NCube/papyrus huggingface dataset:
Modélisation systémique d’une pratique infirmière d’interface en contexte de vulnérabilité sociale

Primary care nurses are key actors in programmes that are dedicated to vulnerable populations within Health and Social Service Centers (HSSC) in Québec. Such programmes provide opportunities to develop a nursing practice at the interface of an HSSC and community resources in order to reduce social vulnerability. Some nurses are now crossing their disciplinary, organisational and sectoral boundaries to engage in what we refer to here as interface nursing practice. Yet, to our knowledge, no study has documented this unfolding practice. Through a constructivist perspective, and building upon an analysis of nursing theorists’ conceptions of practice, the objective of this doctoral study was to produce a systemic model of interface nursing practice in the context of social vulnerability. This research also provides a case to reflect on the theory of practice in nursing science.   A qualitative exploratory study was undertaken in three urban HSSCs. Fifteen primary care nurses participated in semi-structured interviews, followed by one year of direct and participant observation of the interface practice of two nurses. During this time, informal interviews with administrators, interprofessional teams and community actors, as well as an analysis of programme and governmental documents, were conducted to further our understanding of the context of interface nursing practice. Thematic analysis was initiated during data collection, whereas Le Moigne’s systemic modelling methodology was instrumental throughout the interpretive process of qualitative analysis and for the representation of our study results and further theoretical elaboration.    Four inter-related themes qualify interface nursing practice. First, this practice is guided by a goal that is articulated as a social obligation for vulnerable populations, that of becoming autonomous. Second, relational processes are central as nurses interconnect vulnerable individuals with various actors and resources in the community. The third theme depicts interface nursing practice as strategic action. Finally, the fourth theme highlights opposing or contradictory processes that are experienced by nurses engaged in interface practice and that appear to change their sense of professional identity.     Further examination of our results, at the intersection of nursing knowledge and social science theories, underscores fundamental dimensions of the concept of practice that are essential to consider in nursing theory development: the central concepts of care and environment, in addition to those of knowledge and projects. This thesis demonstrates the relevancy of creating coherent linkages with knowledge from various disciplines to strengthen our capacity to theorize nursing practice as well as intervention in the context of social vulnerability.

Keyphrases: interface nursing practice, primary care, vulnerable populations, social vulnerability, systemic model, qualitative research
Le rôle de la dysrégulation du métabolisme du cholestérol par le retrait des estrogènes sur la stéatose hépatique

Estrogens confer to women a cardiovascular protection until menopause. Indeed, the loss of ovarian functions leads to several lipid disorders along with hepatic triglycerides accumulation called hepatic steatosis. Estrogen withdrawal disrupts several cholesterol metabolism pathways that results in both hypercholesterolemia and hepatic steatosis. However, to date, the precise mechanisms by which estrogen withdrawal affect cholesterol metabolism pathways that favour lipid storage in the liver are unclear.   In this regard, works in the present thesis aimed at elucidate the effects of estrogen withdrawal on cholesterol metabolism involved in hepatic steatosis pathogenesis. In the first study, estrogen withdrawal by ovariectomy (Ovx), a well established model for hepatic steatosis and hypercholesterolemia, had enabled the identification of very low density lipoprotein (VLDL) pathway as a contributory element for hepatic steatosis. Since the VLDL pathway relates lipids and cholesterol metabolism, we conducted the second study to explore the role of dietary cholesterol on hepatic lipids. In the second study, the high fat/high cholesterol (HFHC) diet, also recognized as a model for hepatic steatosis development, was used to explore links between cholesterol metabolism and hepatic fat accumulation. Surprisingly, HFHC diet also disrupted the VLDL pathway. Additionally, data provided in this study indicated that a dysregulation of bile acids metabolism might have contributed to the severity of hepatic steatosis induced by the HFHC diet. As a continuation of these projects, we were interested in the concomitant effects of estrogen withdrawal and HFHC diet on hepatic lipid accretion. Interestingly, when combined, Ovx and HFHC diet not only potentiated hepatic lipid accumulation but also molecular disruptions involved in underlying pathways for hepatic steatosis including the VLDL pathway and bile acid secretion.  Overall, data presented in the review of litterature and provided by the three studies related to the present thesis indicate that cholesterol metabolism dysregulation following estrogen withdrawal result in complications that favour hepatic lipid accumulation.

Keyphrases: farneoid X receptor, rat, estrogens, dietary cholesterol, very low density lipoprotein (VLDL), hepatic steatosis, hepatic cholesterol, bile acids, ovariectomy (Ovx)
Les autotransporteurs auto-associatifs d’Escherichia coli : de facteurs de virulence à déterminants sociaux

Autotransporters are versatile virulence factors of Gram-negative bacteria and use one of the simplest and most widespread secretion system in bacteria. The name autotransporter originate from the observation that all the information needed for the secretion of the protein is encoded in its own sequence, meaning that autotransporters do not need a specialized secretion apparatus. Many autotransporters are multifunctional proteins and can perform a large variety of functions. The self-associating autotransporters (SAATs), represented by AIDA-I, TibA and Ag43, are such multifunctional proteins and can mediate the adhesion and invasion of epithelial cells, the auto-aggregation of bacteria and the formation of biofilm. Because of these functionalities, SAATs are considered important virulence factors of Escherichia coli. However, there are many differences between the SAATs and we still do not know their exact role for the bacteria.   Therefore, we have realized a structure-function study of TibA, the least studied SAAT. Our study showed that TibA is a modular protein and that the functional domain of TibA is composed of two modules: an N-terminal module responsible for auto-aggregation and a C-terminal module responsible for adhesion. Our results showed that the organization of AIDA-I, TibA and Ag43 is different and that the SAATs represent different assemblies of modules. We also observed the modular organization when we analyzed various sequence of aidA, suggesting that the SAATs have evolved by a mechanism of domain shuffling. Not surprisingly, we have found new SAATs in Escherichia coli and in other proteobacteria.   Our results also highlighted the importance of auto-aggregation in the functionality of the SAATs. We therefore assessed the mechanism of SAAT-mediated auto-aggregation of bacteria. Our results showed that SAATs mediate auto-aggregation of bacteria through direct SAAT/SAAT interactions and that these interactions were reminiscent of the interactions made by cadherin molecules in eukaryotes. We further observed that the SAATs were involved in homophilic interactions, as it is the case with cadherin molecules.  SAATs are part of the few proteins that are glycosylated in Escherichia coli. We therefore characterized the glycosylation of TibA and found that glycosylation of TibA stabilized the protein and allowed the protein to modulate its conformation, resulting in a fully functional protein.    Taken together, our results suggest that the SAATs may be cadherin-like molecules by bacteria in order to discriminate between self and non-self. Such an ability to discriminate self from non-self is rarely evoked in bacteria, but could play a role in the organization of multicellular communities.

Keyphrases: Escherichia coli, Glycosylation, SAAT, Biofilm, Secretion, Glycosylation, Autotransporter, Adhesion, Auto-aggregation, Biofilm, Cadherin
L'influence de la maternité dans la trajectoire de consommation et de criminalité de femmes toxicomanes judiciarisées

Pregnant women quickly understand the prevailing social expectations that their condition implies. They rapidly realize that there are guidelines that shape their mothering experience.  When addiction and criminality arise, the social stigma is strong because being a mother does not imply such behaviors. By doing so, they face harsh criticism or being labeled as unfit mothers. Scientific literature on addicted mothers provides a comprehensive view of motherhood where it is perceived rather positively. Motherhood is viewed as being a drive for change because of the responsibilities associated with it as well as the social expectations towards women who become mothers. However, despite the fact that many addicted criminalized women are mothers, few studies have been conducted with addicted criminalized women and far less attention has been directed on the impact that motherhood can have on their drug and crime pathways.   This qualitative thesis is aimed at explaining the impact of motherhood on drug and crime pathways of addicted criminalized women. More precisely, the research objective is to grasp the signification of motherhood for addicted criminalized mothers and to comprehend how they make sense of their role. This thesis also aims to understand, in their point of view, what are the links between motherhood and addiction, and finally, their perceptions of the relations between motherhood and criminality.  Thirty eight semi-structured interviews were conducted with incarcerated mothers and with mothers who were receiving help regarding their addiction as outpatients in an addiction rehabilitation centre. A phenomenological analysis allowed us to grasp the complexity of the relations between motherhood, addiction and criminality for the women interviewed and the weight of social expectations on their mothering experience.  Two visions of motherhood were found: an idealized view where motherhood is seen as worthwhile, fulfilling and true to social expectations and a model of «the good deviant mother», which is more adjusted to their reality. The two visions are influent in the way those mothers interpret their addictions, the possibility of being an addicted mother and on their perceptions of their crimes. A process of maternal identity negotiation was also found, events were identified as weakening their maternal identity. As they experienced their pregnancies, through the losses of their children’s custody and through periods of incarceration, they had to use those moment of instability to reflect upon their deviant lifestyles and position themselves regarding the two views of motherhood to maintain a positive maternal identity.

Keyphrases: Recherche qualitative, Motherhood, Criminalized women, Addiction, Qualitative research
Caractérisation pharmacologique et moléculaire des dyskinésies tardives chez un modèle de primate non humain

Tardive dyskinesia (TD) is a potentially disabling and irreversible motor complication including all persistent, abnormal, involuntary movements, classicaly caused by the chronic therapy with typical antipsychotic drugs (haloperidol, fluphenazine). Atypical antipsychotic drugs like clozapine have been introduced because they showed little potential to induce TD, raising the hope to completely eradicate this complication. However, it has been later shown that these drugs have several serious metabolic side- effects and that some atypical molecules are as responsible as typical drugs for inducing TD. Besides, the typical drugs are still widely prescribed in a large spectrum of disorders. For all these reasons, TD still constitutes a major challenge for psychotic disorders treatments especially that the pathophysiology of TD remains elusive and therapeutics are difficult. Based on rodent experiments, it was proposed that dopamine D2 receptor hypersensitivity could be responsible for TD. However, this hypothesis lacks strong support in humans. We suggest, in this thesis, that TD is associated with the hypersensitivity of other receptors, than D2. To investigate the neurochemical basis of TD, we chronically exposed 23 adult capuchin monkeys to haloperidol (median 18.5 months, N=11) or clozapine (median 6 months, N=6). Six unmedicated animals were used as controls. Five haloperidol-treated animals developed mild TD movements, and no TD was observed in the clozapine group. Using receptor autoradiography, we measured dopamine D1, D2, D3 and mGluR5 receptor levels. We also examined the D3 receptor/preprotachykinin mRNA co-expression, and quantified enkephalin and Nur77 mRNA levels, in striatal sections. Unlike clozapine, haloperidol strongly induced dopamine D3 receptor binding sites in the anterior striatum, particularly in TD animals, and binding levels positively correlated with TD intensity. In contrast, D2 receptor binding was comparable to controls, and dopamine D1 receptor binding reduced in the anterior (haloperidol and clozapine) and posterior (clozapine) putamen. Preprotachykinin mRNA-labeled cell count was unaffected by either haloperidol or clozapine, enkephalin mRNA widely increased in all animals, but to a greater extent in TD-free animals. Nur77 mRNA levels in the caudate-putamen were strongly up regulated iv in animals exposed to haloperidol but were spared following clozapine treatment. Interestingly, within the haloperidol-treated group, TD-free animals showed higher Nur77 expression in putamen sub territories compared with dyskinetic animals. These results corroborate our hypersensitivity hypothesis, and indicate that an imbalance between the striatal pathways could contribute to the pathophysiology of TD.

Keyphrases: clozapine, Nur77, tardive dyskinesia, antipsychotic drugs, haloperidol, clozapine, dopamine receptors, basal ganglia, Nur77, D3 receptors, autoradiography, in situ hybridization
Caractérisation phénotypique et génotypique de Campylobacter jejuni et évaluation d’une stratégie de contrôle de la colonisation du poulet de chair par ce pathogène alimentaire

Campylobacter jejuni is the bacterium responsible for campylobacteriosis. It is a human pathogen of concern for public health. One of the transmission routes of this bacteria to humans is by the food chain through poultry meat products. The mechanisms involved in the commensal caecum chicken colonization by C. jejuni are poorly characterized, despite that increasing the knowledge on these mechanisms would allow a better control of the pathogen at the farm. The objectives of this study were to characterize the phenotypic and genetic factors affecting chicken colonization by C. jejuni and to identify news mechanisms involved in this process.   Isolates, recovered from chicken caecal content sampled from conventional farms in 2003 and in 2008 as well as originating from organic farms sampled in 2009, were used. All strains were characterized for their antibiotic resistance profiles (AMR), autoagglutination and chemotaxis properties. Strains originating from conventional farms were further characterized for adhesion/invasion of primary chicken caecal cells. A new microarray was created to detect the presence of 254 genes and variants, all associated with chicken colonization or AMR. An association was made between the strains phenotypic properties and their gene content. Finally, strains possessing different phenotypic and genetic properties were used in a chicken colonization model to assess the efficacy of a novel feed additive to control chicken colonization by C. jejuni.  Strains had variable phenotypic properties and these properties were not correlated, with the exception of adhesion and invasion. The microarray analysis revealed that gene presence was highly variable among the strains, especially for genes involved in the bacterial envelope, the flagella, the chemotaxis receptors and arsenic resistance. The 2003 and 2008 strains had similar phenotypic and genetic properties. Some genes, present in strains possessing higher or lower chicken colonization potentials, were identified. The feed additive was successful in reducing chicken carcass contamination but it increased bacterial caecal counts for some strains. C. jejuni was isolated from half of the sampled organic farms and strains originating from this type of production had low AMR and variable phenotypic properties.

Keyphrases: Campylobacter jejuni, chicken, colonization, microarray, organic, essential oils, organic acids, potential, control
Cohorte de patients avec le VIH/SIDA : échecs virologiques et effets de thérapies antirétrovirales sur la fonction rénale et l'hyperbilirubinémie

Human immonudeficiency virus (HIV) is a virus causing a chronic infection responsible for Acquired Immunodeficiency Syndrome (AIDS), a state of vulnerability of the body where different opportunistic infections will ultimately be fatal. About 30 years after the discovery of the virus, even if no vaccine is available to control the pandemia, situation has changed for the best. With the arrival of highly active anti-retroviral therapy (HAART) in the late 90's, a reduction in HIV/AIDS mortality rate and growing number of persons living with the infection were observed.  The overall objective of this thesis was to address three problematic situations, despite recognised HAART efficacy, especially low-level viremia (LLV) and its relationship with virologic failure, and the impacts of certain antiretrovirals (ARV) on kidney and hepatic functions. The specific objectives were: 1) to study the risk of virologic failure in long-term perspective in undetectable patients under HAART in comparison to patients with persistent LLV; 2) to evaluate the long-term loss of kidney function related to tenofovir (TDF) exposure 3) to evaluate long-term hyperbilirubinemia related to atazanavir (ATV) exposure and other possible determinants.  In order to address the three specific objectives, a cohort of patients 2416 living with HIV/AIDS followed in Montreal since July 1977 was used. For the first objective, analyses and results shown an increased risk of virological failure defined as >1000 copies/mL of HIV RNA, for all categories of persistent LLV as soon as 6 months of persistent duration. Persistent LLV of 50-199 copies/mL for 6 months doubled the risk of virologic failure (Hazard ratio (HR)=2,22, Confidence interval (CI) 95%: 1,60-3,09). The results shed new light for the management of patients with LLV, especially for LLV of 50-199 copies/mL, for which no clinical recommendation is currently available due to a lack of data. For the second objective, an increased risk of loss of kidney function of 63% (HR=1.63; 95% CI:1.26–2.10) associated to TDF exposure in comparison to patients taking other ARV was observed.  The cumulative eGFR loss directly attribuable to TDF also shown that this loss occured during the first years of exposure. This loss was mild in a long-term perspective. For the third objective, it has been shown that the cumulative incidence of hyperbilirubinemia in ATV users was  very high and that regression was possible if ATV exposure was ended. Long-term hyperbilirubinemia related to ATV use was not associated with adverse health outcome.  Overall, this thesis allowed a better understanding of these three problematics currently debated in scientific literature and shed new lights on management of HIV positive patients under therapy.

Keyphrases: Atazanavir, Tenofovir, Antiretroviral therapy, Cohort study, Estimated glomerular filtration rate, HIV, Hyperbilirubinemia, Kidney function, Low-level viremia, Virological failure
Aménagement du cadre dans la psychothérapie de groupe d'orientation analytique auprès des adolescents

Although psychoanalytic group therapy is recognized as being a treatment particularly suitable for teenagers, the development of this practice faces notable limits: there is altogether little written on the subject and there are many different framework settings, several based on pragmatism, even opportunism (Scheidlinger, 1985; Chapelier, 1995). Taking into account this fact and the importance of the framework in the implementation of an analytic therapeutic situation, we made a systematic literature review of the last thirty years relating to psychoanalytic group therapy with teenagers presenting mental health problems. The objective of the essay is to extract a portrait of the framework set up within the three group methods mainly met for this population: the discussion group, the analytic psychodrama group and the group with mediation. The results of our analysis allowed us to extract from literature 1 - a general picture of the analytic groups set up with teenagers, based on the similarities between the three studied group methods, 2 - points of divergence between the discussion and the psychodrama groups and 3 - elements of adaptation of the analytic group framework to the needs and operating mode of teenagers. The limits of our samples unfortunately prevented the data analysis for the groups with mediation. Lastly, the various failures met in the articles (in term of access to the information, of variability in the data and theoretical thinking on the practices) are discussed in the light of constraints that are imposed by clinical reality.

Keyphrases: Psychanalyse, Psychoanalysis, Group psychotherapy, Analytic framework, Peer group, Analytic psychodrama
L'anorexie mentale chez les adolescents et les jeunes adultes de sexe masculin: Recension des écrits

Anorexia nervosa has been the target of many research efforts. The latest studies, however, are mainly focused on female subjects. The literature on males with anorexia nervosa is currently emerging. The review of this literature suggests pooling knowledge about male anorexia nervosa that can be extracted from the literature starting from1996 until 2011. The variables that are specifically targeted are clinical presentation, the premorbid conditions, personality characteristics, sexual orientation and gender identity, comorbid troubles, and prognosis. The comparison and the pooling of the results of 24 studies forming the review allow us in some cases to support observations made by previous research and to identify certain trends. Among other things, there appears to be similarities between the behavioral symptoms of boys and girls. The review identifies some areas where further research is needed and emphasizes the plurality and heterogeneity of research methods.

Keyphrases: Anorexia, Males, Clinical presentation, Premorbid conditions, Personality, Sexual orientation, Sexual activity, Gender identity, Comorbidity, Prognosis
Bioart et bioéthique. Compte-rendu de Bioart : transformations du vivant, sous la direction d’Ernestine Daubner et Louise Poissant

Through examples of bioartistic works and reflections on these, the edited collection Bioart : transformations du vivant highlights the importance of this artistic approach to raising ethical issues related to life, science and the art in itself.

Keyphrases: bioart, moist art, bioethics, scientific uncertainty, genetic art, artificial life, semi-living