For the first time in research in humans, we used simultaneous icEEG-fMRI to examine the link between connectivity in haemodynamic signals during the resting-state (rs) and connectivity derived from ...electrophysiological activity in terms of the inter-modal connectivity correlation (IMCC). We quantified IMCC in nine patients with drug-resistant epilepsy (i) within brain networks in ‘healthy’ non-involved cortical zones (NIZ) and (ii) within brain networks involved in generating seizures and interictal spikes (IZ1) or solely spikes (IZ2). Functional connectivity (
h
2
) estimates for 10 min of resting-state data were obtained between each pair of electrodes within each clinical zone for both icEEG and fMRI. A sliding window approach allowed us to quantify the variability over time of
h
2
(v
h
2
) as an indicator of connectivity dynamics. We observe significant positive IMCC for
h
2
and v
h
2
, for multiple bands in the NIZ only, with the strongest effect in the lower icEEG frequencies. Similarly, intra-modal
h
2
and v
h
2
were found to be differently modified as a function of different epileptic processes: compared to NIZ,
h
BOLD
2
was higher in IZ1, but lower in IZ2, while
h
icEEG
2
showed the inverse pattern. This corroborates previous observations of inter-modal connectivity discrepancies in pathological cortices, while providing the first direct invasive and simultaneous comparison in humans. We also studied time-resolved FC variability multimodally for the first time, finding that IZ1 shows both elevated internal
h
BOLD
2
and less rich dynamical variability, suggesting that its chronic role in epileptogenesis may be linked to greater homogeneity in self-sustaining pathological oscillatory states.
This study investigated the stress-buffering effect of social support on immune function and infectious risk in women with breast cancer, during and after chemotherapy.
Data were collected from 50 ...women with breast cancer before and after their chemotherapy, as well as three months later. Stress was measured by daily hassles related to cancer and social support by marital status (MS) and perceived support from friends (Ps-fr). Blood was collected to measure innate immune markers (i.e., T cells, NK cells and neutrophils). Infections were evaluated using a semi-structured interview. Moderation, mediation and moderated mediation models were computed to test the hypotheses.
Higher stress at baseline was found to significantly predict a higher occurrence of infections during chemotherapy, but not three months later. The relationship between stress and infections was not significantly explained by any of the immune markers. The interaction between stress and social support was tested using MS alone and combined with Ps-fr. A protective effect of social support on the deleterious effect of stress on infectious risk was found. Single patients reporting lower Ps-fr showed the strongest association between stress and infections, while the weakest association was found in patients in a committed relationship with a higher level of Ps-fr.
Women experiencing more stress before the beginning of chemotherapy would appear to be at a higher risk of developing infections during their treatment. Results of this study also suggest that this effect could be buffered by the presence of a romantic partner and by higher Ps-fr.
•The buffering effect of social support in the relationship between stress, immune function and infectious risk has yet to be explored in cancer.•Results of this study showed that a higher stress level prior to chemotherapy was associated with an increased risk for infections during chemotherapy.•The relationship between stress and infections was not significantly mediated by immune alterations.•The buffering effect of social support was supported: Single patients reporting lower support from their friends showed the strongest association between stress and infections.•The weakest association was found in patients in a committed relationship with a higher perceived support from friends.
Most pregnant women gain weight above recommended levels, and this weight gain affects mothers' and children's health. Factors influencing gestational weight gain (GWG) are numerous and include ...eating behaviours. The objective of this study was to evaluate the association between eating behaviours and GWG while considering pre-pregnancy body mass index (BMI).
Fifty-three (n = 53) women were recruited at 9.4 ± 0.6 gestational weeks. At each trimester, they completed the Three-Factor Eating Questionnaire, which evaluates disinhibition, dietary restraint, and susceptibility to hunger. Using a weight gain curve, trimester-specific GWG was calculated with interpolated weights. Total GWG was calculated as the difference between maternal weight before delivery and self-reported pre-pregnancy weight (Canadian Task Force Classification II-2).
Women were aged 31.5 ± 3.5, and 81.1% had a university degree. The proportion of women who gained weight within recommendations was 21%, 28%, and 26%, at each trimester, respectively, and 38% for total pregnancy. Overall, dietary restraint score was lower in the third trimester in comparison with the first (6.1 ± 4.1 vs. 7.2 ± 4.6; P = 0.049), whereas no difference was observed for disinhibition or susceptibility to hunger. Our data suggest that variations in eating behaviours throughout pregnancy were similar among women who exhibited total GWG below, within, or above recommendations (P
× GWG = NS) (NS: not significant; trim: trimester). Similar observations were reported when women were compared according to their pre-pregnancy BMI (P
× BMI = NS).
Maintaining high levels of restraint may be challenging considering the increase in hunger, which could explain the decrease observed in dietary restraint scores. Changes in eating behaviours were not associated with total GWG or pre-pregnancy BMI.
Background Explicit criteria for judging medication safety and use issues in patients with chronic kidney disease (CKD) are lacking. Study Design Quality improvement report. Setting & Participants ...Nephrologists (n = 4), primary care physicians (n = 2), hospital pharmacists with expertise in nephrology (n = 4), and community pharmacists (n = 2). The PAIR (Pharmacotherapy Assessment in Chronic Renal Disease) criteria were applied retrospectively to 90 patients with CKD in a randomized study. Quality Improvement Plan Development of an explicit set of criteria to enable rapid and systematic detection of drug-related problems (DRPs). Using a RAND method, experts judged the clinical significance of DRPs and the appropriateness of a community pharmacist intervention. The PAIR criteria include 50 DRPs grouped into 6 categories. Outcomes DRPs detected using the PAIR criteria compared with implicit clinical judgment by nephrology pharmacists. Measurements Prevalence of DRPs and reliability, validity, and responsiveness of the PAIR criteria. Results A mean of 2.5 DRPs/patient (95% CI, 2.0-3.1) was identified based on the PAIR criteria compared with 3.9 DRPs/patient (95% CI, 3.4-4.5) based on clinical judgment of nephrology pharmacists. Inter-rater reliability coefficients (κ) by PAIR category varied from 0.80-1.00, with an intraclass correlation coefficient (ICC) of 0.93 (95% CI, 0.89-0.95) for total DRPs per patient. Test-retest reliability coefficients by category varied from 0.74-1.00, with an ICC of 0.91 (95% CI, 0.82-0.96) for total DRPs per patient. During the study, the mean number of DRPs per patient did not change significantly when assessed using the PAIR criteria and clinical judgment. Limitation The prevalence of PAIR DRPs may be underestimated due to the retrospective nature of the validation. Conclusion The prevalence of DRPs requiring the intervention of community pharmacists is high in patients with CKD. The PAIR criteria are reliable, but their responsiveness remains to be shown.
BACKGROUND: The impact of dairy intake on cardiometabolic risk factors associated with metabolic syndrome (MetS) needs further research. OBJECTIVE: To investigate the impact of milk consumption on a ...wide array of cardiometabolic risk factors associated with MetS (blood lipids, cholesterol homeostasis, glucose homeostasis, systemic inflammation, blood pressure, endothelial function) in postmenopausal women with abdominal obesity. METHODS: In this randomized, crossover study, 27 women with abdominal obesity consumed two 6-week diets based on the National Cholesterol Education Program (NCEP), one with 3.2 servings/d of 2% fat milk per 2000 kcal (MILK) and one without milk or other dairy (NCEP). The macronutrient composition of both diets was comparable (55% carbohydrates, 15% proteins, 30% fat and 10% saturated fat). RESULTS: The MILK diet had no significant effect on LDL-C, triglycerides, LDL size, CRP and cell adhesion molecule concentrations and on indicators of insulin sensitivity. The MILK diet reduced HDL-C, adiponectin, endothelin and fasting glucose levels as well blood pressure (all P ≤ 0.01), but those changes were comparable to those seen with the NCEP milk-free diet (all between-diet P ≥ 0.07). Finally, the MILK diet was associated with lower VLDL apolipoprotein B fractional catabolic rate (−13.4%; P = 0.04) and plasma sterol concentrations (−12.0%; P = 0.04) compared with the control NCEP milk-free diet. CONCLUSIONS: These data suggest that short-term consumption of low fat milk in the context of a prudent NCEP diet has no favorable nor deleterious effect on cardiometabolic risk factors associated with MetS in postmenopausal women with abdominal obesity.
Au Québec, les années 1970 sont le théâtre de maintes crises sociales. Loin d’être épargné, le monde de l’éducation se retrouve au cœur de plusieurs débats, notamment ceux soulevés par la question de ...la déconfessionnalisation et l’enjeu de la protection du français. Il est aussi marqué par une radicalisation du discours syndical et par d’importantes grèves du personnel enseignant qui paralysent le système scolaire. Dans cet article, nous tâchons de comprendre comment le Conseil supérieur de l’éducation, un organisme de la Révolution tranquille emblématique d’un État-providence technocratique, s’est adapté, sous les deux mandats de Robert Bourassa, afin de mieux jouer son rôle de conseiller critique de l’État. Notre analyse montre une affirmation inédite de l’autonomie de l’organisme-conseil vis-à-vis du ministre et du ministère, mais aussi une difficulté à prendre part aux grands débats sociétaux en comparaison de dossiers plus circonscrits et pratiques. circonscrits et pratiques.
En 1966, l’Union nationale (UN) se fait élire en s’engageant à ralentir, sinon à renverser le rythme des réformes initiées par le gouvernement libéral de Jean Lesage. Création récente de la ...Révolution tranquille, le Conseil supérieur de l’éducation (CSE) s’inquiète du changement de garde politique. En se penchant sur la période de 1966 à 1970, le présent article montre que ces années s’avèrent finalement davantage faites de continuité que de rupture pour le CSE. À l’interne, l’analyse des procès-verbaux des réunions de l’organisme permet de dégager un souci constant des membres, malgré l’expression de points de discorde, de se situer dans la droite ligne du Rapport Parent. À l’externe, la revue des commentaires des milieux conservateurs—nationalistes et religieux—met au jour une certaine consternation devant le refus du ministère de l’Éducation de réorienter l’action du CSE, après la prise du pouvoir par l’UN. La volonté du CSE de se situer au-dessus des querelles partisanes afin d’offrir une expertise rigoureuse au service de l’État désamorce maintes critiques, tout en assurant au nouvel organisme une forte crédibilité auprès des décideurs publics, lesquels accorderont au CSE des ressources de plus en plus importantes.
Introduction:
Chronic kidney disease (CKD) patients are multimorbid elderly at high risk of drug‐related problems. A Web‐based training program was developed based on a list of significant ...drug‐related problems in CKD patients requiring a pharmaceutical intervention. The objectives were to evaluate the impact of the program on community pharmacists' knowledge and skills and their satisfaction with the training.
Methods:
Pharmacists were randomized to the training program or the control group. Training comprised a 60‐minute Web‐based interactive session supported by a clinical guide. Pharmacists completed a questionnaire on knowledge (10 multiple‐choice questions) and skills (2 clinical vignettes) at baseline and a second time within 1 month. Trained pharmacists completed a written satisfaction questionnaire. Semidirected telephone interviews were conducted with 8 trained pharmacists. Changes in knowledge and skills scores were compared between the groups.
Results:
Seventy pharmacists (training: 52; control: 18) were recruited; the majority were women with <15 years' experience. Compared with the control group, an adjusted incremental increase in the knowledge score (22%; 95% confidence interval CI: 16%–27%) and skills score (24%; 95% CI: 16%–33%) was observed in the training group. Most pharmacists (87%–100%) rated each aspect of the program “excellent'' or “very good.” Additional training and adding a discussion forum were suggested to complement the program.
Discussion:
Pharmacists like the Web‐based continuing education program. Over a short time span, the program improved their knowledge and skills. Its impact on their clinical practices and quality of medication use in CKD patients remains to be assessed.
En 1966, l'Union nationale (UN) se fait élire en s'engageant à ralentir, sinon à renverser le rythme des réformes initiées par le gouvernement libéral de Jean Lesage. Création récente de la ...Révolution tranquille, le Conseil supérieur de l'éducation (CSE) s'inquiète du changement de garde politique. En se penchant sur la période de 1966 à 1970, le présent article montre que ces années s'avèrent finalement davantage faites de continuité que de rupture pour le CSE. À l'interne, l'analyse des procès-verbaux des réunions de l'organisme permet de dégager un souci constant des membres, malgré l'expression de points de discorde, de se situer dans la droite ligne du Rapport Parent. À l'externe, la revue des commentaires des milieux conserva-teurs - nationalistes et religieux - met au jour une certaine consternation devant le refus du ministère de l'Éducation de réorienter l'action du CSE, après la prise du pouvoir par l'UN. La volonté du CSE de se situer au-dessus des querelles partisanes afin d'offrir une expertise rigou-reuse au service de l'État désamorce maintes critiques, tout en assurant au nouvel organisme une forte crédibilité auprès des décideurs publics, lesquels accorderont au CSE des ressources de plus en plus importantes.
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