NCube/papyrus huggingface dataset:
Effet du prix des cigarettes et de l’exposition à la publicité en faveur du tabac sur le tabagisme des adolescents d’Amérique du Sud

The tobacco epidemic is responsible for the death of millions of people, and despite this fact the consumption of tobacco products is increasing globally. The majority of smokers now live in low-and middle-income countries, and non-communicable diseases linked to tobacco represent an important burden for these health systems. Such is the case for South American countries, and high smoking prevalence among teenagers of this region is also worrying. This study, based on Global Youth Tobacco Survey data, has examined the impact of cigarette prices and exposure to tobacco advertising on smoking among South American adolescents. Self-reported prices and levels of exposure to advertising have been used to model the relationships, and the smoking behaviors studied were experimentation, participation and consumption. The total survey sample included 134, 073 respondents from 12 countries. The results showed that exposure to tobacco advertising had a positive impact on smoking among adolescents. Although there is a clear consensus in the literature about the negative relationship between cigarette prices and smoking, it could not be demonstrated strongly in this study. Problems inherent to the database may explain these unexpected results and some methodological aspects are questioned.

Keyphrases: Adolescents, Cigarette, Taxes, South America, Low-and middle-income countries, Adolescents, Youth, Smoking, Cigarette, Taxes, Price, Advertising
L'humanité et le droit international

Law is possible only when mankind upholds it. Yet the notion of humanity was not taken into account until late by international law and this only as an object thereof. Since the second half of the 20th century, right after the Second World War, calls for humanity have nevertheless multiplied to the point where it is now a recurring reference both transcending and interdisciplinary. The taking into account of the juridical aspects of humanity remains complex in the Westphalian paradigm which it challenges as it reveals its contradictions over time, but has difficulties to surpass. Thus, all attempts aimed at recognizing that humanity has a personality and a heritage and to ensure its common interests have met with mitigated results. The profound changes which confront international law under the influence of globalization could well be an opportunity to re-think law for humanity, and especially reaffirm the universal values it promotes.

Keyphrases: International Law, Mankind, Sovereignty, Common Heritage of Mankind, Globalization
Influence de la culture organisationnelle et du type de leadership sur la satisfaction au travail des infirmières soignantes

The national average of nurses leaving their job in the first year of employment is 19,9% (O’Brien-Pallas, 2010). Those changes represent an important training cost as it is estimated that hiring and orienting a nurse on a unit costs 30 000$ (Hayes, 2007). This thesis is based on the idea that nurse managers’ leadership style and their management interventions are playing an important role in nurse retention. In turn, retention contributes in maintaining and improving a healthy work environment where those conditions facilitate organisational and operational adaptation (Cummings, 2005). From an environmental perspective for analysing organisational systems, this implies that good functioning of health care establishment depends on its capacity of “acquiring and maintaining resources” (Pfeffer, 2003 p.2), which includes human resources. The goal of the present master’s thesis is to analyse the influence of organisational culture and nurse managers’ leadership style on bedside nurses’ intent to quit actual position and their perceived environment quality. This quantitative study is based on a correlational design. To ensure representativeness, a probability sampling was used. Biostatistician of the College of Nurses of Quebec (OIIQ) provided the names and addresses of 1,000 nurses working on the wards of four hospitals targeted by the study. Four major relations were detected after data analysis. The first relation was established between organisational culture and the type of leadership used by nurse managers. Second relation was established between organisational culture and its impact on bedside nurses’ perceived environment quality. Third relation was established between the type of leadership used by nurse managers and its impact on bedside nurses’ perceived environment quality. Finally, it was demonstrated that resonant leadership acts as a mediator between organisational culture and perceived environment quality. Suggestions for improvements regarding organizational and academic levels and recommendations at the management and nursing practice levels arising from the analysis.

Keyphrases: Leadership, Perceived environment quality, Organisational culture
Fonctions antitumorales de la voie ERK/MAPK et développement rationnel de nouvelles stratégies thérapeutiques

The Extracellular Signal-Regulated Kinases (ERK1/2) regulate multiple cellular processes such as proliferation, survival and differentiation. These kinases are the last component of the ERK/MAPK pathway, which is activated in about 30% of all human cancers. Therefore, current thinking proposes that the ERK/MAPK pathway is a critical mediator of tumor progression. However, a steadily growing number of observations suggest that ERK kinases could trigger tumor suppression as well.  The first aim of this thesis is to determine how ERK signaling triggers tumor suppression and to try to reconcile these mechanisms with its putative contribution to tumor progression. Since our work has a profound impact on the value of some therapies currently in development, the second aim of the thesis is to propose new strategies to fight cancer.  We found that hyperactivation of the ERK kinases induces cellular senescence. Mechanistically, this involves selective proteasome-dependent protein degradation. This “Senescence-Associated Protein Degradation” (SAPD) targets proteins required for several cellular functions, including cell cycle progression, mitochondrial functions and ribosome biogenesis. Furthermore, our results showed that downregulation of ERK signaling not only inhibits the establishment of senescence but promotes cellular reprogramming, thereby allowing precancerous cells to gain tumorigenicity and cancer cells to acquire stem cell-like properties. These results suggest that mechanisms downregulating the ERK/MAPK pathway could promote cancer initiation, metastasis and resistance to multiple therapies. Finally, we demonstrated that the antidiabetic drug metformin targets the transcription factor NF-kB. The latter plays a central role in reprogramming, but also in the generation of deleterious pro-inflammatory cytokines by senescent cells. Hence, we suggest that metformin could be used in combination with other therapies to avoid the side effects of either downregulating or overactivating ERK signaling.  Taken together, the results presented in this thesis demonstrate that the outcome of the ERK/MAPK pathway activity depends on signaling strength. While a moderate activation of the pathway may contribute to cell proliferation, a strong activation induces senescence and, conversely, a low activation promotes cancer cell reprogramming. This versatility of the pathway suggests caution with the use of ERK/MAPK pathway inhibitors, but motivates us to develop new therapeutic strategies, which could include metformin.

Keyphrases: Cancer, ERK, SAPD, SASP, NF-kB, Cancer, ERK, Tumor suppression, Cellular senescence, Protein degradation, SAPD, SASP, Cellular reprogramming, NF-kB, Metformin
Subluxation de la tête radiale suite au malalignement du cubitus proximal : une étude biomécanique

It has been shown that the proximal ulna has a sagittal bow, named the Proximal Ulna Dorsal Angulation (PUDA), unique for each individual.  Non-anatomic reconstruction of the proximal ulna following a complex injury may lead to malunion, arthrosis and instability, hence the importance of understanding its initial anatomy.  The purpose of this study was to evaluate the magnitude of angular malalignement at the proximal ulna dorsal angulation that would lead to radiocapitellar malalignement, with and without an intact annular ligament.  In order to achieve our goal, a biomechanical study was conducted on six fresh frozen specimens, with an elbow movement simulator.  Simulated fractures at the PUDA were stabilized with internal fixation at five different angles.  Then, fluoroscopic images were taken in different elbow and forearm positions, first with the annular ligament intact and then released.  Radial head displacement was quantified with the Radio-Capitellar-Ratio (RCR).  Overall, a significant interaction was found between elbow positions, angles of malalignement and annular ligament integrity.  Radial head subluxation was emphasized when the annular ligament was ruptured.  Moreover, anterior subluxation of the radial head increased as malalignement was fixed into extension and with progressive elbow flexion.  Furthermore, posterior subluxation increased with malalignement into flexion and with elbow extension.  In conclusion, our results demonstrate the importance of obtaining an anatomic reconstruction, specific for each individual’s unique proximal ulna dorsal angulation, following a proximal ulna fracture.  Indeed, malalignment of 5 degrees can lead to abnormal tracking of the radial head, especially when associated with annular ligament tear.

Keyphrases: PUDA, Radial head instability, Radial head subluxation, Radial head dislocation, Proximal ulna fracture, Olecranon fracture, Monteggia fracture, Proximal ulna malalignment, PUDA, Elbow, Radio-capitellar ratio measurement
Élaboration d’un programme de formation continue en ligne sur les soins palliatifs aux personnes atteintes d’insuffisance cardiaque

The benefits of palliative care for people with chronic disease is now recognized worldwide (World Health Organisation, 2004). Despite this fact, many elderly patients with heart failure are still dying in acute care hospital settings cared for by nurses who are inappropriately trained to cope with their condition (National Public Health Institute of Quebec, 2006). This can be solved by training nurses who are likely to care for families with dying patients in the field of palliative care. Unfortunately, today, nurse’s shortage threatens the attendance of continuing education courses. Another idea is to allow nurses to complete their studies online which offer flexible hours and accessible Internet locations. It would be imperative to consider these propositions in favor for palliative care tutoring and online studies in order to insure the well-being of future elderly patients. In consequence, the goal of this paper is to formulate propositions in regards of the content and he form that should have an online course on palliative care for elderly with heart failure. To achieve that aim a synthesis of theoretical and empirical studies on palliative care for heart failure and the use of Internet in continuing education was made.

Keyphrases: Heart failure, Palliative care, End of life palliative care, Online education
Le développement du raisonnement clinique des infirmières nouvellement diplômées en soins critiques

The scientific literature on the clinical practice of newly graduated nurses beginning their career in a critical care unit highlights their initial challenges. However, little research has focused on their need to further develop their clinical reasoning (CR) and the appropriate educational strategies to use in order to meet their learning needs. The goal of this supervised work was to understand, using a critical literature review, different educational strategies to develop the CR of the newly graduated nurses starting to work in critical care, and to propose CR development workshops which would be both achievable and effective. Benner (1982) and Johns (2006) have established that reflection based on clinical experience is a central element to the nurses' professional development. Consequently, reflective practice would benefit nurses in many aspects. Amongst these benefits, reflective practice contributes significantly to the development of clinical skills including the CR. Therefore, we are proposing workshops in which a model of structured reflection, using questioning, has been selected in order to enhance the reflection up to a level where newly graduated nurses, after improving their CR, can evaluate critically their clinical practice.

Keyphrases: Clinical reasoning process, Clinical reasoning, Educational strategies, Critical care, Educational needs
Implanter et pérenniser un système de gestion de la performance des services infirmiers

Background: Due to current economic pressure many projects have emerged in Europe to conceive, evaluate and install performance management systems and tools in health care facilities. Unfortunately, nursing input into the broader clinical care of hospitalized patients remains often under-utilized or sometimes even invisible. The capacity and capability of nursing personnel to enable favorable and improved health care outcomes for patients due to quality and efficiency measurement concepts, systems and tools would have the potential to generate significant benefits, both to the patients and to the overall increase in workplace performance. The objective of this supervised study is to identify the different strategies employed to obtain a sustainable implementation of nursing performance management systems (SGPSI) within health care institutions, and to provide recommendations and guidance to nursing management.  Methodology: The review of literature, including those obtained from CINAHL, Embase, Medline, Google Scholar, as well as various gray literature data, and based on the overall framework of large-scale changes within the health care environment of Perla et al. (2013).  Result: This written analysis identified four areas relating to the framework of Perla et al. (2013), and also proposed 26 strategies for a sustainable implementation of an NPMS.  Conclusion: This review establishes propositions and recommendations that will allow nursing management to implement an SGPSI in a sustainable, cohesive and  efficient manner, through a context-based synergy of the various actors and expertise available within each organization.

Keyphrases: innovation, innovation, nurse, nursing administration, nursing staff, performance measurement systems, quality improvement, performance evaluation
L’exploration de l’aspect humain du transfert de connaissances pour l’amélioration de l’utilisation des données probantes en milieu clinique

The Nursing science literature on the implementation of evidence based practice in a clinical setting highlights the need to find effective strategies to improve the use and sustainability of evidence based practice. The main goal of this paper is to analyze the importance of the human aspect during knowledge transfer in the context of a change in practice based on conclusive data. Both the authors of PARISH and the knowledge conversion model of Nonaka have inspired this paper. These models conceived that richness in communication and the exchange between humans as a source of reflection on the creation of a positive environment to favour change of practice. Our literature review concludes that human relations influence the context of care during the transfer of knowledge of a practice that is evidence based. The analysis findings indicate that team leadership influences both the practice and behaviour of clinicians through the diffusion of the vision and culture of the unit. Our belief is that transformational leadership will generate active participation among clinicians in the decision making process, which in turn will lead to developing critical thinking of clinicians to achieve exemplary practice. In addition, a context of care based on a teaching organization and a culture of evidence based practice with clinical support provides favourable conditions to improve the use of evidence based practice.

Keyphrases: Evidence Based Practice, Knowledge transfer, Model knowledge conversion of Nonaka, Nursing, PARIHS model
Optimisation de la préparation des infirmières œuvrant aux soins intensifs en vue de leur certification canadienne

Nurses working in critical care units face multiple sources of stress such as the use of advanced technologies and the interaction with suffering patients and families.  In addition, these environments are, more than ever, dealing with staffing shortage and retention difficulties, as well as high absenteeism levels (O’Brien-Pallas, Tomblin Murphy, Shamian, Li & Hayes, 2010). Thus, this context holds the potential to affect the psychological health of caregivers. While governmental committees directed interventions toward financial incentives and support, literature rather argues that satisfaction and health can be improved by promoting continuous education and professional growth (Kuokkanen, Leino-Kilpi, & Katajisto, 2003; Leblanc & Sylvain, 2011). National certification, particularly, appears to generate those benefits (Fitzpatrick, Campo, Graham, & Lavandero, 2010; Ridge, 2008; Tigert, 2004).  However, organizational support as been reported as essential so those effects are perceived by the professionals and eventually the patients and the clinical setting (Byrne, Valentine, & Carter, 2004; Niebuhr & Biel, 2007). In the course of a graduate studies’ internship, an educational activity aimed at optimizing the preparation of nurses involved in the certification process was developed and implemented in an intensive care unit. Based on the humanist theory (Cara, 2013; Girard & Cara, 2011; Watson, 1985/2007), the intervention allowed the participants to receive tailored and comprehensive support. Problem-based learning (Barrett & Moore, 2011; Barrows, 2000; Duch, Groh and Allen, 2001) was also used to facilitate learning by contextualizing theoretical content while integrating humanist principles. Following the activity, participants reported feeling more prepared and more supported to achieve the certification process.  The article describes how an educational activity could potentially empower nurses and enhance their personal and professional growth.

Keyphrases: National certification, Credentialing, Critical care, Nurse(s), Psychological health
Développement avec les infirmières en oncologie d’un outil de planification pour l’implantation du dépistage de la détresse auprès de la clientèle

While distress screening is currently the subject of considerable attention, it is not often planned in project management terms. Implementing a distress screening program is a major change that requires careful planning, as failures are often, in fact, related to lack of planning. The nursing literature provides little or no information on project management methodologies. Despite the available documentation on this approach, setting up such a program presents significant challenges because the processes must be clear and well designed.   This is the context within which we developed a planning tool for implementing distress screening in oncology patients. Although the tool is based on the Project Management Institute (PMI) methodology (2008) to guide the more operational aspects of different interventions, we also used the model developed by Hamric, Spross and Hanson (2005) to ensure a nursing perspective. Nurses, nurse administrators, and clinical nurse specialists in oncology also made important contributions to the tool’s development and validation.

Keyphrases: Screening for distress, Project management, Planning, Implementation
La dynamique spatio-temporelle des flux d’oxyde nitreux (N2O) des lacs, rivières, et étangs boréaux

Nitrous oxide (N2O), a potent greenhouse gas with over 300 times the global warming potential of carbon dioxide (CO2), is produced during microbial nitrogen (N) cycling (Trogler 1999). Inland waters, known as active sites of N processing (Seitzinger et al. 2006., Harrison et al. 2008), are nevertheless poorly characterized in recent global N2O budgets (Nevison 2000, Intergovernmental Panel on Climate 2006), especially considering the absence of an estimate for lakes emissions. Although the boreal biome holds the highest density of freshwater on earth (Lehner and Döll 2004), no comprehensive evaluation of N2O emissions from boreal aquatic systems has ever been conducted. In this study, we measured N2O concentrations across a wide range of rivers, lakes, and ponds in four distinct boreal regions of Québec (Canada), and derived water surface-atmosphere N2O fluxes. Net fluxes ranged from -23.1 to 177.9 μmol m-2 d-1, with a large degree of variability across sampled systems, regions, and seasons. Over 40% of the 322 systems sampled acted as N2O sinks during the summer, with one region’s aquatic network being an overall net atmospheric N2O consumer. Seasonally, maximum N2O concentrations were measured during winter due to gas accumulation under the ice, resulting in an outgassing at ice thaw that accounts for approximately 20% of annual flux. Lakes were major drivers of the net freshwater regional flux (up to 90%), and must therefore be integrated in global aquatic N2O budgets. Based on empirical literature data, we estimated global freshwater N2O emissions to be 0.78 Tg N (N2O) yr-1. This number is subtantially influenced by fluxes from high latitude regions (including the boreal biome) which, being extremely variable, may contribute from -9 to 27 % of the total.

Keyphrases: Flux, Nitrous oxide, Freshwaters, Boreal, Greenhouse gas, Nitrogen cycle
Activation du système nerveux autonome lors du sommeil nocturne et lors du sommeil de récupération diurne chez les somnambules et les sujets contrôles

Sleepwalkers show a dysfunction in the regulation of slow-wave sleep (SWS). Autonomic function is closely related to sleep stage regulation and reflects SWS intensity. We thus investigated cardiac autonomic function during SWS in sleepwalkers and controls during normal sleep and recovery sleep following sleep deprivation. Fourteen adult sleepwalkers (9 women, 5 men; 28.1±5.8 years) and 14 sex- and age-matched normal controls (27.8± 6.0 years) were evaluated prospectively by video-polysomnography for one baseline night and during recovery sleep following 25 hours of sleep deprivation. Heart rate (HR) and the spectral components of HR variability during subjects' SWS were investigated during the first and second sleep cycles of both sleep conditions. Five-minute segments of electrocardiographic recordings from SWS were used to investigate HR, low-frequency (LF) and high-frequency (HF) components of the HR spectral decomposition in absolute and normalized units (LFn and HFn), and LF/HF ratio during subjects’ first two sleep cycles. During the first sleep cycle, sleepwalkers, but not controls, showed a decrease in LF/HF ratio and LFn as well as increased HFn from baseline to recovery sleep. During the second sleep cycle, sleepwalkers showed increased HR from baseline to recovery sleep whereas a decrease in HR was observed in controls. Compared to control subjects, sleepwalkers show a greater increase of parasympathetic tone and greater decrease of sympathetic tone during the first sleep cycle of their recovery sleep as compared to baseline. Since the first sleep cycle during recovery sleep constitutes a time window preferentially associated with the occurrence of somnambulistic episodes in predisposed participants, this parasympathetic hyperactivity may be implicated in the pathophysiology of sleepwalking.

Keyphrases: Sleep deprivation, Heart rate variability, Autonomic nervous system, Electrocardiogramm
Synthesis of (S)-cEt-LNA

(S)-cEt-LNA nucleoside was synthesized by three different routes starting from  commercially available 5-methyluridine. The shortest route includes a diastereoselective  methylation of an aldehyde, and a 5-exo-tet cylization of an ether via SN2 displacement.

Keyphrases: (S)-cEt-LNA, Technologie antisens, Nucleoside, Antisense technology