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Sociodemographic patterning of dietary profiles among Inuit youth and adults in Nunavik, Canada: a cross-sectional study
No full textObjectives
Country (traditional) foods are integral to Inuit culture, but market food consumption is increasing. The Qanuilirpitaa? 2017 Nunavik Health Survey (Q2017) reported similar country food consumption frequency compared to that in 2004; however, examining food items individually does not account for diet patterns, food accessibility, and correlations between food items. Our objective was to identify underlying dietary profiles and compare them across sex, age, ecological region, and food insecurity markers, given the links among diet, health, and sociocultural determinants.
Methods
Food frequency and sociodemographic data were derived from the Q2017 survey (N = 1176). Latent profile analysis identified dietary profiles using variables for the relative frequencies of country and market food consumption first, followed by an analysis with those for country food variables only. Multinomial logistic regression examined the associations among dietary profiles, sociodemographic factors, and food insecurity markers (to disassociate between food preferences and food access).
Results
Four overall dietary profiles and four country food dietary profiles were identified characterized by the relative frequency of country and market food in the diet. The patterns were stable across several sensitivity analyses and in line with our Inuit partners’ local knowledge. For the overall profiles, women and adults aged 30–49 years were more likely to have a market food–dominant profile, whereas men and individuals aged 16–29 and 50+ years more often consumed a country food–dominant profile. In the country food profiles, Inuit aged 16–29 years were more likely to have a moderate country food profile whereas Inuit aged 50+ were more likely to have a high country food–consumption profile. A low country and market food–consumption profile was linked to higher prevalence of food insecurity markers.
Conclusion
We were able to identify distinct dietary profiles with strong social patterning. The profiles elucidated in this study are aligned with the impact of colonial influence on diet and subsequent country food promotion programs for Inuit youth. These profiles will be used for further study of nutritional status, contaminant exposure, and health to provide context for future public health programs.Objectifs
Les aliments traditionnels font partie intégrante de la culture inuite, mais la consommation d’aliments du marché est en augmentation. L’enquête de santé des Inuit Qanuilirpitaa? réalisée en 2017 (Q2017) a mis en évidence que la fréquence de consommation d’aliments traditionnels était similaire à celle rapportée en 2004. Or, les fréquences de consommation des aliments pris individuellement ne tiennent pas compte des habitudes alimentaires, de l’accessibilité des aliments et des corrélations entre les aliments consommés. Notre objectif était d’identifier les profils alimentaires sous-jacents et de les comparer selon le sexe, l’âge, la région écologique et les marqueurs d’insécurité alimentaire, étant donné le lien entre l’alimentation, la santé et les déterminants socioculturels.
Méthodes
Les données sur les fréquences alimentaires et sociodémographiques sont issues de l’enquête Q2017 (N=1176). L’analyse des profils latents a permis d’identifier des profils alimentaires en utilisant les variables pour les fréquences relatives de la consommation d’aliments traditionnels et du marché et uniquement celles pour les aliments traditionnels. Des régressions logistiques multinomiales ont été utilisées pour examiner les associations entre les profils alimentaires, les facteurs sociodémographiques et les marqueurs d’insécurité alimentaire (pour dissocier les préférences alimentaires de l’accès aux aliments).
Résultats
Quatre profils alimentaires globaux et quatre profils alimentaires spécifiques à la consommation d’aliments traditionnels ont été identifiés en fonction de la fréquence relative des aliments traditionnels et des aliments du marché dans l’alimentation. Les profils étaient en accord avec les connaissances locales de nos partenaires Inuit. Pour les profils alimentaires globaux, les femmes et les adultes âgés de 30 à 49 ans étaient plus susceptibles d’avoir un profil dominé par les aliments du marché, tandis que les hommes et les personnes âgées de 16 à 29 ans et celles de 50 ans et plus avaient plus fréquemment un profil dominé par les aliments traditionnels. En ce qui concerne les profils de consommation d’aliments traditionnels, les Inuit âgés de 16 à 29 ans étaient plus susceptibles d’avoir un profil modéré de consommation d’aliments traditionnels, tandis que les Inuit âgés de 50 ans et plus étaient plus susceptibles d’avoir un profil élevé de consommation d’aliments traditionnels. Un profil bas de consommation d’aliments traditionnels et de marché était associé à une prévalence plus élevée de marqueurs d’insécurité alimentaire.
Conclusion
Nous avons identifié différents profils alimentaires et ces derniers étaient associés à des caractéristiques socio-démographiques distinctes. Les profils alimentaires mis en lumière dans cette étude concordent avec l’impact du colonialisme sur l’alimentation au Nunavik et aux programmes subséquents de promotion des aliments traditionnels auprès des jeunes Inuit. Ces profils seront utilisés pour une étude plus approfondie du statut nutritionnel, de l’exposition aux contaminants et des issues de santé afin d’identifier des pistes de solutions pour les futurs programmes de santé publique
Social representations of mass timber and prefabricated light-frame wood construction for multi-story housing : the vision of users in Quebec
No full textThe increased use of wood and prefabrication are solutions that are helping to address current and future challenges in the construction sector. However, these practices are slow to become widespread due to the conservative nature of this industry. The objective of this study is to characterize the social representations of Province of Quebec (Canada) individuals with regard to these construction methods in order to determine the motivations and barriers to their use in the construction of multi-story housing. The social representations of a representative panel of the Quebec population were collected through standardized surveys. The data were analyzed using descriptive statistics. The results indicate that the use of wood in the construction of high-rise multi-story housing is not part of the representations of a majority of Quebecers. The motivations identified are the aesthetics of wood and the environmental aspect, although forestry exploitation remains an important concern for respondents. The main barriers are the safety aspect and lifespan because they tend to dominate the other themes in decision making. The results suggest that the acceptance and adoption of these construction methods by users can be improved by adapting the transfer of knowledge towards the negatively perceived themes and the identified social groups
Effect of station format on the psychometric properties of Multiple Mini Interviews
No full textBackground
Given the widespread use of Multiple Mini Interviews (MMIs), their impact on the selection of candidates and the considerable resources invested in preparing and administering them, it is essential to ensure their quality. Given the variety of station formats used and the degree to which that factor resides in the control of training programmes that we know so little about, format's effect on MMI quality is a considerable oversight. This study assessed the effect of two popular station formats (interview vs. role-play) on the psychometric properties of MMIs.
Methods
We analysed candidate data from the first 8 years of the Integrated French MMIs (IF-MMI) (2010–2017, n = 11 761 applicants), an MMI organised yearly by three francophone universities and administered at four testing sites located in two Canadian provinces. There were 84 role-play and 96 interview stations administered, totalling 180 stations. Mixed design analyses of variance (ANOVAs) were used to test the effect of station format on candidates' scores and stations' discrimination. Cronbach's alpha coefficients for interview and role-play stations were also compared. Predictive validity of both station formats was estimated with a mixed multiple linear regression model testing the relation between interview and role-play scores with average clerkship performance for those who gained entry to medical school (n = 462).
Results
Role-play stations (M = 20.67, standard deviation [SD] = 3.38) had a slightly lower mean score than interview stations (M = 21.36, SD = 3.08), p < 0.01, Cohen's d = 0.2. The correlation between role-play and interview stations scores was r = 0.5 (p < 0.01). Discrimination coefficients, Cronbach's alpha and predictive validity statistics did not vary by station format.
Conclusion
Interview and role-play stations have comparable psychometric properties, suggesting format to be interchangeable. Programmes should select station format based on match to the personal qualities for which they are trying to select
Effects of cyproheptadine on mitral valve remodeling and regurgitation after myocardial infarction
No full textBACKGROUND Ischemic mitral regurgitation (MR) is primarily caused by left ventricle deformation, but leaflet thickening with fibrotic changes are also observed in the valve. Increased levels of 5-hydroxytryptamine (5-HT; ie, serotonin) are described after myocardial infarction (MI); 5-HT can induce valve fibrosis through the 5-HT type 2B receptor (5-HT2BR). OBJECTIVES This study aims to test the hypothesis that post-MI treatment with cyproheptadine (5-HT2BR antagonist) can prevent ischemic MR by reducing the effect of serotonin on mitral biology. METHODS Thirty-six sheep were divided into 2 groups: inferior MI and inferior MI treated with cyproheptadine (0.5 mg/kg/d). Animals were followed for 90 days. Blood 5-HT, infarct size, left ventricular volume and function, MR fraction and mitral leaflet size were assessed. In a complementary in vitro study, valvular interstitial cells were exposed to pre-MI and post-MI serum collected from the experimental animals. RESULTS Increased 5-HT levels were observed after MI in nontreated animals, but not in the group treated with cyproheptadine. Infarct size was similar in both groups (11 ± 3 g vs 9 ± 5 g; P = 0.414). At 90 days, MR fraction was 16% ± 7% in the MI group vs 2% ± 6% in the cyproheptadine group (P = 0.0001). The increase in leaflet size following MI was larger in the cyproheptadine group (+40% ± 9% vs +22% ± 12%; P = 0.001). Mitral interstitial cells overexpressed extracellular matrix genes when treated with post-MI serum, but not when exposed to post-MI serum collected from treated animals. CONCLUSIONS Cyproheptadine given after inferior MI reduces post-MI 5-HT levels, prevents valvular fibrotic remodeling, is associated with larger increase in mitral valve size and less MR
Hemodynamic and clinical outcomes in redo-surgical aortic valve replacement vs. transcatheter valve-in-valve
No full textBackground
Transcatheter valve-in-valve replacement (ViV-TAVR) has emerged as an alternative to redo-surgical aortic valve replacement (Redo-SAVR) for the treatment of failed surgical aortic bioprostheses. However, the benefit of ViV-TAVR compared with Redo-SAVR remains debated with regard to short-term hemodynamic results and short- and long-term clinical outcomes.
Objective
This study aimed to compare short-term hemodynamic performance and long-term clinical outcomes of ViV-TAVR vs. Redo-SAVR in patients treated for surgical aortic bioprosthetic valve failure.
Methods
We retrospectively analyzed the data prospectively collected in 184 patients who underwent Redo-SAVR or ViV-TAVR. Transthoracic echocardiography was performed before and after the procedure and analyzed in an echocardiography core laboratory using the new Valve Academic Research Consortium-3 criteria. An inverse probability of treatment weighting was used to compare the outcomes between both procedures.
Results
ViV-TAVR showed lower rate of intended hemodynamic performance (39.2% vs. 67.7%, p < 0.001) at 30 days, which was essentially driven by a higher rate (56.2% vs. 28.8%, p = 0.001) of high residual gradient (mean transvalvular gradient ≥20 mm Hg). Despite a trend for higher 30-day mortality in the Redo-SAVR vs. ViV-TAVR group (8.7% vs. 2.5%, odds ratio [95% CI]: 3.70 [0.77-17.6]; p = 0.10), the long-term mortality was significantly lower (24.2% vs. 50.1% at 8 years; hazard ratio [95% CI]: 0.48 [0.26-0.91]; p = 0.03) in the Redo-SAVR group. After inverse probability of treatment weighting analysis, Redo-SAVR remained significantly associated with reduced long-term mortality compared with ViV-TAVR (hazard ratio [95% CI]: 0.32 [0.22-0.46]; p < 0.001).
Conclusions
ViV-TAVR was associated with a lower rate of intended hemodynamic performance and numerically lower mortality at 30 days but higher rates of long-term mortality compared with Redo-SAVR
Recension des écrits sur les théories ou modèles d’intervention en développement de carrière au féminin face aux défis de la transformation numérique
No full textParmi les écrits sur la transformation numérique (TN) dans la littérature scientifique, peu d'entre eux s'intéressent aux enjeux de genre et aux défis spécifiques qu'elle représente pour les femmes. Cette recension des écrits vise donc dans un premier temps à documenter les défis de la TN pour les travailleurs et plus particulièrement pour les travailleuses. Dans un deuxième temps, cet article propose d'analyser ces défis en parallèle des difficultés déjà présentes dans le développement de carrière (DDC) des femmes afin de documenter, dans un dernier temps, différentes théories ou modèles d'intervention en DDC
Extracurricular activities and adjustment among students at disadvantaged high schools : the mediating role of peer relatedness and school belonging
No full textIntroduction: Participation in extracurricular activities (ECAs) during high school is likely to be associated with higher intrinsic motivation, as well as lower externalizing problems and depressive symptoms, particularly for students in schools located in socioeconomically disadvantaged neighborhoods. However, few studies have explored the processes underlying these positive associations. In this study, we examined whether peer relatedness and school belonging mediated the links between participation in these activities and adolescent academic and psychosocial adjustment and whether another indicator of poverty, namely material deprivation, moderated these links.
Methods: Canadian students (n = 638; 59% girls) at disadvantaged high schools were surveyed at two-time points.
Results and conclusions: Results show that peer relatedness can explain the associations between extracurricular activity participation and (a) school intrinsic motivation and (b) depressive symptoms. Results also revealed that the indirect effect involving the number of activities, peer relatedness and depressive symptoms was only significant among students living in highly deprived areas. These results highlight the contribution of peer relatedness as a potential mediator of the positive association connecting extracurricular activity participation to adjustment among disadvantaged students
Organized activities in adolescence and pro-environmental behaviors in adulthood : the mediating role of pro-environmental attitudes
No full textIntroduction: Organized activities practiced in adolescence are known to foster positive development, including active citizenship. Active citizenship encompasses a wide range of behaviors, one of them being pro-environmental behaviors. Few studies focused on the developmental factors that may predict these behaviors in adults, despite their crucial role in counteracting the current climate crisis. However, prior research showed that attitudes were typically major predictors of behaviors. This study thus tested a model that posited participation in organized activities in adolescence as a predictor of pro-environmental attitudes in emerging adulthood and these attitudes as a predictor of pro-environmental behaviors in adulthood. Methods: Three hundred twenty-one participants (61% girls) from Quebec (Canada) completed all time points across a 17-year period. Participants self-reported their participation in organized activities (sports, cultural, prosocial) from ages 14 to 17, pro-environmental attitudes, from ages 18 to 22, and pro-environmental behaviors, at age 30. Results: Results revealed that pro-environmental attitudes mediate the relationship between adolescent participation in cultural activities and pro-environmental behaviors in adulthood. Practicing sporting or prosocial activities in adolescence did not predict stronger pro-environmental attitudes or behaviors. Interestingly, pro-environmental attitudes consistently predicted pro-environmental behaviors later in life. Conclusions: These findings and prior research suggest participation in cultural activities may provide a space to discuss, imagine change, and cultivate sensitivity towards nature. This may contribute to the development of pro-environmental attitudes and behaviors later in life
Percutaneous transcatheter edge-to-edge mitral valve repair with MitraClip system in the era of G4
No full textThe use of transcatheter edge-to-edge mitral valve repair (TEER) in symptomatic patients with severe mitral regurgitation (MR) has dramatically increased over the last few years. Current guidelines consider TEER as a reasonable option in symptomatic patients with primary or chronic secondary severe MR with high or prohibitive surgical risk and favorable anatomy. However, several anatomical and morphological mitral features have restricted the use of this mini-invasive technique in its early experience. The latest fourth generation (G4) of the MitraClip system has been recently introduced and includes the possibility of independent leaflet grasping and 4 different sizes. This technical update offers the possibility of selecting and combining multiple devices for complex mitral valve anatomies and challenging procedures, which helps expand the applications of TEER. The present review describes the potential advantages and the help of the MitraClip G4 devices to overcome various anatomic and morphologic issues in challenging cases with complex primary and secondary MR procedures
Atteindre les objectifs de performance à tout prix? : les dilemmes des employé(e)s du service à la clientèle
No full textLes objectifs de performance peuvent se voir augmentés en contexte de transformation numérique. Les tâches s'effectuent d'emblée plus efficacement et rapidement à l'aide des technologies de l'information et de communication adoptées dans les organisations. Ainsi, le rythme de travail sur lequel les objectifs de performance reposent soulève de nouveaux enjeux et dilemmes pour les employé(e)s du service à la clientèle, lesquels seront explicités dans cet article