Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional deformity of the spine associated with pain and aesthetic changes. Various health care professionals may be led to evaluate and/or manage ...adolescents presenting AIS. There is no compiling of the studies evaluating the level of knowledge on AIS conservative management among undergraduate students in healthcare.
To identify and map the current studies evaluating the level of knowledge of health profession students on AIS conservative management.
Scoping review.
The search strategy was conducted in Scopus database. Three concepts were included: “Adolescent idiopathic scoliosis”, “Knowledge” and “Undergraduate students studying in a healthcare field”. Studies identification included (1) duplicates removing, (2) title and abstract screening, and (3) full-text screening. The quality of the included studies was assessed. Studies’ characteristics were extracted, and results were summarized.
Searches yielded the identification of 245 citations. After duplicates removal and abstract screening, three full-text articles were identified. Following full-text review, two full-text articles were finally included. Both studies evaluated students in physiotherapy, but using distinct questionnaires. Both studies reported an unsatisfactory level of knowledge.
Knowledge of future health professionals about the conservative management of AIS has been barely evaluated. Therefore, no conclusion can be drawn regarding the level of knowledge of undergraduate health professions’ students on AIS conservative management. The development a standardized questionnaire to adequately assess this knowledge across institutions and professions is required.
•Guidelines on adolescent idiopathic scoliosis (AIS) management are available.•Healthcare students should be aware of AIS evaluation and management.•Only two full-text studies report the level of knowledge among healthcare students.•A standardized questionnaire on AIS knowledge should be developed and validated.
OBJECTIVE—The human scavenger receptor class B type I (Cla-1) plays a key role in cellular cholesterol movement in facilitating transport of cholesterol between cells and lipoproteins. Indirect ...evidence has suggested that Cla-1 gene expression is under the feedback control of cellular cholesterol content. To define the molecular mechanisms underlying such putative regulation, we evaluated whether Cla-1 is a target gene of the sterol regulatory element binding protein (SREBP) transcription factor family.
METHODS AND RESULTS—Transient transfections demonstrated that SREBP factors induce Cla-1 promoter activity and that SREBP-2 is a more potent inducer than the SREBP-1a isoform. The 5′-deletion analysis of 3 kb of the 5′-flanking sequence of the Cla-1 gene, combined with site-directed mutagenesis and electrophoretic mobility shift assay, allowed identification of a unique sterol responsive element. SREBP-mediated Cla-1 regulation was confirmed in stably transfected human embryonic kidney 293 cells expressing the active form of SREBP-2 at incremental levels. In these cell lines, Cla-1 mRNA and protein levels were increased in direct proportion to the level of SREBP-2 expression.
CONCLUSIONS—These findings provide evidence that SREBP-2, a key regulator of cellular cholesterol uptake through modulation of the expression of the low-density lipoprotein receptor gene, may influence cellular cholesterol homeostasis via regulation of Cla-1 gene expression.
Lumbopelvic pain (LBPP) affects 45% to 81% of pregnant women, and 25% to 43% of these women report persistent LBPP beyond 3 months after giving birth. The objective of this study was to investigate ...the association of physical activity, weight status, anxiety, and evolution of LBPP symptoms in postpartum women.
This was a prospective observational cohort study with 3 time-point assessments: baseline (T0), 3 months (T3), and 6 months (T6). Women with persistent LBPP 3 to 12 months after delivery were recruited. At each time point, pain disability was assessed with the Pelvic Girdle Questionnaire and the Oswestry Disability Index (ODI), physical activity with Fitbit Flex monitors, and anxiety with the French-Canadian version of the State-Trait Anxiety Inventory. Weight was recorded using a standardized method. Pain intensity (numerical rating scale, 0-100) and frequency were assessed using a standardized text message on a weekly basis throughout the study.
Thirty-two women were included (time postpartum: 6.6 ± 2.0 months; maternal age: 28.3 ± 3.8 years; body weight: 72.9 ± 19.1 kg), and 27 completed the T6 follow-up. Disability, pain intensity, and pain frequency improved at T6 (P < .001). Participants lost a mean of 1.9 ± 4.5 kg at T6, and this weight loss was correlated with reduction in LBPP intensity (r = 0.479, P = .011) and LBPP frequency (r = 0.386, P = .047), Pelvic Girdle Questionnaire score (r = 0.554, P = .003), and ODI score (r = 0.494, P = .009). Improvement in ODI score at T6 was correlated with the number of inactive minutes at T3 (r = −0.453, P = .026) and T6 (r = −0.457, P = .019), and with daily steps at T6 (r = 0.512, P = .006).
Weight loss is associated with positive LBPP symptom evolution beyond 3 months postpartum, and physical activity is associated with reduction in pain disability.
To assess chiropractic (DC) and naturopathic doctors' (ND) knowledge, attitudes, and behaviour with respect to the pediatric patients in their practice.
Cross-sectional surveys were developed in ...collaboration with DC and ND educators. Surveys were sent to randomly selected DCs and NDs in Ontario, Canada in 2004, and a national online survey was conducted in 2014. Data were analyzed using descriptive statistics, t-tests, non-parametric tests, and linear regression.
Response rates for DCs were n = 172 (34%) in 2004, n = 553 (15.5%) in 2014, and for NDs, n = 171 (36%) in 2004, n = 162 (7%) in 2014. In 2014, 366 (78.4%) of DCs and 83 (61%) of NDs saw one or more pediatric patients per week. Pediatric training was rated as inadequate by most respondents in both 2004 and 2014, with most respondents (n = 643, 89.9%) seeking post-graduate training by 2014. Respondents' comfort in treating children and youth is based on experience and post-graduate training. Both DCs and NDs that see children and youth in their practices address a broad array of pediatric health concerns, from well child care and preventative health, to mild and serious illness.
Although the response rate in 2014 is low, the concerns identified a decade earlier remain. The majority of responding DCs and NDs see infants, children, and youth for a variety of health conditions and issues, but self-assess their undergraduate pediatric training as inadequate. We encourage augmented pediatric educational content be included as core curriculum for DCs and NDs and suggest collaboration with institutions/organizations with expertise in pediatric education to facilitate curriculum development, especially in areas that affect patient safety.
•NDs & DCs most commonly recommend vitamins/minerals, probiotics, EFAs & homeopathics.•Twice as many NDs as DCs recommended NHPs for pediatric use.•Recommended products are most often “generally ...recognized as safe”.•Practitioners often age-adjust dose or choice of the recommended products.
To assess chiropractic (DC) and naturopathic doctors’ (ND) pediatric care natural health product (NHP) recommendations.
Surveys were developed in collaboration with DC and ND educators, and delivered as an on-line national survey. NHP dose, form of delivery, and indications across pediatric age ranges (from newborn to 16 years) for each practitioner’s top five NHPs were assessed. Data were analyzed using descriptive statistics, t-tests, and non-parametric tests.
Of the 421 respondents seeing one or more pediatric patients per week, 172 (41%, 107 DCs, 65 NDs) provided 440 NHP recommendations, categorized as: vitamins and minerals (89 practitioners, 127 recommendations), probiotics (110 practitioners, 110 recommendations), essential fatty acids (EFAs: 72 practitioners, 72 recommendations), homeopathics (56 practitioners, 66 recommendations), botanicals (29 practitioners, 31 recommendations), and other NHPs (33 practitioners, 34 recommendations). Indications for the NHP recommendations were tabulated for NHPs with 10 or more recommendations in any age category: 596 total indications for probiotics, 318 indications for essential fatty acids, 138 indications for vitamin D, and 71 indications for multi-vitamins.
This is the first study documenting the pediatric NHP recommendations of two popular complementary medicine professions. Common NHPs at standard doses are the most frequently recommended products, with use and doses adjusted according to age. High-quality evidence regarding the efficacy, safety, and dosing for NHP use in children is scarce; development of evidence-informed pediatric guidelines is recommended, particularly for the most commonly used and recommended NHPs.
Mental, neurological and substance use (MNS) disorders represent a major source of disability and premature mortality worldwide. However, in developing countries patients with MNS disorders are often ...poorly managed and treated, particularly in marginalized, impoverished areas where the mental health gap and the treatment gap can reach 90%. Efforts should be made in promoting help by making mental health care more accessible. In this article, we address the challenges that psychological and psychiatric services have to face in a low-resource context, taking our experience at a Moroccan rehabilitation center as a case study. A sample of 60 patients were interviewed using a semi-structured questionnaire during the period of 2014-2015. The questionnaire investigated the reactions and feelings of the patients to the rehabilitation program, and their perceived psychological status and mental improvement, if any. Interviews were then transcribed and processed using ATLAS.ti V.7.0 qualitative analysis software. Frequencies and co-occurrence analyses were carried out. Despite approximately 30 million inhabitants within the working age group, Morocco suffers from a shortage of specialized health workers. Our ethnographic observations show that psychiatric treatment can be ensured, notwithstanding these hurdles, if a public health perspective is assumed. In resource-limited settings, working in the field of mental health means putting oneself on the line, exposing oneself to new experiences, and reorganizing one's own skills and expertise. In the present article, we have used our clinical experience at a rehabilitation center in Fes as a case study and we have shown how to use peer therapy to overcome the drawbacks that we are encountered daily in a setting of limited resources.
Validation of the French-Canadian Pelvic Girdle Questionnaire Girard, Marie-Pier; O’Shaughnessy, Julie; Doucet, Chantal ...
Journal of manipulative and physiological therapeutics,
March-April 2018, 2018 Mar - Apr, 2018-03-00, 20180301, Letnik:
41, Številka:
3
Journal Article
Recenzirano
Pain in the pelvic girdle area is commonly reported during pregnancy and the postpartum period, and its impact on quality of life is considerable. The Pelvic Girdle Questionnaire (PGQ), developed in ...2011 in Norway, is the only condition-specific tool assessing pelvic girdle pain–related symptoms and disability. The questionnaire was recently translated and adapted for the French-Canadian population. The objective of this study was to assess the measurement properties of the previously translated French-Canadian PGQ.
Eighty-two women with pelvic girdle pain were included in this validation study. The French-Canadian PGQ, pain intensity Numeric Rating Scale, and Oswestry Disability Index were completed by participants at baseline, 48 hours later, and 3 to 6 months later to assess test-retest reliability, construct validity, responsiveness, floor and ceiling effects, and internal consistency.
Reliability analyses indicated an intraclass correlation coefficient of 0.841 (95% confidence interval CI 0.750-0.901) for the global score. Construct validity analyses indicated a Spearman rank correlation coefficient of 0.696 with the Oswestry Disability Index. Responsiveness analyses identified an effect size of 0.908 (95% CI 0.434-1.644) and an area under the receiver operating characteristics curve of 0.823 (95% CI 0.692-0.953). There was no floor or ceiling effect, and internal consistency analyses indicated a Cronbach α of .933 for the activity subscale and .673 for the symptom subscale.
Overall, the French-Canadian version of the PGQ is reliable, valid, and responsive, suggesting that it can be implemented in both research and clinical settings to assess functional limitations in pregnant and postpartum women.
Scavenger receptor SR-BI has been implicated in HDL-dependent atheroprotective mechanisms. We report the generation of an SR-BI conditional knockout mouse model in which SR-BI gene targeting by loxP ...site insertion produced a hypomorphic allele (hypomSR-BI). Attenuated SR-BI expression in hypomSR-BI mice resulted in 2-fold elevation in plasma total cholesterol (TC) levels. Cre-mediated SR-BI gene inactivation of the hypomorphic SR-BI allele in hepatocytes (hypomSR-BI-KO(liver)) was associated with high plasma TC concentrations, increased plasma free cholesterol/TC (FC/TC) ratio, and a lipoprotein-cholesterol profile typical of SR-BI-/- mice. Plasma TC levels were increased 2-fold in hypomSR-BI and control mice fed an atherogenic diet, whereas hypomSR-BI-KO(liver) and SR-BI-/- mice developed severe hypercholesterolemia due to accumulation of FC-rich, VLDL-sized particles. Atherosclerosis in hypomSR-BI mice was enhanced (2.5-fold) compared with that in controls, but to a much lower degree than in hypomSR-BI-KO(liver) (32-fold) and SR-BI-/- (48-fold) mice. The latter models did not differ in either plasma lipid levels or in the capacity of VLDL-sized lipoproteins to induce macrophage cholesterol loading. However, reduced atherosclerosis in hypomSR-BI-KO(liver) mice was associated with decreased lesional macrophage content as compared with that in SR-BI-/- mice. These data imply that, in addition to its major atheroprotective role in liver, SR-BI may exert an antiatherogenic role in extrahepatic tissues.
Vivre seul Doucet, Marie-Chantal
Sociologie et sociétés,
Printemps 2018, Letnik:
50, Številka:
1
Journal Article
Ce texte, présenté comme un itinéraire de recherche, porte sur le phénomène de la vie seule dans les grandes villes moderne. Le nombre croissant de personnes vivant seules amène à penser que de ...nouvelles dynamiques sont à l’oeuvre. Vivre seul semble tributaire d’un « état d’esprit » contemporain dont la ville est tout particulièrement le théâtre. Des traits communs de ces expériences diversifiées du vivre seul sont examinés sous la loupe d’une sociologie de l’individuation. Or, l’équivoque que représente ce phénomène dans les sociétés contemporaines peut être associé à trois tensions principales que nous allons exposer : une tension entre intériorité et extériorité ; entre proximité et distance ; entre différenciation et identification.
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