Les alliances technologiques stratégiques: de la théorie à la situation canadienne

Technological cooperation between business enterprises has become common-place over the past ten years or so, following an increase in the uncertainty, risk, and costs of research and development brought about by growing international competition and the unsettling impact of data processing technologies (and to a lesser degree biotechnologies) throughout the entire industrial sector. Strategies in R&D cooperation, first adopted by Japanese corporations, were copied by European firms in the early 80s and then by American and Canadian corporations later on. Governments have got in on the action through policies for encouragement of collective R&D. Current theories in economies and business administration are not very useful for understanding this phenomenon. Neo-classical economies' assumption of perfect competition, as well as dissertations on product obsolescence and transaction costs, permeate theories in business administration and do not help us comprehend this new organizational phenomenon. We have, however, come across some crucial leads towards an explanation in certain models of imperfect competition and in managerial studies on informal cooperation by businesses in R&D

Le syndrome Balint

Dans ce court article, les auteures retracent l'historique des groupes Balint. Elles expliquent ensuite son implantation au Québec, spécifiquement à la Clinique des Citoyens de St-Jacques à Montréal. Elles constatent enfin que les sentiments d'unicité et d'intensité constituent le principal apprentissage de ces groupes.In this short article, the authors give an historical view of the Balint Group. They then explain its beginning, in Quebec, specifically at the Citizens Clinic in St.Jacques, Montreal. Those groups are mainly involved in developing feelings of intensity and unicity

Actes du 21e Colloque de l'AQPC

Également disponible en version papier.Titre de l'écran-titre (visionné le 14 avril 2010

Indigenous Nursing Students’ Readiness for Practice Perceptions - Les perceptions d’étudiantes autochtones en sciences infirmières quant à leur préparation à la pratique

Introduction: Despite being well prepared by baccalaureate nursing institutions, senior students often express trepidation and a lack of confidence with respect to their upcoming nursing role. The literature has long explored readiness for practice struggles of new graduate nurses, however, no studies of which we are aware have addressed Indigenous senior nursing students’ perspectives on this topic. By understanding the readiness for practice perceptions of Indigenous nursing students and facilitating the successful transition from student to nurse, nursing education programs can honor the Truth and Reconciliation Commission of Canada’s (2015) Calls to Action related to: 1) increasing the number of Indigenous professionals working in the healthcare field and 2) ensuring the retention of Indigenous healthcare providers in Indigenous communities. Purpose: The purpose of this research is to explore baccalaureate Indigenous nursing students’ perceptions of their readiness for practice. Procedures: A descriptive exploratory study was conducted with a convenience sample of 26 senior baccalaureate nursing students in the province of Saskatchewan, Canada using the Readiness for Practice Survey. Results: Readiness for practice perceptions of Indigenous nursing students in this study are similar when compared with nursing students from the extant literature. With regards to Indigenous students’ perceived clinical problem solving skills they believed they used evidence to make clinical decisions and they were confident in their ability to problem solve. They also felt confident identifying actual or potential safety risk to patients. Students were least comfortable knowing what to do for a dying patient. When considering student learning perspectives, students believed simulation activities assisted them in being prepared for clinical practice. The least effective learning strategy they perceived was reflective journal writing. The majority of participants were satisfied in choosing nursing as a career, however, they were less confident in their readiness for entering the nursing profession. Students were comfortable asking for help and communicating with patients and family members. Participants did not feel overwhelmed with ethical issues and believed they had opportunities to practice skills more than once. Participants specified the nursing skills they were most uncomfortable performing were electrocardiogram or telemetry monitoring and interpretation, responding to an emergency or code blue, and performing tracheostomy care and suctioning. Students indicated their level of comfort in caring for two, three, and four patients and students became less confident as the number of patients they cared for increased. When asked what could have been done to help students feel more prepared to enter the nursing profession, participants had several suggestions including additional anatomy, physiology, pharmacology, and medical surgical theory courses particularly in upper years of the program, increased clinical hours, opportunities to practice psychomotor skills, and opportunities for mentorship both within school and after graduation. Conclusion: The results of the study provide insight into Indigenous students’ readiness for practice experiences and provides knowledge on supports needed to assist graduates’ transitions into their nursing careers. Strategies to enhance Indigenous nurse readiness for practice can assist in creating a representative workforce and ultimately provide culturally safe, quality care for Indigenous individuals and communities. Résumé Introduction : Malgré leur bonne préparation par des établissements d’enseignement qui offrent le baccalauréat en sciences infirmières, les étudiantes finissantes expriment souvent de l’inquiétude et un manque de confiance concernant leur futur rôle d’infirmière. Les écrits ont largement examiné les difficultés de la transition vers la pratique des infirmières nouvellement diplômées; cependant, à notre connaissance, aucune étude n’a abordé les perceptions des étudiantes autochtones en sciences infirmières à ce sujet. En comprenant les perceptions des étudiantes autochtones en sciences infirmières quant à leur préparation à la pratique et en facilitant la transition d’étudiante à infirmière, les programmes en sciences infirmières seront en mesure de respecter les appels à l’action (et recommandations) de la Commission de la vérité et réconciliation du Canada (2015) : 1) de voir à l’accroissement du nombre de professionnels autochtones travaillant dans le domaine des soins de santé; et 2) de veiller au maintien en poste des Autochtones qui fournissent des soins de santé dans les communautés autochtones. Objectif : Le but de cette recherche est d’examiner la perception d’étudiantes autochtones au baccalauréat en sciences infirmières quant à leur préparation à la pratique. Moyens : Une étude descriptive exploratoire a été menée avec un échantillon de convenance de 26 étudiantes finissantes en sciences infirmières en Saskatchewan, au Canada, par le biais du sondage Readiness for Practice ou préparation à la pratique. Résultats :Les perceptions des étudiantes autochtones en sciences infirmières de cette étude, quant à leur préparation à la pratique sont similaires à celles des autres étudiantes en sciences infirmières, rapportées dans les nombreux écrits. Concernant leur perception par rapport à leur capacité à résoudre des problèmes cliniques, les étudiantes autochtones rapportaient utiliser des faits pour prendre des décisions cliniques et se disaient confiantes par rapport à leur capacité de résoudre des problèmes. Elles étaient également sûres de pouvoir identifier les risques potentiels ou réels pour la sécurité des patients. Les étudiantes étaient moins confiantes en leur capacité de fournir des soins et du soutien aux patients en phase terminale. Quant à leurs perceptions des moyens d’apprentissage, les étudiantes croyaient que les activités de simulation les préparaient pour la pratique clinique. Selon elles, la stratégie d’apprentissage la moins efficace était la tenue d’un journal réflexif. La majorité des participantes étaient satisfaites de leur choix de carrière en sciences infirmières; cependant, elles étaient moins confiantes concernant leur capacité à intégrer la profession. Les étudiantes étaient à l’aise de demander de l’aide ainsi que de communiquer avec les patients et les membres de leurs familles. Les participantes ne se sentaient pas dépassées par les problèmes éthiques et croyaient avoir eu des occasions de pratiquer leurs habiletés à plusieurs reprises. Les participantes ont précisé que les activités avec lesquelles elles se sentaient le moins à l’aise étaient de superviser et interpréter des électrocardiogrammes ou de la télémétrie, de répondre à une situation d’urgence ou un code bleu et d’effectuer les soins et l’aspiration de trachéotomies. Les étudiantes ont indiqué leur niveau de confort à s’occuper de deux, trois ou quatre patients, et se sentaient de moins en moins à l’aise lorsque le nombre de patients dont elles prenaient soin augmentait. Lorsqu’on leur a demandé ce qui aurait pu être fait pour les aider à se sentir mieux préparées à intégrer la profession, les étudiantes ont offert plusieurs suggestions, y compris : cours théoriques additionnels en anatomie, physiologie, pharmacologie et médecine-chirurgie , particulièrement en fin de programme; augmentation des heures cliniques; plus d’occasions de pratiquer les habiletés psychomotrices; et, du mentorat avant et après l’obtention du diplôme. Conclusion : Les résultats de l’étude offrent un aperçu de la perception d’étudiantes autochtones quant à leur préparation à la pratique et de nouvelles connaissances sur le soutien nécessaire afin de faciliter la transition des diplômées vers leur carrière en sciences infirmières. Les stratégies pour améliorer la préparation à la pratique des infirmières autochtones peuvent aider à créer une main-d’œuvre représentative et, ultimement, offrir des soins culturellement sécuritaires et de qualité aux personnes et aux communautés autochtones

A Groundbased Imaging Study of Galaxies Causing DLA, subDLA, and LLS Absorption in Quasar Spectra

We present results from a search for galaxies that give rise to damped Lyman alpha (DLA), subDLA, and Lyman limit system (LLS) absorption at redshifts 0.1 ~< z ~< 1 in the spectra of background quasars. The sample was formed from a larger sample of strong MgII absorbers (W_0^(2796) >= 0.3 A) whose HI column densities were determined by measuring the Ly-alpha line in HST UV spectra. Photometric redshifts, galaxy colors, and proximity to the quasar sightline, in decreasing order of importance, were used to identify galaxies responsible for the absorption. Our sample includes 80 absorption systems for which the absorbing galaxies have been identified, of which 54 are presented here for the first time. The main results of this study are: (i) the surface density of galaxies falls off exponentially with increasing impact parameter, b, from the quasar sightline relative to a constant background of galaxies, with an e-folding length of ~46 kpc. Galaxies with b >~ 100 kpc calculated at the absorption redshift are statistically consistent with being unrelated to the absorption system. (ii) log N(HI) is inversely correlated with b at the 3.0 sigma level of significance. DLA galaxies are found systematically closer to the quasar sightline, by a factor of two, than are galaxies which give rise to subDLAs or LLSs. The median impact parameter is 17.4 kpc for the DLA galaxy sample, 33.3 kpc for the subDLA sample, and 36.4 kpc for the LLS sample. (iii) Absorber galaxy luminosity relative to L*, L/L*, is not significantly correlated with W_0^(2796), log N(HI), or b. (iv) DLA, subDLA, and LLS galaxies comprise a mix of spectral types, but are inferred to be predominantly late type galaxies based on their spectral energy distributions. The implications of these results are discussed. (Abridged)Comment: Accepted for publication in MNRA

Idéations suicidaires du personnel de la santé pendant la pandémie de COVID-19 : une évaluation écologique momentanée

Introduction: The COVID-19 pandemic had an impact on the psychological health of healthcare workers (HCWs). Cross-sectional studies report suicidal ideation in this population during this period, but no longitudinal study has examined the evolution of these ideas over time. Objectives: To assess the evolution of suicidal ideation of HCWs during the first two waves of the COVID-19 pandemic among Quebec (Canada) HCWs and to identify the risk factors involved. Methods: A longitudinal study among Quebec (Canada) HCWs using ecological momentary assessment was conducted between May 8, 2020, and March 31, 2021 (corresponding to the second half of the first wave to the end of the second). Participants (n=865) answered weekly questions related to anxiety (GAD-7), depression (PHQ-9), suicidal ideation (PHQ-9 Q.9), exposure to COVID-19, exposure to COVID-19-related deaths, their infection status and that of their co-workers and loved ones, as well as the amount of time they spent consuming news related to COVID-19. Results: Proportion of suicidal ideation increased from May to June 2020 (second half of the first wave) peaking at 18% before declining up to March 2021. Anxiety and depression symptoms severity increased those ideations as well as having a colleague confirmed positive to COVID-19. Social support does not appear to be a protective factor for suicidal ideation. Suicidal thoughts are associated with media consumption and appear to be mediated by the presence of clinical distress expressed as depressive or anxiety states. Discussion and conclusion: Media consumption in a pandemic context is associated with anxiety and depression, the more severe states of which may express suicidal ideation. Without inferring causality relationship, it seems advisable for HCWs to limit their media exposure during a disaster such as a pandemic.Introduction : La pandémie de COVID-19 a eu un impact sur la santé psychologique des travailleurs de la santé (TS). Des études transversales rapportent la présence d’idées suicidaires chez cette population pendant cette période, mais aucune étude longitudinale n’a examiné l’évolution de ces idées dans le temps. Objectifs : Évaluer l’évolution des idées suicidaires des TS au cours des deux premières vagues de la pandémie de COVID-19 au Québec (Canada) et identifier les facteurs de risque impliqués. Méthodes&nbsp;: Une étude longitudinale, utilisant l’évaluation écologique momentanée, a été menée entre le 8 mai 2020 et le 31 mars 2021 (correspondant à la période entre la moitié de la 1re vague à la fin de la seconde) auprès des TS québécois. Les participants (n=865) ont répondu de façon hebdomadaire à des questions relatives à l’anxiété (GAD-7), à la dépression (PHQ-9), aux idées suicidaires (PHQ-9 Q.9), à l’exposition à la COVID-19, à l’exposition aux décès liés à la COVID-19, à leur statut infectieux et à celui de leurs collègues et de leurs proches, ainsi qu’au temps passé à consommer des nouvelles liées à la COVID-19. Résultats : La proportion d’idées suicidaires a augmenté de mai à juin 2020 (deuxième moitié de la première vague) atteignant un pic à 18% avant de diminuer par la suite jusqu’en mars 2021. La gravité des symptômes d’anxiété et de dépression était corrélée positivement avec les idéations suicidaires, tout comme le fait d’avoir un collègue infecté à la COVID-19. Le soutien social ne semble pas être un facteur protecteur des idées suicidaires. Les idées suicidaires sont corrélées à la consommation de médias et un effet médiateur est observé par la présence d’une détresse clinique exprimée par des états dépressifs ou anxieux. Discussion et conclusion : La consommation de médias dans un contexte de pandémie est associée à de l’anxiété et à de la dépression, dont les états les plus graves peuvent exprimer des idées suicidaires. Sans inférer un lien de causalité, il semble recommandé aux travailleurs de la santé de limiter leur exposition aux médias lors d’une catastrophe telle qu’une pandémie

Suicidal Ideation of Healthcare Workers During COVID-19: An Ecological Momentary Assessment

Introduction: The COVID-19 pandemic had an impact on the psychological health of healthcare workers (HCWs). Cross-sectional studies report suicidal ideation in this population during this period, but no longitudinal study has examined the evolution of these ideas over time. Objectives: To assess the evolution of suicidal ideation of HCWs during the first two waves of the COVID-19 pandemic among Quebec (Canada) HCWs and to identify the risk factors involved. Methods: A longitudinal study among Quebec (Canada) HCWs using ecological momentary assessment was conducted between May 8, 2020, and March 31, 2021 (corresponding to the second half of the first wave to the end of the second). Participants (n=865) answered weekly questions related to anxiety (GAD-7), depression (PHQ-9), suicidal ideation (PHQ-9 Q.9), exposure to COVID-19, exposure to COVID-19-related deaths, their infection status and that of their co-workers and loved ones, as well as the amount of time they spent consuming news related to COVID-19. Results: Proportion of suicidal ideation increased from May to June 2020 (second half of the first wave) peaking at 18% before declining up to March 2021. Anxiety and depression symptoms severity increased those ideations as well as having a colleague confirmed positive to COVID-19. Social support does not appear to be a protective factor for suicidal ideation. Suicidal thoughts are associated with media consumption and appear to be mediated by the presence of clinical distress expressed as depressive or anxiety states. Discussion and conclusion: Media consumption in a pandemic context is associated with anxiety and depression, the more severe states of which may express suicidal ideation. Without inferring causality relationship, it seems advisable for HCWs to limit their media exposure during a disaster such as a pandemic

QASI: A collaboration for implementation of an independent quality assessment programme in India

Objective: The HIV pandemic remains a significant global health concern. Accurate determination of CD4+ T-cells in patient samples relies on reliable CD4 enumeration. The Quality Assessment and Standardization programme for Immunological measures relevant to HIV/AIDS (QASI) programme of the Public Health Agency of Canada provides clinical laboratories from resource-limited countries with a mechanism to evaluate the quality of CD4 testing and develop the implementation of an independent national External Quality Assessment (EQA) programme. This study describes how QASI helped develop the capacity for managing a sustainable national CD4 EQA programme in India. Design: Supported by the Public Health Agency of Canada and Clinton Foundation HIV/AIDS Initiative, QASI engaged with the National AIDS Control Organization and the Indian National AIDS Research Institute to assist in technology transfer in preparation for the implementation/ management of an independent CD4 EQA programme. Technology transfer training was provided to support corrective actions and to improve the quality of CD4 testing. Inter- laboratory variation of EQA surveys between pre- and post-skill development was compared. Results: Prior to training, coefficient of variation values were 14.7% (mid-level CD4 count controls) and 39.0% (low-level). Following training, variation was reduced to 10.3% for mid- level controls and 20.0% for low-level controls. Conclusion: This training assisted the National AIDS Control Organization and the Indian National AIDS Research Institute in identifying the information necessary for management of an EQA programme, and developed the foundation for India to provide corrective actions for sites with challenges in achieving reliable results for CD4 enumeration. This led to a demonstrable improvement in CD4 testing quality and illustrates how country-specific training significantly improved CD4 enumeration performance for better clinical management of HIV care in India

The Germline and Somatic Origins of Prostate Cancer Heterogeneity

Newly diagnosed prostate cancers differ dramatically in mutational composition and lethality. The most accurate clinical predictor of lethality is tumor tissue architecture, quantified as tumor grade. To interrogate the evolutionary origins of prostate cancer heterogeneity, we analyzed 666 prostate tumor whole genomes. We identified a compendium of 223 recurrently mutated driver regions, most influencing downstream mutational processes and gene expression. We identified and validated individual germline variants that predispose tumors to acquire specific somatic driver mutations: these explain heterogeneity in disease presentation and ancestry differences. High-grade tumors have a superset of the drivers in lower-grade tumors, including increased frequency of BRCA2 and MYC mutations. Grade-associated driver mutations occur early in tumor evolution, and their earlier occurrence strongly predicts cancer relapse and metastasis. Our data suggest high-and low-grade prostate tumors both emerge from a common premalignant field, influenced by germline genomic context and stochastic mutation timing. Significance: This study uncovered 223 recurrently mutated driver regions using the largest cohort of prostate tumors to date. It reveals associations between germline SNPs, somatic drivers, and tumor aggression, offering significant insights into how prostate tumor evolution is shaped by germline factors and the timing of somatic mutations.</p