RésuméLa littérature suggère l'hypothèse d'une santé différentielle des francophones en situation minoritaire au Canada. L'effet de minorité sur la santé perçue a été mesuré à l' aide des Enquêtes sur la santé dans les collectivités canadiennes (ESCC) de 2001 et 2003. Une analyse de régression logistique multivariée séquentielle montre que les francophones minoritaires -hommes et femmes -sont plus enclins à déclarer une moins bonne santé que les anglophones majoritaires. Contrairement aux femmes, cette disparité chez les hommes demeure significative même lorsque nous ajustons pour certains grands déterminants de la santé. L'étude illustre que l' action des déter-minants de santé peut être ainsi modulée par le rapport minoritaire/majoritaire. Les inégalités ainsi révélées appellent à une réflexion sur les politiques d' accès linguistique aux soins de santé.
AbstractLiterature suggests the hypothesis that there is a health differential for minority Frenchspeaking groups in Canada. The effect of minority on perceived health has been measured using the 2001 and 2003 Canadian Community Health Survey (CCHS). The sequential multivariate logistic regression analysis shows that the minority Frenchspeaking groups -men and women -are more likely to declare a poorer health condition than the majority English-speaking groups. Contrary to women, this disparity among men groups remains significant even when adjustments are made according to some of the key health determinants. The study shows that the action of health determinants can be modulated by the minority/majority ratio. The identified disparities remind the need for a reflection on linguistic healthcare access policies.
Abstract. The internalization of signaling receptors such as the insulin receptor is a complex, multi-step process. The aim of the present work was to determine the various steps in internalization of the insulin receptor and to establish which receptor domains are implicated in each of these by the use of receptors possessing in vitro mutations. We find that kinase activation and autophosphorylation of all three regulatory tyrosines 1146, 1150, and 1151, but not tyrosines 1316 and 1322 in the COOH-terminal domain, are required for the ligand-specific stage of the internalization process; i.e., the surface redistribution of the receptor from microvilli where initial binding occurs to the nonvillous domain of the cell. Early intracellular steps in insulin signal transduction involving the activation of phosphatidylinositol Y-kinase are not required for this redistribution. The second step of internalization consists in the anchoring of the receptors in clathrincoated pits. In contrast to the first ligand specific step, this step is common to many receptors including those for transport proteins and occurs in the absence of kinase activation and receptor autophosphorylation, but requires a juxtamembrane cytoplasmic segment of the ~-subunit of the receptor including a NPXY sequence. Thus, there are two independent mechanisms controlling insulin receptor internalization which depend on different domains of the #-subunit.
BackgroundPregnant women were recruited into the Alberta Pregnancy Outcomes and Nutrition (APrON) study in two cities in Alberta, Calgary and Edmonton. In Calgary, a larger proportion of women obtain obstetrical care from family physicians than from obstetricians; otherwise the cities have similar characteristics. Despite similarities of the cities, the recruitment success was very different. The purpose of this paper is to describe recruitment strategies, determine which were most successful and discuss reasons for the different success rates between the two cities.MethodsRecruitment methods in both cities involved approaching pregnant women (< 27 weeks gestation) through the waiting rooms of physician offices, distributing posters and pamphlets, word of mouth, media, and the Internet.ResultsBetween May 2009 and November 2010, 1,200 participants were recruited, 86% (1,028/1,200) from Calgary and 14% (172/1,200) from Edmonton, two cities with similar demographics. The most effective strategy overall involved face-to-face recruitment through clinics in physician and ultrasound offices with access to a large volume of women in early pregnancy. This method was most economical when clinic staff received an honorarium to discuss the study with patients and forward contact information to the research team.ConclusionRecruiting a pregnancy cohort face-to-face through physician offices was the most effective method in both cities and a new critically important finding is that employing this method is only feasible in large volume maternity clinics. The proportion of family physicians providing antenatal and post-natal care may impact recruitment success and should be studied further.
Objectives
Super refractory status epilepticus (SRSE) is a stage beyond refractory status that requires general anesthesia as management. Electroconvulsive therapy (ECT) is recommended only as a potential treatment option beyond general anesthesia and after all other options have been exhausted. Its effect on aborting status has been minimally researched. We present the largest case series to our knowledge exploring the effect of ECT on SRSE.
Methods
Eight adults hospitalized for SRSE received ECT in an attempt to abort status after other treatment modalities were exhausted. Electroconvulsive therapy consisted of a 504-mC (≈99.4 J) stimulus delivered bifrontotemporally with a constant 0.5-millisecond pulse width. Seizure activity during ECT was monitored visually and correlated to the single-channel recording provided by the apparatus.
Results
There was neurotelemetry or clinical evidence of improvement within 24 hours after the full course of ECT treatment in 5 (63%) of the 8 cases. Cases that improved were given an average of 7.8 total ECT stimulations, eliciting an average of 4.2 total seizures.
Conclusions
Although it is difficult to determine the exact role of ECT in the improvement of 63% of our cases, we present a series of patients for whom pharmacotherapy, ketogenic diet, and general anesthesia otherwise did not produce an appreciable effect on status prior to implementation of ECT. These findings suggest that cases of SRSE may benefit from ECT administration.
RésuméDifférentes thèses s’affrontent quant au rôle politique des médias. Le centre-ville de Hull, où la géographie et l’histoire ont amené la concentration d’un nombre imposant de lieux de consommation publique d’alcool, ce qui a entraîné son lot de désordre, de débordements festifs et d’activités « criminelles » variées, fournit l’occasion de les confronter. L’analyse des 1 124 articles qu’a consacrés le quotidienLe Droità cette question entre 1980 à 1999, éclairée par un ensemble d’entrevues auprès des acteurs dans ce dossier, illustre comment celui-ci s’est inséré dans le processus décisionnel entourant l’usage des lieux, en le provoquant, l’accélérant et le légitimant.
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