bluuebunny/crossref_metadata_2025 huggingface dataset:
Do we need more training for interdisciplinary and interprofessional collaboration prior to implementing any primary care research action?
Authors: Lionis Christos , Petelos Elena
Published: September 2019

There has been a continuously increasing focus and discussion on interdisciplinary collaboration in primary
care, across various settings and in different forums, during the past few years. Interprofessional and interdisciplinary
collaboration should be a cornerstone of daily practice and context-relevant research. We considered
it important for this manuscript to attempt to address some of the key issues linked to the recognised need for
competence-based training, focusing on interdisciplinary and interprofessional collaboration, so as to promote
and enhance context-relevant research in primary care. This article provides a general introduction and an overview
of this topic, along with some key concepts and operational definitions. These key definitions and their
interrelated nature are examined in detail, including those of practice-based research network, patient-centred
primary care research, and interdisciplinary partnership for research. Furthermore, this paper outlines the reasons
for the strong focus on composition and the development of strategies to enhance the research capacity of
interdisciplinary partnerships throughout training. Workforce training, retention and academic collaboration
are considered, with a particular focus on primary care, and existing interprofessional relationships and perceptions
thereof. Organizational aspects influencing relationships and practice are considered along with their
contribution in terms of practice, research and discourse. Finally, conclusions and recommendations, formed
under the prism of rapidly changing population needs, person-centred values and the imperative need of bringing
innovation to the patient in an effective and efficient manner, are presented for further discussion.
Effect of diamond microdermabrasion on oily skin: a case report
Authors: Havemeister Justyna , Chilicka Karolina
Published: September 2019

Background: The history of microdermabrasion dates back to ancient Egypt. The first treatment in Europe occurred in 1985 and has since become a popular method of exfoliation of the superficial layers of skin. Microdermabrasion is an effective method of taking care of the skin of the face and body, bringing about immediate effects in the treatment of deep scars and stretch marks. Aim of the study: To determine the effectiveness of diamond microdermabrasion on a person with hyperuricemia of the sebaceous glands. Materials and methods: Based on interviews, a case analysis, and the impact of diamond microdermabrasion on the structure of the skin’s surface, the level of hydration, oiliness and epidermal exfoliation were analyzed. Case report: The subject was a 22-year-old woman struggling with oily skin. A few acne lesions and a large number of blackheads were observed in her nasal area. An interview was conducted prior to the procedure to eliminate any contraindications. The study was conducted within a period of 4 months at 3-week intervals. The Nati Skin Analyzer was used to determine the skin parameters of the patient. Results: After applying a series of treatments using the microdermabrasion apparatus, satisfactory results were obtained in the form of reduced peeled sebum and improved skin hydration in the T and U zones. Conclusions: The study shows that diamond microdermabrasion treatment has a beneficial effect on the patient’s skin condition. Phot ographs before and after the surgery document the positive effects this series of treatments had. There was a decrease in the level of sebum secretion and the elimination of skin changes in the form of acne or open comedones.
Knowledge of neurologists and gynaecologists regarding reproductive and maternity issues in women with epilepsy
Authors: Jasnos Ilona , Cieślik Aleksandra , Wanot Joanna , Sejboth Justyna , Szurlej Dariusz , Gurowiec Piotr
Published: September 2019

Background: Epilepsy is one of the most common neurological disorders, with more than 400,000 individuals in Poland (about 1% of the population) affected. Epilepsy complicates approximately 0.5% of pregnancies. Objective: To determine the level of knowledge that neurologists and gynaecologists have about reproductive and maternity issues for women with epilepsy. Material and methods: This study included 141 neurologists and physicians undergoing specialist training in neurology as well as 72 gynaecologists and physicians undergoing specialist training in gynaecology. A validated questionnaire was used to survey these neurologists and gynaecologists, who worked in Silesia Province. Results: In the group of physicians advising on contraception, significantly (p=0.003) more gynaecologists than neurologists recommended hormonal birth control. Significantly more (p=0.031) neurologists than gynaecologists believed that monotherapy with antiepileptic medications should be aimed for before a planned pregnancy in women with epilepsy. More than a half of the surveyed physicians (56.8%) believed that pregnant women with epilepsy can have a natural delivery. Conclusions: On the basis of these results, we have concluded that gynaecologists and, to a lesser extent, neurologists should have more extensive knowledge regarding reproductive and maternity issues for women with epilepsy. We further propose that close collaboration between neurologists and gynaecologists in the care of epileptic women is necessary.
What should a cosmetologist know about dermatological lesions on the face?
Authors: Rubas Klaudia , Maj Joanna
Published: September 2019

In everyday practice, cosmetologists often observe abnormalities on the facial skin of his or her clients. Facial lesions have a diverse clinical picture, although most are benign. However, some lesions may be malignant and demand fast diagnosis and treatment. Among benign lesions are xanthomas, epidermal cysts, milia and seborrheic keratoses. Xanthomas are usually localized on the eyelids and often coexist with dyslipidemia. They appear clinically as yellowish papules that vary in size. Epidermal cysts are the most common type of skin cyst. They typically occur on the head and neck, and usually affect young adults in their 20s. Milia are common skin lesions that are typically numerous in presence and appear as small-sized sebaceous papules. Seborrheic keratoses are another important type of lesion that are localized on the face and may be disturbing for clients. These are benign tumors that usually appear in individuals over 50 years of age and have an incidence that rises with age. Typically, they are brown in color but they can also be other colors including black, yellow, grey or bluish.
Other skin changes include basal cell carcinoma, actinic keratosis, squamous cell carcinoma and lentiginous malignant melanoma. Basal cell carcinoma is a slow-growing, locally malignant epithelial cancer of the skin. This cancer presents mainly in areas exposed to ultraviolet (UV) radiation. Actinic keratosis is a pre-cancerous lesion that is associated with UV radiation. It predisposes to squamous cell carcinoma and other skin cancers rarely. In contrast to basal cell carcinoma, squamous cell carcinoma may cause metastases with high mortality. Melanoma on the head and face usually takes the form of a lentiginous malignant melanoma. This manifests clinically as a brown spot that slowly grows centrifugally. Melanomas vary in size and color. Dermoscopy is an important tool that may help during diagnosis of facial lesions.
Given the severe consequences of some skin lesions, it is very important for cosmetologists to have knowledge of the conditions described above. This is because he or she is often the first person who can persuade the client to undergo further diagnosis.
The problem of aging of the population as one of the most important challenges for social policy and public health.
Authors: Shpakou Andrei , Shpakau Aliaksandr , Kuzniatsou Aleh
Published: September 2019

Background: Population aging is one of the most important social policy and public health challenges for the state. Increased proportions of older people is accompanied with increased negative attitudes manifested toward them, as represented by ageism, the discrimination against the elderly, contributing to their exclusion from public life. Aim of the study: To study the prevalence and characteristics of ageism manifestations in healthcare institutions in the city of Grodno (Belarus) and to consider measures to minimize it. Material and methods: 250 random urban respondents from Grodno age 60 or more not undergoing treated in healthcare institutions were anonymously questioned. Data analysis was performed using different statistical methods. Results: The majority of respondents rated geriatric, social and medical care in the country as functioning at a high level. The share of elderly people who felt age discrimination was 70 (28.0%) and was independent from the gender and age of the respondents. Clinical departments were mentioned by 24 (34.3%) of respondents as places where manifestations of ageism were seen, particularly in emergency rooms – 14 (20.0%) and family doctor offices– 17 (24.3%). In 35 (50%) of cases, the family doctor explained the symptoms of the disease by the onset of old age, which can be regarded as a manifestation of ageism. Conclusions: Training in the field of geriatrics is very important for medical professionals. Failure to take measures to ensure a holistic (integrated) approach in the treatment and care of elderly must be considered discriminatory. Particular measures should be taken to develop all types of care for the elderly, increasing the level of patient satisfaction with medical services and reducing the frequency of gerontological ageism manifestations.
Is upper gastrointestinal bleeding still a life-threatening condition?
Authors: Janczak Dariusz , Marschollek Paweł , Marschollek Karol , Owczarzak Marcin , Bąkowski Wojciech , Bąkowska Katarzyna , Chabowski Mariusz
Published: September 2019

Background: Upper gastrointestinal bleeding is a common clinical problem and one of the main reasons for
emergency hospitalization. It is associated with an overall mortality rate of 2% to 13%, despite advances in medical
therapy. First-choice management is conservative treatment with endoscopic hemostasis.
Aim of the study: The aim of the study was to examine the epidemiological and clinical characteristics of
patients with upper gastrointestinal bleeding with a focus on the course of hospitalization based on the etiology
Material and methods: A retrospective study was conducted in the Department of Surgery at the 4th Military
Teaching Hospital in the years 2011–2016, comprising a total of 200 hospitalizations. 150 (75%) of the study
group were men, and the mean age was 63.6±15.8 years.
Results: Patients most frequently presented with melena (n=105; 53.1%) and hematemesis (n=79; 40%) or coffee
ground vomiting (n=57; 28.7%). . 138 (69%) of hemorrhages were managed with endoscopic hemostasis, and
in 43 (21.5%) of cases conservative treatment was adequate. In 12 (6%) of cases, laparotomy was the first-choice
therapy and in 7 (3.5%) cases, surgery was performed after an attempt at endoscopic treatment had failed. The
sources of bleeding were: gastric ulcer – 58 (29%), duodenal ulcer – 48 (24%), esophageal varices – 31 (15.5%),
gastric tumor – 15 (7.5%), Mallory-Weiss syndrome – 10 (5%), and Dieulafoy’s lesion – 3 (1.5%). 16 (8%) of the
hospitalizations were fatal.
Conclusions: Upper gastrointestinal bleeding still has a high mortality rate (8%). It more frequently affects men
and the elderly. Gastric and duodenal ulcers are the most common etiologies of bleeding. Esophageal varices and
neoplasms are also a significant source of bleeding. Despite the progress in the pharmacological treatment of peptic
ulcers, the complications resulting from gastrointestinal bleeding continue to be a serious clinical problem.
Physicians’ personal health practices and their effect on their patients‘ health practices.
Authors: Dresner Yizchak , Frank Erica , Shani Michal , Vinker Shlomo
Published: September 2019

Background: Although much has been written about the potential power of the association between physicians’ personal health practices and those of their patients, we found few objective studies of this relationship. We therefore investigated this association using objectively measured health care indicators. Aim of the study: The aim of the study was to show the association between physicians’ own screening/immunization practices and their patients screening/immunization practices. Material and methods: We assessed 8 indicators of quality of health care (screening and vaccination practices) for primary care physicians (n=1488) and their adult patients (n = 1 886 791) in Israel’s largest health maintenance organization. The physicians were also patients in this health care system Results: For all 8 indicators, patients whose physicians were compliant with the preventive practices were more likely (p < 0.05) to also have undergone these preventive measures than patients with noncompliant physicians. We also found that more similar preventive practices showed somewhat stronger relations. For example, among patients whose physician had received the influenza vaccine, 49.1% of eligible patients received influenza vaccines compared to 43.2% of patients whose physicians did not receive the vaccine (5.9% absolute difference, 13.7% relative difference). This is twice the relative difference (7.2%) shown for pneumococcal vaccine—eligible patients of influenza-vaccinated versus non vaccinated physicians (60.9 vs 56.8%).When we examined the rates of un-related practices, we found that, for example,mammography rates were identical for patients whose physicians did and did not receive the influenza vaccine Conclusions: We found a consistent, positive relation between physicians’ and patients’preventive health practices. Objectively establishing this healthy doctor—healthy patient relationship should encourage preventionoriented health care systems to better support and evaluate the effects on patients of improving the physical health of medical students and physicians.
Mineral content of menus offered by social welfare home
Authors: Zołoteńka-Synowiec Marzena , Całyniuk Beata , Malczyk Ewa , Misiarz Marta , Zgraja Aleksandra
Published: September 2019

Background: The aging of the population in Poland and globally has increased interest in nutrition for the elderly. Their diets are inappropriate, but modifications should be introduced gradually. This is important in hospital settings, sanatoriums or social care homes, where patients have few choices. Aim of the study: The study aimed to assess the content of the selected mineral salts in ten day menus offered by the Social Welfare Home based on season of the year. Material and methods: The study included 40 menus offered in four seasons of the year for the residents of the Social Welfare Home in Lower Silesia. The mineral content of the foods on the menus were assessed. We considered the physical activity of the elderly (1.4—Physical Activity Level) using norms developed by the Food and Nutrition Institute, and calculated the average norms of the analysed nutrients for people over 60 years of age. Results: The diets were low in minerals such as calcium and potassium, and contained an excessive amount of phosphorus, sodium, iron and zinc in all seasons. Although magnesium levels in the spring and summer were appropriate, deficits appeared in autumn and winter diets. Conclusions: The evaluated menus showed inadequate supplies of the assessed mineral salts. More analysis and adjustments to planned meals is recommended.
O CREAS PAEFI na perspectiva de mulheres vítimas de violência e profissionais: uma análise a partir da Teoria Bioecológica do Desenvolvimento Humano
Authors: Rosa Nailane Fabris , Nascimento Célia Regina Rangel
Published: September 2019

Estudo qualitativo cujo objetivo foi investigar se o Centro de Referência Especializado da Assistência Social-Proteção e Atendimento Especializado a Famílias e Indivíduos (CREAS PAEFI) de um município do *, compunha a rede de apoio social e afetiva de mulheres vítimas de violência por seus companheiros. Foram entrevistadas 10 mulheres vítimas de violência, usuárias do serviço e 6 profissionais atuantes na equipe. Os dados foram analisados por meio da Análise de Conteúdo e discutidos com base na Teoria Bioecológica do Desenvolvimento Humano. O serviço foi avaliado positivamente e as interações entre os profissionais e as mulheres vítimas de violência favoreceram processos proximais que promoveram mudanças positivas nas características pessoais das usuárias, reforçando relações que elas possuíam com suas famílias e outros contextos. Concluiu-se que o serviço integrou a rede de apoio sócio afetiva dessas mulheres, atuando como um microssistema significativo que favoreceu o desenvolvimento delas frente à situação de violência.
O amigo imaginário na visão de psicólogos e psiquiatras infantis
Authors: Marion Juliana , Londero Angélica Dotto , Pereira Caroline Rubin Rossato , Souza Ana Paula Ramos de
Published: September 2019

A presente pesquisa buscou compreender como os profissionais da área de Psicologia e Psiquiatria, com atuação na clínica infantil, entendem a presença do fenômeno do amigo imaginário na infância. Três psicólogos e dois psiquiatras, com 5 anos ou mais de experiência, foram entrevistados sobre suas práticas profissionais. Os participantes foram recrutados em clínicas de atendimento à criança em uma cidade do interior do Rio Grande do Sul. A análise de conteúdo indicou que os profissionais consideravam o fenômeno um acontecimento saudável do desenvolvimento e facilmente diferenciável da sintomatologia da psicose. Além disso, acreditavam que a fantasia pode servir como um recurso para o profissional investigar a realidade psíquica da criança, facilitando a comunicação nos atendimentos. A partir desses resultados, buscou-se contribuir com a literatura nacional acerca do tema, ainda escassa, e com a atuação e conhecimento dos profissionais da área de saúde infantil e todos aqueles que estão em constante contato com crianças (profissionais escolares, familiares, etc.).
Small Bowel Adenocarcinoma, Version 1.2020, NCCN Clinical Practice Guidelines in Oncology
Authors: Benson Al B. , Venook Alan P. , Al-Hawary Mahmoud M. , Arain Mustafa A. , Chen Yi-Jen , Ciombor Kristen K. , Cohen Stacey A. , Cooper Harry S. , Deming Dustin A. , Garrido-Laguna Ignacio , Grem Jean L. , Hoffe Sarah E. , Hubbard Joleen , Hunt Steven , Kamel Ahmed , Kirilcuk Natalie , Krishnamurthi Smitha , Messersmith Wells A. , Meyerhardt Jeffrey , Miller Eric D. , Mulcahy Mary F. , Nurkin Steven , Overman Michael J. , Parikh Aparna , Patel Hitendra , Pedersen Katrina S. , Saltz Leonard B. , Schneider Charles , Shibata David , Skibber John M. , Sofocleous Constantinos T. , Stoffel Elena M. , Stotsky-Himelfarb Eden , Willett Christopher G. , Johnson-Chilla Alyse , Gregory Kristina M. , Gurski Lisa A.
Published: September 2019

Small bowel adenocarcinoma (SBA) is a rare malignancy of the gastrointestinal tract that has increased in incidence across recent years. Often diagnosed at an advanced stage, outcomes for SBA are worse on average than for other related malignancies, including colorectal cancer. Due to the rarity of this disease, few studies have been done to direct optimal treatment, although recent data have shown that SBA responds to treatment differently than colorectal cancer, necessitating a separate approach to treatment. The NCCN Guidelines for Small Bowel Adenocarcinoma were created to establish an evidence-based standard of care for patients with SBA. These guidelines provide recommendations on the workup of suspected SBA, primary treatment options, adjuvant treatment, surveillance, and systemic therapy for metastatic disease. Additionally, principles of imaging and endoscopy, pathologic review, surgery, radiation therapy, and survivorship are described.
Engaging Community-Based Cancer Physicians: Experience of the Memorial Sloan Kettering Cancer Center Cancer Alliance
Authors: Lipitz-Snyderman Allison , Kennington Jessica , Hogan Brooke , Korenstein Deborah , Kalman Leonard , Nair Suresh , Yu Peter , Sabbatini Paul , Pfister David
Published: September 2019

Background: The proliferation of relationships between community health systems and academic medical centers has created a need to identify effective components of these models. This article reports on frontline physician experiences, with one such relationship established through the Memorial Sloan Kettering Cancer Center (MSK) Cancer Alliance. MSK created the Alliance with the goals of rapidly bringing the newest standards of care into community settings and increasing patient access to clinical trials in their local communities. Methods: Alliance leadership administered a 10-question anonymous survey to physicians treating patients with cancer across the 3 Alliance member health systems: Hartford HealthCare Cancer Institute, Lehigh Valley Cancer Institute, and Miami Cancer Institute at Baptist Health South Florida. The purpose of the survey was to identify opportunities to improve physician engagement. Results: There were 103 clinician respondents across Alliance members, of which 87 reported participation in a disease management team and were included in the final analysis. Most respondents reported high value from Alliance activities, such as attending MSK tumor boards (94%) and lecture series (96%), among those who reported them applicable. Across all respondents, most reported satisfaction with engagement opportunities, such as MSK physician participation in their institution’s meetings (76%). When asked where they would like to see increased engagement, the most commonly reported response was for more lecture series (45%). Most respondents (88%) reported that the Alliance led to practice change, either for themselves or for other clinicians at their institution. Many attributed this practice change to MSK disease-specific process measures. Conclusions: The activities most valued by community physicians were heavily physician relationship–based. The encouraging experience of the MSK Cancer Alliance suggests that activities involving physician investment may be effective for promoting practice change in the context of cross-institution relationships. Future research is needed in this area.
Survival After Definitive Chemoradiotherapy With Concurrent Cisplatin or Carboplatin for Head and Neck Cancer
Authors: Xiang Michael , Colevas A. Dimitrios , Holsinger F. Christopher , Le Quynh-Thu X. , Beadle Beth M.
Published: September 2019

Background: For definitive chemoradiotherapy (chemoRT) of head and neck squamous cell carcinoma (HNSCC), cisplatin is the preferred concurrent agent, with superiority over cetuximab for HPV-associated oropharyngeal squamous carcinoma recently shown in 2 randomized trials (RTOG 1016 and De-ESCALaTE). Patients who are not candidates for cisplatin may be treated with carboplatin instead, but its comparative efficacy is unclear. We analyzed nationwide patterns of care and cancer-specific outcomes after cisplatin- versus carboplatin-based chemoRT. Patients and Methods: Patients with locoregionally advanced (stages III–IVB according to the 6th and 7th editions of the AJCC Cancer Staging Manual) squamous cell carcinoma of the oropharynx, larynx, or hypopharynx who received definitive radiotherapy (RT) were identified in the linked SEER-Medicare database. The concurrent chemotherapy regimen was determined through corresponding Medicare claims. Death caused by HNSCC (cancer-specific mortality [CSM]) was analyzed with competing risks. Propensity score analysis and multivariable Fine-Gray regression were used to adjust for baseline differences, including age and comorbidity. Results: We identified 807 patients who received cisplatin-based chemoRT and 342 who received carboplatin-based chemoRT. Most carboplatin recipients (68%) had combination chemotherapy, predominantly with paclitaxel. Carboplatin- and cisplatin-based chemoRT had similar incidences of death attributable to HNSCC (3-year CSM, 29% vs 26%; P=.19), which persisted in propensity score–matched analysis. In addition, no significant difference in overall survival was seen in the matched cohorts. ChemoRT with either cisplatin or carboplatin was superior to RT alone and RT with concurrent cetuximab. In the multivariable model, the adjusted hazard ratio of CSM for carboplatin relative to cisplatin was 1.01 (95% CI, 0.79–1.28; P=.94). Conclusions: Definitive carboplatin-based chemoRT was equivalent to cisplatin-based therapy and superior to RT alone and RT with concurrent cetuximab. In light of recent results of the RTOG 1016 and De-ESCALaTE trials, our findings suggest that carboplatin-based regimens warrant prospective investigation as an alternative to cisplatin for patients who are not cisplatin candidates.
Small Bowel Adenocarcinoma: Etiology, Presentation, and Molecular Alterations
Authors: Pedersen Katrina S. , Raghav Kanwal , Overman Michael J.
Published: September 2019

Small bowel adenocarcinoma (SBA) is a rare cancer that has been treated similarly to colorectal cancer (CRC) in the advanced setting. Incidence has been increasing as detection efforts have been improving for these challenging-to-diagnose tumors, but patients frequently experience prolonged nonspecific symptoms due to delayed diagnosis. As a result of such delays and likely due to variant biology, patient outcomes for SBA are inferior to those for CRC at all stages of diagnosis. Recent molecular studies highlight the genomic differences underpinning these tumors and suggest new future pathways for treatment, distinct from CRC.
La rigueur dans les activités éducatives, l’application de la méthode psychoéducative. À la mémoire de Gilles Gendreau, psychoéducateur
Authors: Le Blanc Marc
Published: September 2019

Gilles Gendreau a proposé aux psychoéducateurs et à l’ensemble des éducateurs spécialisés une méthode de travail pour animer des activités éducatives. Cet article rend hommage à cette contribution scientifique et professionnelle fondamentale pour le travail des psychoéducateurs. Il rend compte de l’application rigoureuse de la méthode psychoéducatives, ses huit opérations professionnelles et la structure d’ensemble des quatorze composantes interactives d’une activité. Cette méthode est d’abord présenté. Par la suite, l’article décrit par qui, en quelle quantité, à quelles activités, avec quelle intégralité et avec quelle conformité la méthode psychoéducative a été appliqué. En conclusion, les commentaires portent sur les conditions nécessaires à la formation à l’application de cette méthode de travail et sur l’encadrement utiles pour maintenir son application.
L’utilisation psychoéducative : une compétence du psychoéducateur
Authors: Caouette Martin , Pronovost Jocelyne
Published: September 2019

L’utilisation constitue l’une des huit opérations professionnelles du modèle psychoéducatif. Malgré la pertinence clinique qui lui est reconnue depuis le début de la profession, cette opération semble souvent ignorée ou mal comprise dans la pratique professionnelle et de surcroit, pose certains questionnements dans son application dans certains champs de pratique en psychoéducation. Dans cet écrit, nous souhaitons approfondir ce concept dans la perspective qu’il puisse être généralisable à l’ensemble des clientèles auprès desquelles les psychoéducateurs interviennent. Pour ce faire, nous avons procédé dans un premier temps à une recension des écrits sur le concept d’utilisation afin d’en préciser la définition et le processus et de décrire certaines modalités qui ont été appliquées. Par la suite, nous proposons un cadre d’analyse des pratiques d’utilisation s’appuyant sur le triptyque savoir, savoir-faire et savoir-être afin de situer l’utilisation comme une compétence du psychoéducateur. Finalement, certains éléments relatifs à la formation et à la pratique psychoéducatives sont abordés.
L’Utilisation de devis expérimentaux à cas unique en psychoéducation
Authors: Lanovaz Marc J.
Published: September 2019

L’une des opérations professionnelles de la psychoéducation, l’évaluation des résultats, consiste à effectuer un suivi continu des effets de l’intervention proposée par le psychoéducateur. Pour ce faire, les devis expérimentaux à cas unique représentent une option à privilégier puisqu’ils permettent (a) d’évaluer l’efficacité de l’intervention et (b) de démontrer que l’intervention est responsable des changements observés. L’objectif de cet article est de guider les psychoéducateurs dans la sélection et la mise en place de devis expérimentaux à cas unique pour évaluer les effets d’interventions en milieu de pratique. Premièrement, les éléments à considérer lors de la planification de l’évaluation de l’intervention sont présentés. Ensuite, les devis ABAB, avec alternance de traitements, à niveaux de base multiples et avec changement de critères sont décrits en mettant l’accent sur leurs avantages et leurs limites. La sélection et l’application de chaque devis sont aussi illustrées à l’aide d’exemples. Finalement, les défis associés à l’implantation des devis expérimentaux à cas unique sont examinés en discutant des facteurs environnementaux qui pourraient prévenir et faciliter leur adoption par des psychoéducateurs en milieu de pratique.
La psychanalyse ne résiste pas a l’analyse
Authors: Larivée Serge , Coulombe Éric
Published: September 2019

Ce texte comprend quatre parties. Dans la première, nous insistons sur deux aspects : la présentation de l’analyse de 31 cas traités par Freud mettant en évidence la non efficacité de son approche et l’aveu de Freud quant à sa vocation littéraire. Au cours de la deuxième partie, nous montrons que le caractère dogmatique des débuts de la psychanalyse sévit encore aujourd’hui dans certains milieux. Nous verrons d’abord que le dogmatisme a mis fin à la carrière de Piaget à titre de psychanalyste, puis nous insisterons sur le fait que la soumission à l’autorité, une caractéristique centrale du dogmatisme, imprègne la psychanalyse et que le cas fondateur de celle-ci, Anna O., repose sur le dogme et le mensonge. Dans la troisième partie, à l’aide d’exemples tirés des écrits de Lacan, Dolto et Bettelheim ainsi que de la pratique actuelle, nous répondrons à ceux qui prétendent que la psychanalyse a évolué, que tel n’est pas nécessairement le cas. Enfin, nous mettons en évidence que la tentative des psychanalystes de récupérer le courant de la neuropsychologie à leur profit ne tient pas la route.
Le modèle psychoéducatif : une avenue porteuse pour qualifier les services en réadaptation avec hébergement au CJM-IU
Authors: Le Blanc Andrée , Desjardins Sophie , Larose Christine , Masse Daniel
Published: September 2019

L’article porte sur l’implantation du modèle psychoéducatif dans tous les services de réadaptation destinés aux adolescent(e)s du CJM-IU, placés en vertu soit de la Loi sur la santé et les services sociaux, soit de la Loi sur la protection de la Jeunesse, soit de la Loi sur le système de justice pénale pour les adolescents. Sont décrites d’abord les origines conceptuelles du projet puis la structure de travail mise en place pour favoriser la participation d’une cinquantaine d’équipes d’éducateurs oeuvrant auprès d’adolescents hébergés en foyers de groupe ou en internat. Sont ensuite présentées les étapes de la démarche d’implantation des opérations professionnelles inhérentes au modèle psychoéducatif appliquées aux groupes. Enfin sont évoqués les principaux défis que pose l’implantation complète et durable de ce modèle en raison de la diversité des formations et de la mobilité du personnel éducatif.
Portait de la consommation de substances psychoactives chez les adolescents atikamekw
Authors: Plourde Chantal , Pronovost Jocelyne , Alain Marc , Arseneault Catherine , Laperrière Jenny
Published: September 2019

Cet article présente les résultats quantitatifs d’une étude portant sur les habitudes de consommation de substances psychoactives (SPA) menée en 2007-2008 auprès d’adolescents dans deux communautés atikamekw. L’étude a été réalisée en milieu scolaire secondaire ; les données proviennent de 172 répondants qui ont accepté de remplir la grille de dépistage de la consommation problématique d’alcool et de drogues chez les adolescents (DEP-ADO). Les résultats indiquent une consommation d’alcool et/ou de drogues importante, qui débute de manière précoce et que l’on peut considérer comme étant problématique pour bon nombre de ces jeunes. Plusieurs disent vivre des conséquences négatives importantes reliées à leur consommation. Bien que peu de différences entre les sexes ressortent de nos résultats d’un point de vue statistique, les jeunes filles sont plus nombreuses à boire de façon excessive et vivent davantage de conséquences négatives du point de vue de leur santé physique et psychologique. Enfin, nos résultats indiquent que très peu de jeunes se tournent vers des ressources d’aide professionnelles pour faire face à leur problème de consommation. Cette étude met en évidence l’importance de la prévention et du dépistage dans les programmes touchant la toxicomanie chez les jeunes.
Approche centrée sur les enfants de deux ans : profils sociaux et origines conatives, cognitives, motrices et environnementales
Authors: Barriol Céline , Garitte Catherine
Published: September 2019

Le jeune enfant est un être social : il doit être étudié comme un « tout » (conatif, cognitif et social) intégré dans ses milieux de vie. Cette recherche, en se fondant sur une approche centrée sur la personne, vise à comprendre comment les caractéristiques sociales, conatives, cognitives, motrices et environnementales d’un jeune enfant s’intègrent pour former un « tout ». Les objectifs sont 1) d’établir des profils sociaux (comportementaux) de 61 enfants de deux ans, et 2) de montrer qu’au sein d’un même profil les enfants présentent des similitudes psychologiques (conatives, cognitives, motrices) et environnementales (familiales et extra-familiales). Les comportements sociaux ont été observés écologiquement. Le tempérament a été évalué par la mère à l’aide de questionnaires. La compréhension des émotions, le langage et la motricité globale ont été évalués par un expérimentateur à l’aide d’échelles. Les résultats mettent en évidence cinq profils sociaux d’enfants qui se distinguent socialement, psychologiquement et environnementalement. Si l’on tient compte de la notion de continuité/discontinuité, certains de ces profils semblent être précurseurs de difficultés ultérieures.
Gorgeous Girlies in Glittering Gyrations!
Authors: Blais-Tremblay Vanessa
Published: September 2019

Dans la littérature sur la danse exotique de la première moitié duxxesiècle, la danseuse noire apparaît soit comme la victime d’une industrie du divertissement capitalisant sur les mises en scène érotisantes, exotisantes et primitivisantes de son corps, soit comme la parodie subversive du stéréotype dit « primitif-exotique » incarné sur scène. Pour paraphraser bell hooks, le plaisir corporel, voire charnel, lié à la danse est avant tout abordé en tant que réalité à laquelle il faut résister, qui doit être masquée ou transcendée, ce qui force ainsi un processus de distanciation entre le travail artistique de la danseuse et le capital érotique de son corps. Dans cet article, l’auteure s’appuie sur une collection d’entretiens réalisés dans le contexte du travail de recherche ayant mené à la production cinématographiqueShow Girls: Celebrating Montreal’s Legendary Black Jazz Scene(1999) avec des danseuses qui travaillaient dans l’industrie du spectacle durant l’« âge d’or » du jazz montréalais (1925-1955). Les récits que révèlent ces entretiens permettent d’aller au-delà des questions de représentation dans la littérature sur la danse exotique pour poser un regard sur l’agentivité artistique de ces femmes qui résistent à la désarticulation entre leur travail artistique et le capital érotique de leurs corps.
« One Man’s Trash is another Man’s Treasure » : remise en question du capital érotique féminin dans la série Girls1
Authors: Martine Parent Anne
Published: September 2019

La sociologue Catherine Hakim a théorisé la notion de capital érotique en y voyant une source d’empowerment pour les femmes. Toutefois, Hakim fait l’impasse sur l’inscription de ce capital à même le système patriarcal. L’auteure analyse dans son article un épisode de la série Girls, « One Man’s Trash », dans lequel s’opère une remise en question des normes qui définissent le capital érotique pour les femmes.
Gene/environment interaction and autoimmune disease
Authors: Harris Tamia A , Bel Shai
Published: September 2019

Autoimmune diseases are complex illnesses in which the body’s immune system attacks its own healthy tissues. These diseases, which can be fatal, gravely impact the quality of life of those afflicted by them with no cure currently available. The exact etiology of autoimmune diseases is not completely clear. Biomedical research has revealed that both genetic and environmental factors contribute to the development and progression of these diseases. Nevertheless, genetic and environmental factors alone cannot explain a large proportion of cases, leading to the possibility that the two factors interact in driving disease onset. Understanding how genetic and environmental factor influence host physiology in a manner that leads to the development of autoimmune diseases can reveal the mechanisms by which these diseases manifest, and bring us closer to finding a cure for them. In this chapter, we will review the current research of genetic/environmental interactions that contribute to development of autoimmune diseases, with an emphasis on interactions between the host and the multitudes of microbes that inhabit it, the microbiota.
Health Workforce Assessment in Jakarta for Effective HIV Policy Implementation: Challenges and Opportunities toward Epidemic Control
Authors: Deussom Rachel Hoy , Rottach Elisabeth , Prabawanti Ciptasari , Rahmat Edhie , Rachmawati Tetty , Sirajulmunir Nanda
Published: September 2019

Abstract Strategic efforts are needed in Indonesia to implement the recently released human immunodeficiency virus (HIV) Test and Treat policy which promotes increased treatment uptake, known to have important economic benefits. Of Indonesia’s estimated 631,635 people living with HIV (PLHIV) in 2018, only 12% are on treatment. The USAID- and PEPFAR-funded Human Resources for Health in 2030 (HRH2030) Program undertook policy analysis and assessed the available health workforce and service delivery at select sites in Jakarta to identify and anticipate Test and Treat implementation gaps. A mixed methods concurrent triangulation design was used, including policy analysis, key informant interviews, and site-level tools to capture workforce availability, skills, quality, and performance. Results indicate priorities to: define and implement HIV standards of practice for the Test and Treat policy; improve relevance and coordination of pre-service and in-service training programs; and support managers to optimize task and workforce allocation, including allocating lower-skilled workers to routine testing. Additional site-level data are needed from rural and remote sites in Indonesia, where fewer health workers are distributed. Efficiencies can help sustain HIV programs and contribute to epidemic control.Abstrak Upaya strategis dibutuhkan Indonesia untuk implementasi kebijakan Pemeriksaan dan Pengobatan (Test and Treat) HIV, seperti yang diterbitkan oleh USAID dan PEPFAR. Kebijakan ini mendorong peningkatan cakupan pengobatan yangd diyakini penting secara ekonomi. Diperkirakan pada tahun 2018 terdapat 631,635 ODHA di Indonesia dan hanya 12% yang menjalani pengobatan. Program HRH2030 yang didanai oleh USAID dan PEPFAR melakukan analisis kebijakan dan penilaian ketersediaan tenaga kesehatan dan pelayanan HIV di beberapa unit layanan di Jakarta, untuk mengidentifikasi dan mengantisipasi kesenjangan implementasi kebijakan. Kajian menggunakan metode campuran dengan melakukan analisis kebijakan, wawancara informan kunci, dan serangkaian alat asesmen tingkat unit layanan untuk menangkap informasi terkait ketersediaan, keterampilan, kualitas, dan kinerja tenaga kesehatan. Hasil kajian ini memprioritaskan adanya penetapan dan penerapan standar praktik layanan HIV yang sesuai dengan kebijakan Pemeriksaan dan Pengobatan. Peningkatan koordinasi program pendidikan pra-layanan dan pelatihan dalam jabatan dan dukungan kepada manajer unit layanan untuk mengoptimalkan alokasi tugas dan tenaga kesehatan menjadi hal yang penting. Pendekatan ini diharapkan dapat meningkatkan efisiensi layanan dan keberlanjutan program HIV. Data dan informasi tingkat unit layanan dibutuhkan, khususnya dari wilayah pedesaan dan terpencil.
Evaluasi Ekonomi Penggunaan Antibiotika Profilaksis Cefotaxime dan Ceftriaxone pada Pasien Operasi Seksio Sesarea di Rumah Sakit X
Authors: Aisyah Echa , Nadjib Mardiati
Published: September 2019

AbstrakPemberian antibiotik profilaksis pada operasi seksio sesarea sangat dianjurkan. Menurut pedoman umum penggunaan antibiotik obat dipilih atas dasar keamanan dan efektivitas biaya. Evaluasi ekonomi parsial berupa analisis biaya dan luaran ini menggunakan metode alongside observational study, data dikumpulkan selama bulan April–Mei 2017 secara prospektif mencakup 60 pasien dengan operasi seksio sesarea yang mendapatkan antibiotik profilaksis, membandingkan efektivitas biaya antara Cefotaxime dan Ceftriaxone. Hasil uji statistik menunjukkan bahwa tidak ada perbedaan karakteristik pada 60 pasien tersebut. Analisis menggunakan perspektif rumah sakit, dilaksanakan di rumah sakit milik Pemerintah di Jawa Barat. Hasil Systematic Review menunjukkan bahwa tidak ada perbedaan efikasi pada penggunaan kedua obat tersebut. Hasil penelitian ini menkonfirmasi bahwa tidak ada perbedaan outcome klinis (berupa infeksi luka operasi) antara pasien yang mendapatkan antibiotik profilaksis Ceftriaxone dengan antibiotik Cefotaxime. Komponen biaya terbesar adalah biaya operasional (84,79%), diikuti biaya alokasi dari unit penunjang (13,68%), biaya investasi (1,2%) dan biaya pemeliharaan (0,32%). Analisis biaya satuan memberikan hasil biaya inkremental sebesar Rp. 342.535 pada satu episode rawat inap. Rumah sakit memiliki potensi untuk menghemat sebesar Rp. 317.529.945 setahun dengan memilih antibiotik profilaksis Cefotaxime pada pasien operasi seksio sesarea. AbstractA prophylactic antibiotic for patients with cesarean section surgery is highly recommended in the clinical guideline. The use of antibiotics is selected by using criteria safety and cost-effectiveness. This partial economic evaluation in the form of cost and outcome analysis was using alongside observational study method, prospective data were collected from April to May 2017 covering 60 patients with cesarean section surgery who received prophylaxis antibiotics, comparing cost-effectiveness between Cefotaxime and Ceftriaxone. The statistical test showed that there were no differences of characteristics in the 60 patients. The analysis based on the hospital perspective carried out in a public hospital in West Java. The Systematic Review showed that there was no difference in the efficacy of the drugs. This study confirmed that there was no difference in clinical outcome on surgical wound infections either in the patient who received Ceftriaxone prophylaxis or Cefotaxime. The greatest component of the cost was the operational cost (84.79%), followed by indirect cost (13.68%), investment cost (1.2%), and maintenance cost (0.32%). The analysis suggested the incremental cost was IDR342,535 in one episode of treatment. The hospital would save the cost of IDR317,529,945 a year by choosing Cefotaxime prophylactic antibiotics for patients with cesarean section surgery.
The complete mitochondrial genomes of five longicorn beetles (Coleoptera: Cerambycidae) and phylogenetic relationships within Cerambycidae
Authors: Wang Jun , Dai Xin-Yi , Xu Xiao-Dong , Zhang Zi-Yi , Yu Dan-Na , Storey Kenneth B. , Zhang Jia-Yong
Published: September 2019

Cerambycidae is one of the most diversified groups within Coleoptera and includes nearly 35,000 known species. The relationships at the subfamily level within Cerambycidae have not been convincingly demonstrated and the gene rearrangement of mitochondrial genomes in Cerambycidae remains unclear due to the low numbers of sequenced mitogenomes. In the present study, we determined five complete mitogenomes of Cerambycidae and investigated the phylogenetic relationship among the subfamilies of Cerambycidae based on mitogenomes. The mitogenomic arrangement of all five species was identical to the ancestral Cerambycidae type without gene rearrangement. Remarkably, however, two large intergenic spacers were detected in the mitogenome ofPterolophiasp. ZJY-2019. The origins of these intergenic spacers could be explained by the slipped-strand mispairing and duplication/random loss models. A conserved motif was found betweentrnS2andnad1gene, which was proposed to be a binding site of a transcription termination peptide. Also, tandem repeat units were identified in the A + T-rich region of all five mitogenomes. The monophyly of Lamiinae and Prioninae was strongly supported by both MrBayes and RAxML analyses based on nucleotide datasets, whereas the Cerambycinae and Lepturinae were recovered as non-monophyletic.
Assessing blue orchard bee (Osmia lignaria) propagation and pollination services in the presence of honey bees (Apis mellifera) in Utah tart cherries
Authors: Boyle Natalie K. , Pitts-Singer Theresa L.
Published: September 2019

Osmia lignaria is a commercially available, native solitary bee species recognized for its propensity to forage upon and pollinate tree fruit crops such as apple, almond and cherry. This study evaluated the implementation of O. lignaria co-pollination with honey bees in central Utah commercial tart cherry orchards during 2017 and 2018 bloom. Three paired 1.2 ha sites were selected for evaluation of cherry fruit set and yield with and without managed O. lignaria releases alongside the standard honey bee hive stocking rate of 2.5 hives/ha. Osmia lignaria supplementation did not measurably increase cherry fruit set, fruit per limb cross-sectional area or fruit weight. The lack of differences in yield is likely a consequence of local saturation of pollinator services supplied by managed honey bees throughout experimental orchards, such that no additive benefit of managed O. lignaria releases were measurable. An increase in managed O. lignaria populations was achieved in 2017 but not 2018, possibly due to unknown changes to orchard management or environmental factors. While flying O. lignaria in Utah tart cherries may support sustainable in-field bee propagation, their subsequent impacts on tart cherry yield were not detected when paired with standard stocking densities of honey bees.