NCube/papyrus huggingface dataset:
La pratique de la bioéthique : quel horizon méthodologique?

This paper proposes to see the field of bioethics as a set of activities operating through two main modes of identification: the purpose of the activity (ethical issues raised by medicine, health and well-being) and the method of the activity. The paper summarizes some of the highlights of these two modes as they have historically and gradually contributed to differentiate bioethics. In so doing, the paper also suggests an original interpretation of the future of this field, in associating methodological concerns with a democratic agenda.

Keyphrases: bioethics, histoire, history, epistemology, method
Conflict of Interest in University Technology Transfer

Conflicts of interest (COI) and commitment in universities are not only issues limited to university researchers; they may become issues for individuals’ professional actions or decisions at the level of administrative staff. For example, people associated with technology transfer licensing also need to be alert to COI, and to ensure they take appropriate measures to meet their commitments and work in line with the interests of their employer (the University) and the researchers with whom they work.

Keyphrases: conflict of interest, conflict of commitment, university, technology transfer, commercialization, patent
Archéologie amérindienne au Québec : intérêts divergents et collaboration fragile entre archéologues et communautés autochtones

In this fictional case study, a preliminary excavation agreement has been reached between the local Innu community, the Ministry of Culture and the Status of Women and an archaeological firm, in order to enable the protection of a site dated to the Late Woodland period. Following the discovery of a burial, the terms of the agreement are no longer met. This is a problematic case in Quebec archeology where the interests of different actors conflict.

Keyphrases: archeology, native communities, ethnocentrism, Late Woodland, excavation permits, legislation
Conflict of Interest Policies at Canadian Universities and Medical Schools: Some Lessons from the AMSA PharmFree Scorecard

Launched in 2007, the American Medical Students Association (AMSA) PharmFree Scorecard is an annual ranking of conflict of interest (COI) policies at American medical centres; it focuses on COIs that may occur when medical education seems likely to be influenced by university-industry relationships, especially those with the pharmaceutical and medical device industries. The PharmFree Scorecard has proven influential in stimulating changes in policy regarding the management of COI at American medical institutions, thus it provides a useful jumping off point for reflection on how and why medical education institutions in other countries – and for our purposes, Canada – should pay more attention to the appropriate identification and management of COI. The PharmFree Scorecard methodology examines a diversity of factors and interests that could influence medical education; as such, it is an interesting approach to analysing the COI policies of medical schools. To test its utility or applicability outside the US, we decided to apply the PharmFree Scorecard to the COI policies of the 16 Canadian universities hosting medical schools. Overall, Canadian institutions rank very poorly, especially in ensuring that education and training tools are provided to staff, students and faculty members to enable the identification and management of COI. However, differences between the US and Canadian medical education contexts, e.g., with regards to the governance and funding of universities, limit to some extent the direct applicability of the AMSA ranking. Canadian medical schools – and their host universities – nonetheless have much to learn from insights provided by the AMSA PharmFree Scorecard ranking, although they can and should go further in developing their own COI policies and procedures.

Keyphrases: conflict of interest, medical schools, policies, Canada, American Medical Student Association (AMSA)
Guidelines for Reducing the Negative Public Health Impacts of Medical Tourism

International travel for medical care, or medical tourism, creates ethical and safety concerns for patients. Guidelines could be developed and distributed to help address these concerns, but they may at the same time appear to endorse this practice.

Keyphrases: medical tourism, guidelines, cross border care, complicity, transplant tourism, reproductive tourism
Reference Letters and Conflict of Interest: A Professor’s
Dilemma

This case study examines some of the challenges, and in particular conflicts of interest, that professors face in writing letters of reference for their students.

Keyphrases: conflict of interest, university, reference letters, students, professors
University Textbooks: An Acceptable Conflict of Interest?

This case study examines the conflicts of interest that arise when university professors use as required course readings their own textbooks.

Keyphrases: conflict of interest, university, professors, course textbooks
Bioethics in Health Policy Development: A Primer for Decision-Makers

Most commonly recognised as a close bedfellow of medicine and regulators of biomedical research, the field of bioethics has recently expanded its academic jurisdiction to include a growing role in decision-making processes within health policy contexts. From this expansion, health professionals and administrators are increasingly knowledgeable of the utility and necessity to incorporate ethical considerations in policy development. However, many of these professionals have difficulty defining the link between ethics and decision-making processes, and what role – if any – bioethicists play in the structuring of health policies. Written for a multidisciplinary audience, this article aims to help clarify these concepts by providing a readily tangible overview of ethical analysis in health policy. The discussion will define common ethical issues in health policy and how frameworks structured upon principles of ethics can guide policy development and aid the decision-making capacities of health professionals. The discussion concludes by describing the role of the bioethicist in this process as a professional that serves to translate knowledge between applied ethics and decision-making contexts in health. Upon reading this article, it is expected that health professionals, regardless of occupational background, will gain a better understanding of ethical issues in health policy development, and as such, the bioethicist will hopefully cease to be viewed as an odd bedfellow amongst policy-makers.

Keyphrases: bioethics, health policy, knowledge translation, decision-making, framework
La gestion de l’Avastin par le bioéthicien : transfert d’une responsabilité politique?

Avastin is a paradigmatic example of a common situation in the health system: the introduction of promising but very expensive new drugs. This situation disrupts the delicate balance of the health system and causes problems for various stakeholders such as patients, health professionals, bioethicists and managers.

Keyphrases: Avastin, Bioethicist, Accountability, Public health system
Public Health Genomics : une forme de rhétorique ?

The aim of this article is to analyze to what extent the new multi-disciplinary field recently created, public health genomics, displays rhetoric. The rhetoric will be examined through its proper meaning as the art of speech, but also through its actual pejorative meaning as the opposition between words and actions, information and misinformation. The main goal of public health genomics (PHG) is the effective and responsible translation of genomic knowledge for public health ends. The PHG wants to bridge over two presumably opposed fields: the biomedical domain on one side and public health on the other. But is it really the case? What is hidden behind this discourse

Keyphrases: public health, genomics, rhetoric
Somatic Cell Therapy: A Genetic Rescue for a Tattered Immune System?

The case of Andrew Gobea, the first child to receive experimental gene therapy for severe combined immunodeficiency (SCID), and a reflection on the associated ethical implications of gene therapy research.

Keyphrases: somatic cells, gene therapy, experimental research, clinical trials
Allergy Refugees: Should They Stay or Should They Go?

Severe allergies towards common and typically benign substances pose a growing challenge to population health around the globe. While the incidence of allergic disease has expanded at an alarming rate, efforts to ensure that allergy sufferers have access to adequate allergy treatments are far from universal; global inequalities in access to essential allergy medications are demonstrative of this fact. The ramifications due to these inequalities are broad and numerous. This case study shows that global inequalities in the provision of allergy drugs are pertinent to one particular context involving refugee claimants.

Keyphrases: allergie, allergy, refugee, essential medicines, public health, ethics
Le bon air et la bonne grâce : attitudes et gestes de la figure noble dans l’art européen (1661-1789)

This thesis concerns the characteristic gestures and attitudes of the aristocratic figure in European art between 1661 and 1789. This period corresponds to the lifetime of a noble bodily ideal named “le bon air” and “la bonne grâce”, from its formulation at Louis XIV’s court and hegemonic propagation until its decline with the French Revolution. A panoply of means (exercises, orthopaedic instruments…) have been invented by the Ancien Régime society to embody a grace that should appear inborn and testify to noble birth. The dancing-master enjoyed the monopoly of inculcating this grace and elaborating it in accordance with highly aesthetic criteria. Most of the bon air and bonne grâce gestures and postures are here catalogued, described and associated with their original connotative values, showing that a deep and meticulous knowledge of body techniques can sharpen our understanding of a great proportion of Early Modern artworks.  The author agues that this bodily habitus transcended every field concerned with the noble body (education, theatre, dance, opera, martial arts…) and came to infiltrate most pictorial genres, challenging age-old artistic traditions and imposing itself as a modern alternative to the grace of the Ancients.  Portraiture, fashion plates, porcelain figurines, city and garden landscapes were the most affected by this phenomenon. Bonne grâce thus affirmed itself in a visual culture, which in return reinforced the very social practices that mirrored. The circular migration of aristocratic gestures between life and art caused a standardisation of both aristocratic body and figure. Within pastoral, history painting and genre scenes, the aristocratic ideal reveals itself antithetically in the figure of the peasant, the Pierrot and the Harlequin, and idealistically in those of the gallant shepherd and gallant hero. The substitution of emphatic gestures and strong facial expressions for ones based on restraint and dissimulation gave birth to a new historia that was less legible, but more subtle and suggestive, in accordance with aristocratic taste and sensibility.

Keyphrases: Art history, Cultural history, History of the body, Gesture in art, Seventeenth- and Eighteenth-Century, Aristocratic grace, Dancing-Master, Propriety, Posture, Posture and carriage, Narration
Étude du rôle de la phosphorylation du complexe Mre11-Rad50-Xrs2 dans le maintien de l'intégrité génomique

The genome of every cell is constantly subjected to stresses that could compromise its  integrity. DNA double-strand breaks (DSB) are amongst the most damaging events for a cell  and can lead to gross chromosomal rearrangements, cell death and cancer if improperly  repaired. Homologous recombination and non-homologous end joining (NHEJ) are the main  repair pathways responsible for the repair of DSBs. However, the mechanistic basis of both  pathways is fundamentally different and the regulation of the choice between both for the  repair of DSBs remains largely misunderstood. The Mre11-Rad50-Xrs2 (MRX) complex acts  as a DSB first responder and contributes to repair by both homologous recombination and  NHEJ. Being at the crossroads of both DSB repair pathways, the MRX complex is therefore in  a convenient position to influence the repair choice. This thesis unravels two distinct  phosphorylation systems modifying the MRX complex and specifically regulating repair by  NHEJ. The first relies on cell cycle progression and inhibits NHEJ, while the second requires  the presence of DNA damage and is necessary for efficient NHEJ. Together, our results  suggest a model in which the MRX complex would act as an integrator of phospho-stimuli in  order to regulate the DSB repair pathway choice.

Keyphrases: Tel1/ATM, CDK, Mre11-Rad50-Xrs2 complex, double-strand break, cell cycle, DNA damage  response, DNA damage checkpoints, homologous recombination, NHEJ, Nijmegen breakage  sundrome, Tel1/ATM, CDK
Le rôle du récepteur B1 des kinines dans le développement de la rétinopathie diabétique

Diabetic retinopathy is associated with retinal vascular changes, including blood retinal barrier breakdown, vascular inflammation and blood flow alterations. It has been proposed that kinin B1 receptor, which is upregulated in the diabetic retina, could be involved in the development of these pathological features of diabetic retinopathy. In a rat model of diabetes induced by Streptozotocin (STZ), the effects of kinin B1 receptor antagonists on retinal perfusion, vascular permeability, leukostasis, gene expression of inflammatory mediators and production of superoxide anion in the retina were evaluated. The results show that in 2-week diabetic rats, topical ocular application of the water soluble kinin B1 receptor antagonist LF22-0542 (10 µl of 1% solution, twice per day) for a 7-day period reverses vascular hyperpermeability, leukostasis, oxidative stress and gene expression of inflammatory mediators (B1R, iNOS, COX-2, VEGF-R2, IL-1β and HIF-1α) in the retina. Single oral administration (3 mg/kg) of SSR240612, a selective non-peptide B1 receptor antagonist, induces a decrease of retinal blood flow in 4-day diabetic rats but has no effect on retinal blood flow reduction present at 6 weeks of diabetes. Therefore, B1 receptor has a protective role in early diabetes by preserving a normal blood flow in the retina. These data suggest that B1 receptor exerts protective and adverse effects in the diabetic retina. They also support a key role for B1 receptor in retinal inflammation and the development of vascular alterations. B1 receptor could therefore represent a promising therapeutic target for the treatment of diabetic retinopathy.

Keyphrases: Inflammation, B1 receptor, Diabetes, Diabetic retinopathy, Inflammation, Kinins, Leukostasis, Oxidative stress, Retina, Retinal blood flow, Vascular permeability
Amplitude de mouvement du coude, développement d’une méthode de mesure radiographique et identification des facteurs influents

The most commonly used instrument for elbow range of motion measurement is the universal goniometer. However great controversy remains regarding its reliability and validity. Hence this study presents an accurate and precise alternative: a radiographic method of measurement. The limits of the radiographic method and potential sources of error were first evaluated through a biomechanical study. Fifty-one volunteers then participated in a clinical study in which this radiographic method was compared to the goniometer for elbow range of motion measurement. Finally, the great precision of radiographic measurements allowed us to study the potential influence of various demographic and anthropometric factors on elbow range of motion in the last part of this work. Regarding the clinical study, the goniometric and radiographic methods differ but they correlate. The goniometer’s measurement error was ±10.3° during extension measurement and ±7.0 ° for flexion. Secondly, the radiographic method provides consistent results despite malpositioning of the upper limb during radiographic image acquisition and easily preventable sources of error were identified. The study finally found an association between the range of motion and various factors, including age, sex, BMI, and the arm and forearm circumferences. In conclusion, error associated with the use of the goniometer could be tolerated in a clinical setting, the instrument being both inexpensive and simple to use. However, its use is discouraged in the research context, where a measurement error of 10° is unacceptable. The radiographic method, being more precise and accurate, represents a much better alternative.

Keyphrases: Range of motion, Elbow, Goniometry, Radiography, Mobility
Leadership dans le contexte de transformation des organisations de santé de première ligne au Québec : étude de la création et de l'implantation des groupes de médecine de famille(GMF)

Background: Family medicine groups (FMGs) were implemented in Quebec in the early 2000s in order to improve accessibility and integration of primary care. Of these new organizations, we know very little about the ways in which actors involved in the change have exercised their leadership in order to influence implementation of FMGs.  Objectives: The main objective of this study was to determine roles and activities of key change actors involved in implementation of FMGs. Further, actors’ capacities and contextual factors that influenced leadership throughout the process of organizational change, were examined.  Methodology: This is a multiple cases study based on three FMGs with different organizational characteristics. Semi-structured interviews were conducted with professionals of each FMG (physicians, clinician nurses and managers). Further, FMGs’ organizational documents have been consulted in order to diversify sources of data.  Findings: We observed an evolution of leadership roles and actions throughout the process of organizational change. The strategic role of physicians in charge of FMGs appeared particularly important in order to communicate the need for practice change and the new vision and model of family medicine practice before creating FMGs. Further, these physicians have exercised leadership in defining roles and activities of each FMGs member in the phase of initiation. A more collective leadership has been observed during the implementation phase, through influence interactions among all FMGs members and external actors supporting their implementation.  Conclusion: This proposed conceptual model allowed identification of leadership process which involves different roles and actions depending on phases of organizational change. Moreover, it helped to examine actors’ capacities and contextual factors that have influenced the leadership process during the creation and the implementation of FMGs.

Keyphrases: leadership, leadership, organizational change, process of influence, roles and actions, FMG
Le stéréotype, un vecteur hégémonique : une analyse intertextuelle au sein du répertoire cinématographique nord-américain

Stereotypes, caricatural representions about social groups, are always denounced, still present everywhere. The diverse cultural productions surrounding us everyday, from tv shows to politic articles, from everyday life discourse to hollywood movies, contribute to reproduce these caricatural representations. This persistence of certain representations – unperceived as stereotypical – participate in stereotypical process : by their recurrence and supposedly evident nature, they seem taken-for-granted, as an objective mirror of a tangible reality. Even if this categorisation is sometimes questionned, it is not the nature of this classification that is called into question but which essentialist qualities, which true inherent characteristics, should be enumerate under this label. Yet, the characteristics presented by the stereotype are not universal : this is the work of an ongoing, historical, cultural and political construction. Thus, the stereotype is an hegemonic vehicule which translates ideological trends underlying its expression : it embodies the ways by which are legitimized and naturalized these representations in a specific context. In this paper, I shall define theoretically the stereotypes and probe how function their underlying ideologies within social discourse, and more precisely within mediacultures. I shall investigate their political nature, normative impacts and ideological functions. Then, using a critical intertextual approach, I will try to detect empirically which stereotypes and ideologies are pregnant in three hollywood romantic comedies. From the observation of this cultural prouctions of entertainment, I will extricate two main ideologies : one capitalistic and one patriarchal; which will lead to underline other underneath but linked ideologies of heterosexuality, masculinity, socio-economic ideal, etc.

Keyphrases: Stereotypes, Hegemony, Social discourse, Intertextuality, Ideologies, Romantic comedies
La paix adjar

Between 1989 and 1994, two civil conflicts occurred in Georgia together with major political violence. South Ossetia and Abkhazia, two of the three regions with autonomous status within Soviet Georgia, are the scene of these conflicts. Clashes are otherwise avoided in the case of Adjaria, the third region with an autonomous status. The reasons of this relative adjar peace are not obvious at first glance, especially when considering the chaotic situation in which Georgia is at the time of the USSR collapse.  It seems appropriate then to further address the Georgian region of Adjaria, a region that certainly has experienced strong tensions with the newly independent Georgian state, although without turning into an open conflict. Because of the similarity between Abkhazia and Adjaria, the geopolitical arguments, or those concerning institutional structures, can only provide a partial explanation. It is rather an argument based on identity and putting forward relations between groups that appears to be determinant to explain the absence of conflict in Adjaria.

Keyphrases: Complexe mythes-symboles, Institutions, Civil war, Ethnic group, Identity affiliation, Myth-symbol complex, Geopolitics, Institutions, Centre-periphery relation