It was also observed that encapsulation does not lead to quantitative and quantitative loss of antibodies contained in the powder. However, despite the encouraging in vitro results, in the in vivo C. jejuni assay, no inhibition or reduction of birds’ colonization could be observed. This lack of effectiveness of the encapsulated egg yolk powders should not be due to a loss of the quantity and/or quality of the antibodies as supported in the in vitro experiments. This shows that more research is needed to determine the optimal conditions for potentialized egg yolk powder to be use in vivo as a food additive to control C. jejuni colonization in chickens.

Keyphrases: Campylobacter jejuni, Immunoglobuline, Campylobacter jejuni, Chicken colonization, Egg yolk powder, Immunoglobulin
Elucidation of the biological roles of Wnt5a signaling in follicle development

Follicle health is determined by an array of endocrine, paracrine and autocrine factors. Pituitary gonadotropins (LH and FSH) are major drivers of follicle development, but their actions are modulated by local hormones and growth factors. The WNT family of secreted glycoproteins are signaling molecules that act to modulate and coordinate follicular responses to the gonadotropins, and whose activities are indispensable for ovarian function and female fertility. WNTs are normally categorized according to pathway(s) via which they signal. The role of canonical WNT members and components such as CTNNB1, WNT4, WNT2, FZD4 and FZD1 is well established during follicle development in rodents. Whether WNTs play similar roles in monovular species remains essentially unknown. Moreover, the role of non-canonical WNTs in the rodent ovary is unclear. The objectives of the present thesis were (1) to elucidate the hormonal regulation of WNT5a expression and the physiological role of WNT5a in bovine granulosa cells in vitro and (2) to identify the physiological roles of WNT5a in the mouse ovary by conditional gene inactivation. The results of this thesis are presented in two articles. In the first article, the role of WNT5a in bovine granulosa cells was investigated in vitro. We found that WNT5A is a negative regulator of FSH-stimulated granulosa cell steroidogenesis, and that it acts by suppressing canonical WNT signaling activity and inducing the noncanonical MAPK8/JUN pathway. In the second article, we generated granulosa-specific knockout mouse models to examine the roles of two non-canonical WNTs, WNT5a and WNT11, in different stages of the follicular development. Our results showed that WNT5a is required for normal female fertility, follicle development and ovarian steroidogenesis, and is an antagonist of gonadotropin responsiveness that acts via the suppression of canonical WNT signaling. However we did not observe any significant defects in fertility of WNT11 knockout mice. Together, our work demonstrates that WNT5a is essential for normal follicle development and acts to inhibit differentiation in granulosa cells. In overview, we provided a novel and comprehensive investigation, using multiple models and techniques, to determine the mechanisms by which WNT5a regulates follicle development.

Keyphrases: WNT5a, Knock-out mouse, Cow, Follicle development, Ovarian steroidogenesis, Granulosa cells
Non-Invasive Prenatal Testing: Review of Ethical, Legal and Social Implications

Non-invasive prenatal testing (NIPT) using cell-free fetal DNA (cffDNA) from maternal blood has recently entered clinical practice in many countries, including Canada. This test can be performed early during pregnancy to detect Down syndrome and other conditions. While NIPT promises numerous benefits, it also has challenging ethical, legal and social implications (ELSI). This paper reviews concerns currently found in the literature on the ELSI of NIPT. We make four observations. First, NIPT seems to exacerbate some of the already existing concerns raised by other prenatal tests (amniocentesis and maternal serum screening) such as threats to women’s reproductive autonomy and the potential for discrimination and stigmatization of disabled individuals and their families. This may be due to the likely upcoming large scale implementation and routinization of NIPT. Second, the distinction between NIPT as a screening test (as it is currently recommended) and as a diagnostic test (potentially in the future), has certain implications for the ELSI discussion. Third, we observed a progressive shift in the literature from initially including mostly conceptual analysis to an increasing number of empirical studies. This demonstrates the contribution of empirical bioethics approaches as the technology is being implemented into clinical use. Finally, we noted an increasing interest in equity and justice concerns regarding access to NIPT as it becomes more widely implemented.

Keyphrases: test prénatal non-invasif (TPNI), discrimination, attitudes eugéniques, non-invasive prenatal testing (NIPT), ethical legal and social issues (ELSI), reproductive autonomy, informed consent, pregnancy termination, discrimination, eugenic attitudes, NIPT implementation
Plan d’intervention visant à soutenir le processus décisionnel concernant l’implantation d’un dispositif d’assistance ventriculaire auprès des patients vivant avec l’insuffisance cardiaque avancée et leur famille

The offer of a ventricular assist device (VAD) involves complex choices and informed decision. The decision-making support in this context requires nursing practice skills to promote better patient outcomes. This project aimed to co-develop and pilot an intervention plan to support shared decision-making (SDM) for patients considering a VAD, their caregivers and the multidisciplinary healthcare team. The project involved a focus group for patients and caregivers to explore their decision-making needs, regular team meetings, a workshop for professionals on SDM approach and clarification of professional values, and the creation of a decision aid based on these needs. The focus group’s main results revealed patient’s needs to better understand their life trajectory with, or without, a VAD, caregiver’ needs for better stress management, and the need for better resource accessibility. Regular team meetings aimed to inform and to collect comments to insure feasibility and sustainability of the project. The SDM workshop aimed to increase competence toward this approach and the use of the decision aid tool. The resulting decision aid answered the team’s initial needs for informational support, decisional process standardization and optimization of information exchange. An algorithm was developed to help patients and families reflect on their treatment options according to their values and life objectives. This project is timely relevant given the increase in VAD implantation in Canada. The intervention could also be applicable to other decision-making situations in which active patient and family participation can improve the quality of the process.

Keyphrases: Heart failure, Ventricular assist device, Shared decision-making, Decision aid
L'apprentissage de l'approche systémique familiale dans la formation universitaire de premier cycle en sciences infirmières

Several scientific literature supports the importance of family support in a family systems approach, but few nurses incorporate it into their practice (Duhamel, 2010). Several factors related to the working environment account for this situation (Henderson, 2002), as well as initial training. Indeed, students who complete an undergraduate nursing program feel poorly equipped and supported in their practice of family care (Blöndal et al., 2014). A thorough review of programs in Nursing Schools (NS) in Quebec has shown that the notions of family systems approach are taught in a single course and not included in other courses of the curriculum, limiting the integration of knowledge in nursing practice. Following several written submissions and consultations, the committee working to update the bachelor program at the NS from the University of Montreal (UdeM) proposed to divide the formation of family systems approach over the three years of the Bachelor . This situation gave rise to the current training project, with the goal of integrating learning the family systems approach in university undergraduate education in nursing. As part of the internship, the intern, initially established conceptual links between family systems approach and Modèle humaniste des soins infirmiers - UdeM. Thereafter, the trainee has developed, in consultation with those concerned, educational activities aimed at the development of care-related skills to the family and that, for the first undergraduate year of training in nursing. These training activities were presented as a guide, presented in this training report, to the attention of teachers, who will teach the family systems approach in the context of a first program degree in nursing. These training activities aim a better assimilation of knowledge in family systems approach for future nurses, to enhance their sense of competence, and improve the quality of care for patients and families.

Keyphrases: family nursing, family systems approach, learning
Transfert de connaissances sur les interventions infirmières pour la prévention du suicide auprès des gens vivant avec un trouble concomitant de santé mentale et de toxicomanie

Based on the numbers of the Institut national de santé publique du Québec (2010), the province of Québec ranks fourth among a total of twenty-one countries with its suicidal rate. Suicide is considered a public health problem, its prevention is a priority since 1994 (Cliniques psychiatriques de France, 2010) and it is seen as an avoidable major problem by the World Health Organisation (Organisation mondiale de la santé, 2011). The evaluation of the suicidal risk is only a first step that must lead to an adequate outreach. Despite the fact that tools and knowledge are now available, standardized and implemented in the organisation of the Centre Hospitalier de l’Université de Montréal (CHUM), they are not always adequately put into practice. As long as the nurses do not apply correctly the follow-ups, improvements will never be seen in the efficiency of the healthcare. The objectives of the present work are to find-out ways to help all of the outreach workers of the Unité de Psychiatrie des toxicomanies (UPT) of the CHUM in their evaluation process as well as in their practice, and thus ameliorating the prevention of suicides amongst people living with concurrent disorders. In order to achieve this goal, the transmission of suicidal prevention knowledge appears to be a key to improve the nursing work as well as the quality and the security of the healthcare. This study proposes to determine which model or models of knowledge transmission are more adequate for those working in the suicidal prevention section of the UPT. After a critical analysis of diverse models of knowledge transmission found in theoretical and empirical writings, and keeping in mind that changing a clinical practice is a complex and difficult process, we propose a combination of various models. The major theoretical models are the RNAO (2002), the NICE (2007) as well as the Oxman, Thomson, Davis & Haynes strategies (1995), and they should allow the implementation of the knowledge transmission principle in the nursing outreach work oriented towards suicidal prevention, beneficing those living with concurrent disorders of mental health and drug addiction. Some recommendations for the nursing work and research are also presented.

Keyphrases: Suicide, Toxicomanie, Knowledge transmission, Mental health, Drug addiction, Nurse outreach, Suicidal prevention, Concurrent disorders
Favoriser le développement du rôle des infirmières chefs afin d'accroître les pratiques basées sur des résultats probants en centre hospitalier

Two points stand out from observing training and coaching sessions on evidence-based practice (EBP). First, the process of reflection that guides decision making and intervention by staff nurses with respect to patients does not always seem to take account of the notions learned in training. Straus, Tetroe, and Graham (2009) referred to this years ago when they pointed out that a gap existed between evidence and decision making across the various levels of the healthcare system, including among health professionals. Second, characteristics related to head nurses and organizations influence their interventions to the detriment of EBP (Doherty-King & Bowers, 2011). Presented in the form of an integrative and critical review of the literature, this supervised work seeks to propose an intervention strategy geared to developing the role of head nurses in promoting the application of research-based knowledge by hospital staff nurses. Its aim is to identify the barriers and facilitators encountered by head nurses and to highlight interventions capable of supporting the lasting implementation of EBP in their care units. To meet these two objectives, an electronic search of the empirical literature was carried out on three databases. On the 532 empirical studies found, 16 were retained and analyzed based on the knowledge-to-action (KTA) framework developed by Straus, Tetroe, and Graham (2011). The result of this analysis and the recommendations that flow from them are presented, discussed and then summarized in a table. Results show that in order to foster the application of EBP among staff nurses, head nurses and senior managers in organizations could implement interventions centred on each of the seven steps of the KTA process proposed by Straus et al. (2011). Moreover, interventions under the responsibility of organizations turn out to be prerequisites for others that could be delivered by head nurses. Furthermore, it emerges that head nurses and organizations must deploy interventions that take account not only of the local context but also of the barriers and facilitators encountered in the course of implementing, operationalizing and monitoring EBP in units. Finally, staff nurses would stand to benefit from interventions focused on communication, role modeling, and support delivered by head nurses and their hierarchical superiors throughout the KTA process (Straus & al., 2011).

Keyphrases: Head nurses, Professional role, Acute care hospital, evidence-based practice, Integrative review
L’étendue optimale de la pratique de l’infirmière et l’infirmière clinicienne en première ligne

Mistakenly, many nurses, nursing managers and other professionals associate their scope of practice to the tasks they accomplish in their work day. However, exercising the full scope of nursing practice is related to the use of one’s abilities demonstrating a high level of knowledge and judgment tinged by skills, training and experience across the field of practice (D’Amour et al., 2012). This paper, which specifically targets primary care nursing managers, is a tool for primary care nursing managers aimed at understanding and defining the scope of nursing practice to better implement changes in organizational contexts and optimize this said practice. The scoping review analysis of articles revealed the findings that the expected role of the primary care nurse technician is to work with the client and his family in his care process while the expected role of the nurse clinician is not only to intervene in the client/family care process but to contribute to the advancement of the practice, whether it is for the creation of partnerships, professional development of nursing staff or research. This analysis also showed an important distinction between the expected role and the role behavior. Indeed, the role behavior reflects the suboptimal use of both the nurse technician and the nurse clinician who are, among others, assigned to tasks that require none of their professional skills. Training, decision making mechanisms, practice environment and collaboration certainly have an influence on the scope of nursing practice in primary care. Nevertheless, through changes operated by primary care nursing managers, optimizing the scope of nursing practice is mission impossible. By adopting a transformational leadership, educating the manager to the concept of optimal scope of practice and introducing the role of case manager for the nurse clinician, both the roles of the nurse and the nurse clinician in primary care can be clearly defined

Keyphrases: Scope of nursing practice, Optimize, Primary care