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Introduction: Transcutaneous cardiac pacing (TCP) is recommended for the treatment of symptomatic bradycardia, a life-threatening condition. Although TCP is taught in ACLS (advanced cardiac life support) courses, it is a difficult skill to master for junior residents. The main objective of this study is to measure the impact of having access to a checklist on successful TCP implementation. Our hypothesis was that the availability of a CL would improve performance of junior residents in the management of symptomatic bradycardia by facilitating TCP. Methods: We conducted a prospective, randomized, single-site study. First-year residents entering postgraduate programs and taking a mandatory ACLS course were enrolled. Students had didactic sessions on the management of symptomatic bradycardia followed by hands-on teaching on a low-fidelity manikin (ALS® simulator, Laerdal) using a CL conceived for this project as a teaching tool. Study participants were then assessed with a simulation scenario requiring TCP. Participants were randomly assigned to groups with and without CL accessibility. Performances were graded on six critical tasks. The primary outcome was the successful use of TCP, defined as having completed all tasks. Participants then completed a post-test questionnaire. Sample size estimation was based on a previous project (Ranger et al., 2018). Accepting an alpha error of 0.05 and a power of 80%, 45 participants in each group would permit the detection of 26.5% in performance gain. Results: Of 250 residents completing the ACLS course in 2017, 85 voluntary participants were randomized to a control group (no CL available during testing, n = 42) or an experimental group (CL available during testing, n = 43). Six participants in the experimental group adequately used TCP compared to five participants in the control group (p = 0.81, chi-squared test). Out of the 43 participants who had access to the CL, only 2 (5%) used it. Reasons why the CL was infrequently used were stated as the following: 24 participants (56%) mentioned not realizing it was available, 8 (19%) considered it was of little to no utility and 5 (19%) forgot a CL existed. Conclusion: Availability of a checklist previously used during simulation teaching did not increase junior residents’ capacity to correctly apply TCP. Non-recognition of CL availability and decreased perceived need for it were the main reasons for marginal use. Our results suggest that there are many limiting factors to CL effectiveness.
Introduction: The quality of life of children with sickle cell disease (SCD) depends on the severity, timing and number of painful episodes (vaso-occlusive crises, VOC) and their need for medical treatment and hospitalizations. The objective of this study was to explore the experiences of pediatric patients and their families during VOC. Methods: This qualitative study used semi-structured one-on-one and focus group interviews, designed in partnership with two patients and one parent, in a single center, tertiary care pediatric university-affiliated hospital. Two groups of participants were interviewed independently: (1) adolescent patients aged 12 to 18 years old hospitalised within the last 2 years for VOC, (2) parents of pediatric patients with SCD hospitalised within the last 2 years for VOC. Data was transcribed in full and analysed using NVivo12. Descriptive thematic content analysis was performed by coding themes emerging from data. After validating codes through interjudge assessment by consensus, themes from teenagers’ and parent's discourses were systematically compared for the final analysis. Results: Between June and August 2018, 8 interviews were conducted. 10 parents and 5 adolescents participated. Teenagers’ and parents’ answers mirrored each other's. Prompt pain relief was crucial, although the side effects of pain relief medications used were an added source of suffering. Recent quality improvement initiatives such as standardised order sheets were noteworthy improvements, though personalizing care to each patient's with pharmacological and non-pharmacological methods was also important to participants. Given the unpredictability and severity of VOC, their impact on both patients’ and families’ lives were substantial, as was the long term emotional burden. Parents felt guilty given the hereditary nature of the disease, they encouraged neonatal and prenatal testing, and they sought definitive treatments for both VOC and SCD. Tensions within parent-teenager relationships were described centered on developing autonomy and protecting the child to improve adherence to treatments. Conclusion: Participants emphasized the need to provide timely adequate analgesia, through both standardised quality improvement initiatives and a personalised approach to analgesia. Understanding the impact of VOC on patients’ lives and their socio-familial context is important to tailor clinical interventions.
To assess the relative validity of a new, web-based, self-administered 24 h dietary recall, the R24W, for assessment of energy and nutrient intakes among French Canadians.
Each participant completed a 3d food record (FR) and the R24W on three occasions over a 4-week period. Intakes of energy and of twenty-four selected nutrients assessed by both methods were compared.
Québec City metropolitan area.
Fifty-seven women and fifty men (mean (sd) age: 47·2 (13·3) years).
Equivalent proportions of under-reporters were found with the R24W (15·0%) and the FR (23·4%). Mean (sd) energy intake from the R24W was 7·2% higher than that from the FR (10 857 (3184) kJ/d (2595 (761) kcal/d) v. 10 075 (2971) kJ/d (2408 (710) kcal/d); P<0·01). Significant differences in mean nutrient intakes between the R24W and the FR ranged from –54·8% (i.e. lower value with R24W) for niacin to +40·0% (i.e. higher value with R24W) for alcohol. Sex- and energy-adjusted deattenuated correlations between the two methods were significant for all nutrients except Zn (range: 0·35–0·72; P<0·01). Cross-classification demonstrated that 40·0% of participants were classified in the same quartile with both methods, while 40·0% were classified in the adjacent quartile and only 3·6% were grossly misclassified (1st v. 4th quartile). Analysis of Bland–Altman plots revealed proportional bias between the two assessment methods for 8/24 nutrients.
These data suggest that the R24W presents an acceptable relative validity as compared with the FR for estimating usual dietary intakes in a cohort of French Canadians.
The present study aimed to develop and validate a questionnaire assessing social support for healthy eating in a French-Canadian population.
A twenty-one-item questionnaire was developed. For each item, participants were asked to rate the frequency, in the past month, with which the actions described had been done by family and friends in two different environments: (i) at home and (ii) outside of home. The content was evaluated by an expert panel. A validation study sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on items to assess the number of subscales. Internal consistency reliability was assessed using Cronbach’s ɑ. Test–retest reliability was evaluated with intraclass correlations between scores of the two completions.
Men and women from the Québec City area (n 150).
The content validity assessment led to a few changes, resulting in a twenty-two-item questionnaire. Exploratory factor analysis revealed a two-factor structure for both environments, resulting in four subscales: supportive actions at home; non-supportive actions at home; supportive actions outside of home; and non-supportive actions outside of home. Two items were removed from the questionnaire due to low loadings. The four subscales were found to be reliable (Cronbach’s ɑ=0·82–0·94; test–retest intraclass correlation=0·51–0·70).
The Social Support for Healthy Eating Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. This questionnaire will be useful to explore the role of social support and its interactions with other factors in predicting eating behaviours.
There is a relative consensus about the detrimental impact of childhood maltreatment on later mental health problems and behavioral difficulties. Prior research suggests that neurophysiological stress mechanisms may partly mediate this association. However, inconsistent findings regarding hypothalamic-pituitary-adrenal axis and sympathetic responses to stress complicate this investigation. Furthermore, the concordance in these two stress systems is not well understood. We tested whether the severity of maltreatment affected the association between maltreatment and cortisol and heart rate (HR) stress responses and the symmetry of these responses. Participants were 155 males (56 maltreated and 99 controls) aged 18 to 35 years. Cortisol and HR were measured in response to the Trier Social Stress Test. Childhood maltreatment, sociodemographic factors, and health-related factors were measured using self-reported questionnaires. Maltreated participants had higher cortisol responses to stress in comparison to controls. However, a shift from moderate to lower to higher cortisol responses was noted as the severity of the experiences increased. Participants exposed to more experiences of maltreatment also showed a greater symmetry between cortisol and HR stress responses. Our findings provide further support for persistent dysregulation of the HPA axis following childhood maltreatment, of which the expression and symmetry with the sympathetic system may change according to the severity of experiences.
Cellular adhesion depends on the integration of numerous signaling inputs generated by the chemical and physical properties of the substrate. The complex coupling among inputs makes it challenging experimentally to deconvolve their individual contributions to the adhesion process. To address this roadblock, we have employed a combination of electron beam and optical lithographic techniques to fabricate substrates with independently tunable topographical and chemical signaling cues. Arrays of gold nanostructures were patterned atop quartz substrates, half of which were etched into gold-capped nanopillars. Individual A549 cells exposed simultaneously to Arg-Gly-Asp-functionalized etched and non-etched arrays exhibited strongly preferential adherence to the nanopillars.
Background: With a growing and aging population, the number of individuals with AD and dementias and their associated costs are expected to increase in Canada. Up to now, no national mechanism was in place to monitor the epidemiological burden of AD and dementias. This presentation will showcase the first CCDSS data available on these conditions. Methods: Through the CCDSS, a Federal/Provincial/Territorial partnership, health administrative databases are linked to collect data on chronic conditions. Using selected ICD-9(CM)/ICD-10 codes for AD and dementias, the validated case definition implemented to identify relevant cases aged 65+ is:
1+ hospitalizations; or
3+ physician claims within 2 years, with a 30-day-gap between each claim; or
1+ anti-dementia drug prescriptions.
Prevalence and incidence rates will be presented by 5-year age group, sex, province/territory, and fiscal year. Results: Overall, incidence and prevalence rates were higher in women. The prevalence rate approximately doubled between 5-year age groups and sex differences tended to widen with age. While aged-standardised data show increasing prevalence rates over time, incidence rates fluctuated but suggest a decline since 2009/10. Conclusions: CCDSS data can be used to monitor the burden of AD and dementias in Canada. This information is important for the assessment of prevention actions and the planning of health care resources.
Introduction: Transcutaneous cardiac pacing (TCP), a skill taught in Advanced Cardiovascular Life Support (ACLS) courses, is recommended to treat unstable bradycardia. Training manikins currently available fail to reproduce key features of TCP and might be suboptimal to teach this procedure.The objective of this study was to measure the impact of a modified high-fidelity manikin on junior residents’ TCP competency during an ACLS course. We hypothesized that the use of this high-fidelity manikin improves junior residents’ performances. Methods: This prospective cohort study was conducted at the Université de Montréal in July 2015 and 2016. First-year residents undergoing their mandatory ACLS course were enrolled. The control group (2015) received the traditional curriculum, which includes hands-on teaching on Advanced Life Support manikins. The intervention group (2016) received a similar curriculum, but used a modified high-fidelity manikin that reproduces key features of TCP (e.g. use of multifunction pads, TCP induced patient twitching, ECG artifacts). Cohorts were tested with a simulation scenario requiring TCP. Performances were graded based on six critical tasks: turns on pacer function, applies multifunction pads, recognizes TCP is ineffective, achieves captures, verifies mechanical capture and prescribes sedation. Our primary outcome was successful use of TCP defined as having completed all tasks. Secondary outcomes were the success rates for each task. These were compared using Pearson’s chi-squared test. We anticipated that the success rate of TCP would increase from 20% to 50%. To obtain a power of more than 90%, 48 participants were needed in both cohorts. Results: A total of 50 residents were recruited in both cohorts. No resident that received the traditional curriculum was able to successfully establish TCP while 18 residents trained on the modified high-fidelity manikin succeeded (0 vs 36%, P<0.001). Furthermore, the latter were more likely to recognize when pacing was inefficient (12 vs 86%, P<0.001), obtain ventricular capture (2 vs 48%, P<0.001), and check for a pulse rate to confirm capture (0 vs 48%, P<0.001). Conclusion: Successful use of TCP is a difficult skill to master for junior residents. A modified high-fidelity manikin during ACLS training significantly improves their ability to establish effective pacing.
The present study aimed to develop and validate a questionnaire assessing perceived food environment in a French-Canadian population.
A questionnaire, the Perceived Food Environment Questionnaire, was developed assessing perceived accessibility to healthy (nine items) and unhealthy foods (three items). A pre-test sample was recruited for a pilot testing of the questionnaire. For the validation study, another sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on the items to assess the number of factors (subscales). Cronbach’s α was used to measure internal consistency reliability. Test–retest reliability was assessed with Pearson correlations.
Men and women from the Québec City area (n 31 in the pre-test sample; n 150 in the validation study sample).
The pilot testing did not lead to any change in the questionnaire. The exploratory factor analysis revealed a two-subscale structure. The first subscale is composed of six items assessing accessibility to healthy foods and the second includes three items related to accessibility to unhealthy foods. Three items were removed from the questionnaire due to low loading on the two subscales. The subscales demonstrated adequate internal consistency (Cronbach’s α=0·77 for healthy foods and 0·62 for unhealthy foods) and test–retest reliability (r=0·59 and 0·60, respectively; both P<0·0001).
The Perceived Food Environment Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. Further validation is recommended if the questionnaire is to be used in other populations.
The present study aimed to develop and validate a nutrition knowledge questionnaire in a sample of French Canadians from the province of Quebec, taking into account dietary guidelines.
A thirty-eight-item questionnaire was developed by the research team and evaluated for content validity by an expert panel, and then administered to respondents. Face validity and construct validity were measured in a pre-test. Exploratory factor analysis and covariance structure analysis were performed to verify the structure of the questionnaire and identify problematic items. Internal consistency and test–retest reliability were evaluated through a validation study.
Six nutrition and psychology experts, fifteen registered dietitians (RD) and 180 lay people participated.
Content validity evaluation resulted in the removal of two items and reformulation of one item. Following face validity, one item was reformulated. Construct validity was found to be adequate, with higher scores for RD v. non-RD (21·5 (sd 2·1) v. 15·7 (sd 3·0) out of 24, P<0·001). Exploratory factor analysis revealed that the questionnaire contained only one factor. Covariance structure analysis led to removal of sixteen items. Internal consistency for the overall questionnaire was adequate (Cronbach’s α=0·73). Assessment of test–retest reliability resulted in significant associations for the total knowledge score (r=0·59, P<0·001).
This nutrition knowledge questionnaire was found to be a suitable instrument which can be used to measure levels of nutrition knowledge in a Canadian population. It could also serve as a model for the development of similar instruments in other populations.
We investigated the association between junk food consumption at lunchtime (JCL) and fast-food outlet access near school among secondary-school children in Quebec.
A geographic information system database was used to characterize the food environment around a sub-sample of 374 public schools in which 26 655 students were enrolled. The outcome variable was JCL during the previous week, dichotomized into low JCL (none or once) v. high JCL (twice or more). Access to fast-food outlets near school was assessed using an existing database of fast-food outlets in Quebec. Covariates included student (age, sex and self-rated perceived health), family (familial status and parental education) and school (urban/rural status and deprivation) variables. Hierarchical logistic regression models were employed for analyses using PROC GLIMMIX of SAS version 9.3.
Province of Quebec, Canada.
We used data from the Quebec Health Survey of High School Students (QHSHSS) 2010–11, a survey of secondary-school Quebec students.
Exposure to two or more fast-food outlets within a radius of 750 m around schools was associated with a higher likelihood of excess JCL (OR=1·50; 95 % CI 1·28, 1·75), controlling for the characteristics of the students, their families and their schools.
The food environment surrounding schools can constitute a target for interventions to improve food choices among secondary-school children living in the province of Quebec. Transforming environments around schools to promote healthy eating includes modifying zoning regulations that restrict access to fast-food outlets around schools.
Sickle cell disease is known to cause various degrees of vasculopathy, including impact on heart function. The aims of this single-centre, retrospective study were to assess cardiac chamber size and function and the relationship with haematological indices such as haemoglobin, aspartate aminotransferase, reticulocytosis and bilirubin, lactate dehydrogenase in sickle cell disease.
Right ventricle and left ventricle diastolic diameters, left ventricle mass estimate, left ventricle shortening fraction, myocardial performance index, and an index of myocardial relaxation (E/E’) were calculated and correlated with haematological parameters.
A total of 110 patients (65% haemoglobin SS, 29% haemoglobin SC) were studied at a mean age of 12.14±5.26 years. Right ventricle dilatation and left ventricle dilatation were present in 61.5 and 42.9%, respectively. Left ventricle mass was abnormal in 21.9%; all patients had normal myocardial performance index, 31.4% had abnormal E/E’, and left ventricle shortening fraction was low in 38.1%. Cardiac dilatation was best correlated with haemoglobin, aspartate aminotransferase, reticulocytosis and bilirubin. Best subset regression analysis yielded significant additional prediction for right ventricle or left ventricle dilatation with haemoglobin, bilirubin, and lactate dehydrogenase. Abnormal E/E’ was solely predictable with haemoglobin level. Hydroxyurea-treated patients had improved diastolic function.
Right ventricle dilatation was more prevalent than left ventricle dilatation. The long-term consequences of right ventricular dilatation, clinical consequences, and association with pulmonary vasculopathy need to be further determined.
Antibiotics are commonly used in poultry feed as growth promoters. This practice is questioned given the arising importance of antibiotic resistance. Antimicrobial peptides can be used as food additives for a potent alternative to synthetic or semi-synthetic antibiotics. The objective of this study was to develop a peptide production method based on membrane adsorption chromatography in order to produce extracts with antimicrobial activity against avian pathogens (Salmonella enterica var. Enteritidis, Salmonella enterica var. Typhimurium, and two Escherichia coli strains, O78:H80 and TK3 O1:K1) as well as Staphylococcus aureus. To achieve this, buttermilk powder and purified lactoferrin were digested with pepsin. The peptide extracts (<10 kDa) were fractionated depending on their charges through high-capacity cation-exchange and anion-exchange adsorptive membranes. The yields of cationic peptide extracts were 6·3 and 15·4% from buttermilk and lactoferrin total peptide extracts, respectively. Antimicrobial activity was assessed using the microdilution technique on microplates. Our results indicate that the buttermilk cationic peptide extracts were bactericidal at less than 5 mg/ml against the selected avian strains, with losses of 1·7 log CFU/ml (Salm. Typhimurium) to 3 log CFU/ml (E. coli O78:H80); viability decreased by 1·5 log CFU/ml for Staph. aureus, a Gram-positive bacterium. Anionic and non-adsorbed peptide extracts were inactive at 5 mg/ml. These results demonstrate that membrane adsorption chromatography is an effective way to prepare a cationic peptide extract from buttermilk that is active against avian pathogens.
Introduction: Sickle cell vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visit and admission in children with this condition. With this study, we aim to evaluate whether the implementation of an oral morphine protocol has led to improved care of sickle cell disease (SCD), translated by a reduced hospitalization rate, an increased oral administration rate and faster opiate administration time, comparing cohorts of patients presenting to the emergency department (ED) and hematology outpatient clinic (HOC) with VOC pre and post implementation. Methods: Retrospective chart review of patients with SCD followed at CHU Ste-Justine, who presented to the ED and HOC with VOC, in the year pre and post implementation of the protocol. Patients with a VOC diagnosis during the study periods were selected in each department’s database. The primary outcome was to evaluate the hospitalization rate. The rate of oral administration, as well as the opiate administration time from inscription in the ED or arrival in the HOC were also calculated. We estimated that 35 patients per arm would be sufficiently powered to detect at least a 30% rate reduction of admissions, with a power of 80% and a significance of 0.05. Results: Over the two periods, a total of 105 patients (49 pre and 56 post) were included from the ED and 62 patients (36 pre and 26 post) from the HOC. Both departments showed a reduction in hospitalization rate: a difference of 48% (95% CI 32, 61) in ED and 38% (95% CI 13, 57) in HOC. Both showed an increase in the rate of oral administration: a difference of 36% (95% CI 19, 50) in ED and 33% (95% CI 8, 53) in HOC. There was a non-significant difference of 10 min (95% CI -10, 25) in the opiate administration time in ED, as opposed to HOC where a significant difference of -45 min (95% CI -71, -6) was found, with both presenting median times over the recommended 60 minutes post implementation. Both settings showed an increase in the percentage of patients without IVs; a difference of 17% (95% CI 4, 30) in ED and 55% (95% CI 72, 31) in HOC. Conclusion: This study validates the use of our oral morphine protocol for the treatment of VOC, by showing a significant reduction in hospitalization rates. Although delays remain in our opiate administration time, our protocol decreased the number of painful IV procedures.
Homocysteine (Hcy) is an intermediary sulphur amino acid recognised for pro-oxidative properties in several species which may weaken immune competence in piglets. In this species, there is an acute 10-fold increase of concentrations of plasma Hcy (pHcy) during the first 2 weeks of life. The present experiment aimed to determine if pHcy in piglets can be regulated by oral supplementations of betaine as a methyl group supplier, creatine for reducing the demand for methyl groups, choline with both previous functions and vitamin B6 as enzymic co-factor for Hcy catabolism. A total of seventeen sows (second parity) were fed gestation and lactation diets supplemented with folic acid (10 mg/kg) and vitamin B12 (150 µg/kg). Eight piglets in each litter received daily one of the eight following oral treatments (mg/kg body weight): (1) control (saline); (2) betaine (50); (3) choline (70); (4) creatine (300); (5) pyridoxine (0·2); (6) treatments 2 and 5; (7) treatments 3 and 4; and (8) treatments 2, 3, 4 and 5. According to age, pHcy increased sharply from 2·48 µm at birth to 17·96 µm at 21 d of age (P < 0·01). Concentrations of pHcy tended to be lower (P = 0·09) in treated than in control piglets but the highest and sole pairwise significant decrease (23 %) was observed between treatments 1 and 8 (P = 0·03). Growth from birth to 21 d of age was not influenced by treatments (P > 0·70). Therefore, it appears possible to reduce pHcy concentrations in suckling piglets but a combination of all chosen nutrients is required.
A school environment that encourages students to opt for food with sound nutritional value is both essential and formative in ensuring that young people adopt healthy eating habits. The present study explored the associations between the socio-economic characteristics of the school environment and the school food environment.
A cross-sectional survey was conducted in 2008–2009. Descriptive and bivariate analyses were performed on data from public primary and secondary schools.
Quebec, Canada. The school food offering was observed directly and systematically by trained research assistants. Interviews were conducted to fully describe food offerings in the schools and schools’ child-care services.
A two-stage stratified sampling was used to build a representative sample of 143 French-speaking public schools. The response rate was 66·2 %.
The primary and secondary schools in low-density areas were more likely to be located near diners (primary: P=0·018; secondary: P=0·007). The secondary schools in deprived areas were less likely to have a regular food committee (P=0·004), to seek student input on menu choices (P=0·001) or to have a long lunch period (P=0·010). The primary schools in deprived areas were less likely to have a food service (P=0·025) and their meal periods were shorter (P=0·033).
The schools in areas with lower socio-economic status provided an environment less favourable for a healthy diet. From a public health perspective, the results of this analysis could assist policy makers and managers to identify actions to support the creation of favourable school environments.
We developed a specific cognitive–existential intervention to improve existential distress in nonmetastatic cancer patients. The present study reports the feasibility of implementing and evaluating this intervention, which involved 12 weekly sessions in both individual and group formats, and explores the efficacy of the intervention on existential and global quality of life (QoL) measures.
Some 33 nonmetastatic cancer patients were randomized between the group intervention, the individual intervention, and the usual condition of care. Evaluation of the intervention on the existential and global QoL of patients was performed using the existential well-being subscale and the global scale of the McGill Quality of Life (MQoL) Questionnaire.
All participants agreed that their participation in the program helped them deal with their illness and their personal life. Some 88.9% of participants agreed that this program should be proposed for all cancer patients, and 94.5% agreed that this intervention helped them to reflect on the meaning of their life. At post-intervention, both existential and psychological QoL improved in the group intervention versus usual care (p = 0.086 and 0.077, respectively). At the three-month follow-up, global and psychological QoL improved in the individual intervention versus usual care (p = 0.056 and 0.047, respectively).
Significance of results:
This pilot study confirms the relevance of the intervention and the feasibility of the recruitment and randomization processes. The data strongly suggest a potential efficacy of the intervention for existential and global quality of life, which will have to be confirmed in a larger study.
Probiotic Lactobacillus and Bifidobacterium species are generally fastidious bacteria and require rich media for propagation. In milk-based media, they grow poorly, and nitrogen supplementation is required to produce high bacterial biomass levels. It has been reported that caseinomacropeptide (CMP), a 7-kDa peptide released from κ-casein during renneting or gastric digestion, exhibits some growth-promoting activity for lactobacilli and bifidobacteria. During the digestive process, peptides derived from CMP are detected in the intestinal lumen The aim of this study was to evaluate the effects of peptic and tryptic digests of CMP on probiotic lactic acid bacteria growth in de Man, Rogosa and Sharpe broth (MRS) and in milk during fermentation at 37 °C under anaerobic conditions. The study showed that pepsin-treated CMP used as supplements at 0·5 g/l can promote the growth of probiotics even in peptone-rich environments such as MRS. The effect was strain-dependent and evident for the strains that grow poorly in MRS, with an improvement of >1·5 times (P<0·05) by addition of pepsin-treated CMP. Trypsin-treated CMP was much less efficient as growth promoter. Moreover, pepsin-treated CMP was effective in promoting the growth in milk of all probiotic lactic acid bacteria tested, with biomass levels being improved significantly, by 1·7 to 2·6 times (P<0·05), depending on the strain. Thus, supplementation of MRS and of milk with pepsin-treated CMP would be advantageous for the production of high biomass levels for Bifidobacteria and Lactobacilli.
Les approches de soins centrées sur la personne sont de plus en plus recommandées en vue d’améliorer la qualité des soins de longue durée. Au Québec (Canada), l’approche relationnelle de soins a été implantée dans plusieurs établissements. Cette étude porte sur le point de vue des soignants formés sur l’utilité de cette approche ainsi que sur leur capacité à la transférer en pratique. Des questionnaires comportant des questions ouvertes ont été administrés un mois après la formation (n=392). Les réponses ont été catégorisées selon une approche qualitative. Les répondants perçoivent que certaines dimensions de l’approche sont hors de leur portée ou s’opposent à leurs croyances. Ils rapportent des pressions liées aux contraintes temporelles, à leurs collègues ainsi qu’aux familles des résidents. Ces résultats indiquent que la formation ne suffit pas à transformer les pratiques. Il faut également agir sur les croyances des individus ainsi que sur les situations de travail
Caseinomacropeptide (CMP), a 7-kDa phosphoglycopolypeptide fragment released from κ-casein during milk renneting, is heterogeneous with respect to post-translational glycosylation. Several studies have reported that CMP has growth-promoting activity on lactic acid bacteria belonging to the genera Bifidobacterium. The aim of this study was to evaluate the effect of glycosylation and sequence variations between bovine and caprine CMP on the growth of two probiotics: Lactobacillus rhamnosus RW-9595-M and Bifidobacterium thermophilum RBL67. The growth-promoting activities of CMP (mixture of glycosylated (gCMP) and non-glycosylated (aCMP) fractions), aCMP and gCMP were measured in a basal minimal culture medium using turbidimetric microplate assay at 37 °C. Supplementation of the culture media at 2 mg/ml significantly improved maximum growth by 1·5 to 1·8 times depending on the strain, the additive (CMP, aCMP, gCMP), and the bovine or caprine origin (P < 0·05). CMP preparations also decreased the time needed to reach the inflexion point of the growth curve and increase the cell density at that time (P < 0·05). The effects of CMP preparations were dose dependent and significantly superior to the effect of bovine β-lactoglobulin added to the culture media. As gCMP and aCMP were as efficient as bovine and caprine CMP (P > 0·1), it was concluded that the presence of oligosaccharides linked to CMP was not essential for growth-promoting activity of CMP.