Genomic and phenomic predictions help capture low-effect alleles promoting seed germination in oilseed rape in addition to QTL analyses.

KEY MESSAGE: Phenomic prediction implemented on a large diversity set can efficiently predict seed germination, capture low-effect favorable alleles that are not revealed by GWAS and identify promising genetic resources. Oilseed rape faces many challenges, especially at the beginning of its developmental cycle. Achieving rapid and uniform seed germination could help to ensure a successful establishment and therefore enabling the crop to compete with weeds and tolerate stresses during the earliest developmental stages. The polygenic nature of seed germination was highlighted in several studies, and more knowledge is needed about low- to moderate-effect underlying loci in order to enhance seed germination effectively by improving the genetic background and incorporating favorable alleles. A total of 17 QTL were detected for seed germination-related traits, for which the favorable alleles often corresponded to the most frequent alleles in the panel. Genomic and phenomic predictions methods provided moderate-to-high predictive abilities, demonstrating the ability to capture small additive and non-additive effects for seed germination. This study also showed that phenomic prediction estimated phenotypic values closer to phenotypic values than GEBV. Finally, as the predictive ability of phenomic prediction was less influenced by the genetic structure of the panel, it is worth using this prediction method to characterize genetic resources, particularly with a view to design prebreeding populations.

Gas Phase Ionization Energy of Heptacene.

The ionization energy is a fundamental property that is relevant to charge transport in organic semiconductors. We report adiabatic ionization energies (AIEs) of heptacene at 6.21 and 7.20 eV for the X̃+B2g and Ã+Au states, respectively, as the next larger member of the acene series using mass- and isomer-selective double imaging photoelectron photoion coincidence spectroscopy. The X̃+ state energy decreases monotonically with an increase in size within the homologous series of acenes and approaches an asymptotic limit [AIE(polyacene) = 5.94 ± 0.06 eV] based on a fit with an exponential decay function. As byproducts of heptacene formation from cycloreversion of diheptacenes, 5,18-, 7,16-, and 6,17-dihydroheptacene can be detected, and their AIE is similar to that of their largest acene subunit (anthracene and tetracene, respectively), in very good agreement with computational treatments.

Orientation, electronic decoupling and band dispersion of heptacene on modified and nanopatterned copper surfaces.

The adsorption of heptacene (7 A) on Cu(110) and Cu(110)-(2 × 1)-O was studied with scanning tunneling microscopy, photoemission orbital tomography and density functional calculations to reveal the influence of surface passivation on the molecular geometry and electronic states. We found that the charge transfer into the 7 A molecules on Cu(110) is completely suppressed for the oxygen-modified Cu surface. The molecules are aligned along the Cu-O rows and uncharged. They are tilted due to the geometry enforced by the substrate and the ability to maximize intermolecular π-π overlap, which leads to strong π-band dispersion. The HOMO-LUMO gap of these decoupled molecules is significantly larger than that reported on weakly interacting metal surfaces. Finally, the Cu-O stripe phase was used as a template for nanostructured molecular growth and to assess possible confinement effects.

Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study.

BACKGROUND: Monitoring of the macrocirculation during surgery provides limited information on the quality of organ perfusion. OBJECTIVE: We investigated the feasibility of perioperative microcirculatory measurements in children. METHODS: Sublingual microvessels were visualized by handheld videomicroscopy in 11 children (19 mo - 10 yrs) undergoing surgery > 120 min at four time points: T0) after induction of anesthesia; T1) before end of anesthesia, T2) 6 h post surgery and T3) 24 h post surgery. RESULTS: Measurements were feasible in all children at T0 and T1. At T2 and T3, imaging was restricted to 6 and 4 infants, respectively, due to respiratory compromise and missing cooperation. The capillary density was reduced at T1 compared to T0 (8.1 mm/mm2 [4.0-17.0] vs. 10.6 mm/mm2 [5.1-19.3]; p = 0.01), and inversely related to norepinephrine dose (Pearson r = -0.65; p = 0.04). Microvascular flow and serum glycocalyx makers Syndecan-1 and Hyaluronan increased significantly from T0 to T1. CONCLUSION: Perioperative microcirculatory monitoring in children requires a high amount of personal and logistic resources still limiting its routine use. Major surgery is associated with microvascular alterations and glycocalyx perturbation. The possible consequences on patient outcome need further evaluation. Efforts should concentrate on the development of next generation devices designed to facilitate microcirculatory monitoring in children.

Erythropoietin-driven dynamic proteome adaptations during erythropoiesis prevent iron overload in the developing embryo.

Erythropoietin (Epo) ensures survival and proliferation of colony-forming unit erythroid (CFU-E) progenitor cells and their differentiation to hemoglobin-containing mature erythrocytes. A lack of Epo-induced responses causes embryonic lethality, but mechanisms regulating the dynamic communication of cellular alterations to the organismal level remain unresolved. By time-resolved transcriptomics and proteomics, we show that Epo induces in CFU-E cells a gradual transition from proliferation signature proteins to proteins indicative for differentiation, including heme-synthesis enzymes. In the absence of the Epo receptor (EpoR) in embryos, we observe a lack of hemoglobin in CFU-E cells and massive iron overload of the fetal liver pointing to a miscommunication between liver and placenta. A reduction of iron-sulfur cluster-containing proteins involved in oxidative phosphorylation in these embryos leads to a metabolic shift toward glycolysis. This link connecting erythropoiesis with the regulation of iron homeostasis and metabolic reprogramming suggests that balancing these interactions is crucial for protection from iron intoxication and for survival.

Dataset for the metabolic and physiological characterization of seeds from oilseed rape (Brassica napus L.) plants grown under single or combined effects of drought and clubroot pathogen Plasmodiophora brassicae.

Faced with the challenges of adapting agriculture to climate change, seed production should have increased resilience to abiotic stress factors and the expected proliferation of pathogens. This concerns both the nutritional quality and seed vigor, two crucial factors in seedling establishment and yield. Both qualities are acquired during seed development, but how environment influences the genetic and physiological determinisms of these qualities remains to be elucidated. With a world production of 71 Mt of seeds per year, oilseed rape (Brassica napus) is the third largest oleaginous crop. But its productivity must cope with several abiotic stresses, among which drought is one of the main constraints in current and future climate scenarios. In addition, clubroot disease, caused by the pathogen Plasmodiophora brassicae, leads to severe yield losses for the Brassica crops worldwide. Clubroot provokes the formation of galls on the infected roots that can restrict the flow of water and nutrients within the plant throughout the growth cycle. In order to get new insights into the impact of single or combined constraints on seed qualities, metabolic profiling assays were run for a collection of 330 seed samples (including developing, mature and imbibed seeds) harvested from plants of two B. napus cultivars ("Express" and "Montego") that were grown under either drought conditions, the presence of P. brassicae, or a combination of both stresses. Metabolites were identified and quantified by UPLC or GC. In addition, monitoring germination traits was conducted for 60 mature seed lots under in vitro conditions using an automated phenotyping platform. The present dataset contains the raw contents for 42 metabolites (nmol.mg-1 of seed dry weight) filtered and analyzed with statistical tests as well as germination speed and percentages. This dataset is available under accession at Data INRAE. These data will contribute to a better understanding of the crosstalk between the plant responses to water deprivation and/or pathogen attack and how it compromises seed quality. A better understanding of the molecular and physiological responses of the seed to (a)biotic stress on a molecular and physiological will be a first step to meet scientific and technological challenges of adapting seeds to their environment.

Factors Influencing the Accuracy of Freehand Implant Placement: A Prospective Clinical Study.

(1) Background: The objective of implant prosthetic restoration is to ensure the best possible rehabilitation of function and esthetics. Optimal positioning of the implant with regard to the bone availability, surrounding soft tissue, and prosthetic sustainability should be strived for during implant placement. The factors influencing freehand implant placement and the accuracy achieved with this procedure are investigated in this prospective clinical study. (2) Methods: Implants were placed in the single-tooth edentulous sites of the premolar and molar areas in 52 patients. Three-dimensional (3D)-planning was performed virtually prior to the freehand implant operation, and the desired position of the implant was provided to the surgeon. (3) Results: The deviations between the planned and the actually achieved position with freehand implant placement showed the following mean values and standard deviations: angle 8.7 ± 4.8°, 3D deviation at the implant shoulder 1.62 ± 0.87 mm, mesiodistal deviation 0.87 ± 0.75 mm, buccolingual deviation 0.70 ± 0.66 mm, and apiocoronal deviation 0.95 ± 0.61 mm. The type of jaw had a significant influence on accuracy. Major deviations were observed in the lower jaw. Furthermore, the timing of implant placement influenced the mesiodistal deviation and angular deviation; (4) Conclusions: Freehand implant placement demonstrated a higher level of deviation between the planned and actually achieved implant positions. In particular, the ranges showed a large spread. From a prosthetic point of view, there may be complications during the restoration of the prosthetic crown if the implant exit point is not optimally located or if the implants show a high angular deviation.

ScreenSeed as a novel high throughput seed germination phenotyping method.

A high throughput phenotyping tool for seed germination, the ScreenSeed technology, was developed with the aim of screening genotype responsiveness and chemical drugs. This technology was presently used with Arabidopsis thaliana seeds to allow characterizing seed samples germination behavior by incubating seeds in 96-well microplates under defined conditions and detecting radicle protrusion through the seed coat by automated image analysis. This study shows that this technology provides a fast procedure allowing to handle thousands of seeds without compromising repeatability or accuracy of the germination measurements. Potential biases of the experimental protocol were assessed through statistical analyses of germination kinetics. Comparison of the ScreenSeed procedure with commonly used germination tests based upon visual scoring displayed very similar germination kinetics.

Perspectives Among Canadian Physicians on Factors Influencing Implementation of Mifepristone Medical Abortion: A National Qualitative Study.

PURPOSE: Access to family planning health services in Canada has been historically inadequate and inequitable. A potential solution appeared when Health Canada approved mifepristone, the gold standard for medical abortion, in July 2015. We sought to investigate the factors that influence successful initiation and ongoing provision of medical abortion services among Canadian health professionals and how these factors relate to abortion policies, systems, and service access throughout Canada. METHODS: We conducted 1-on-1 semistructured interviews with a national sample of abortion-providing and nonproviding physicians and health system stakeholders in Canadian health care settings. Our data collection, thematic analysis, and interpretation were guided by Diffusion of Innovation theory. RESULTS: We conducted interviews with 90 participants including rural practitioners and those with no previous abortion experience. In the course of our study, Health Canada removed mifepristone restrictions. Our results suggest that Health Canada's initial restrictions discouraged physicians from providing mifepristone and were inconsistent with provincial licensing standards, thereby limiting patient access. Once deregulated, remaining factors were primarily related to local and regional implementation processes. Participants held strong perceptions that mifepristone was the new standard of care for medical abortion in Canada and within the scope of primary care practice. CONCLUSION: Health Canada's removal of mifepristone restrictions facilitated the implementation of abortion care in the primary care setting. Our results are unique because Canada is the first country to facilitate provision of medical abortion in primary care via evidence-based deregulation of mifepristone.

Slow implementation of mifepristone medical termination of pregnancy in Quebec, Canada: a qualitative investigation.

Objectives: Mifepristone for first-trimester medical termination of pregnancy (MTOP) became available in Quebec in 2018, one year after the rest of Canada. Using the theory of the Diffusion of Innovation (DOI) and the transtheoretical model of change (TTM), we investigated factors influencing the implementation of mifepristone MTOP in Quebec.Material and Methods: Semi-structured interviews were conducted with 37 Quebec physicians in early 2018. Deductive thematic analysis guided by the theory of DOI explored facilitators and barriers to physicians' adoption of mifepristone MTOP. We then classified participants into five stages of mifepristone adoption based on the TTM. Follow-up data collection one year later assessed further adoption.Results: At baseline, three physicians provided mifepristone MTOP (Maintenance) and two were about to start (Action). Thirteen physicians at Preparation and Advanced Contemplation stages intended to start while, within the Slow Contemplation, two intended to start and ten were unsure. Seven had no intention to provide mifepristone MTOP (Pre-Contemplation). Major reported barriers were: complexity of local health care organisations, medical policy restrictions, lack of support, and general uncertainty. One year later, ten physicians provided mifepristone MTOP (including three at baseline) and nine still intended to, while seventeen did not intend to start provision. Seven of sixteen participants (44%) who worked in TOP clinics at baseline were still not providing MTOP with mifepristone one year later.Conclusion: Despite ideological support, mifepristone MTOP uptake in Quebec is slow and laborious, mainly due to restrictive medical policies, vested interests in surgical provision and administrative inertia.

High throughput phenotyping dataset related to seed and seedling traits of sugar beet genotypes.

Several seed and seedling traits are measured to evaluate germination and emergence potential in relation with environmental conditions. More generally, these traits are also measured in the field of ecology as simple traits that can be correlated to other adaptative traits more difficult to measure on adult plants, as for example traits of the rooting system. Methods were developed for deep high throughput phenotyping of hundreds of genotypes from dry seed to the end of heterotrophic growth. The present dataset comes from a project on genotyping and phenotyping of populations of genotypes, with different geographic and genetic origins so as to increase genotypic diversity of sugar beet in terms of germination and early growth traits, evaluated at low temperatures. Data were collected in relation to the creation of the first sugar beet crop ontology. This dataset corresponds to the first automated phenotyping of a population of 198 genotypes and 4 commercial control varieties and is hosted on INRAE public depository under the reference number doi.org/10.15,454/AKNF4Q. The equipment and methods presented here are available on a phenotyping platform opened to collaborative research and adaptable for specific services for characterizing thousands of genotypes on different crops or other species. The phenotyping values can also be linked to genomic information to study the genetic determinism of the trait values.

Barriers and Facilitators to the Implementation of First Trimester Medical Abortion With Mifepristone in the Province of Québec: A Qualitative Investigation.

OBJECTIVE: Mifepristone became available in Canada in January 2017, but provincial medical policy delayed its use for medical abortion (MA) in Québec for 1 year. The objective of this study was to identify barriers and facilitators experienced by physicians who could potentially provide this newer abortion practice in Québec. METHODS: This study was part of the Canadian Contraception and Abortion Research Team-Mifepristone Implementation Study, an observational, prospective, mixed-methods study. Interviews were conducted with physicians representing all health regions of Québec. Using thematic analysis guided by diffusion of innovation theory, the study identified key barriers and facilitators to implementation. RESULTS: From January 2017 to March 2018, study investigators interviewed 25 family physicians and 12 obstetrician-gynaecologists. Most were women (81%), over 40 years old (65%), with >20 years in practice since residency (49%). Less than half of the sample provided abortion services (41%), and only 8% provided MA with mifepristone. Key barriers to implementation were: (1) uncertainty or confusion about policies regarding MA, (2) lack of human resources or support from colleagues, (3) uncertainty about product distribution, (4) confusion about professional collaboration, and (5) lack of local infrastructure. Key facilitators were: (1) perception of support and influence from colleagues, (2) previous experience with provision of first trimester MA, (3) requests for first trimester MA by patients or other physicians, and (4) knowledge of research on mifepristone MA. CONCLUSION: Despite Health Canada's approval of mifepristone in Canada and supportive federal policies for provision of MA in primary care, physicians in the province of Québec face onerous barriers to the practice of mifepristone MA.

Examining Relationships Between Resilience Protective Factors and Moral Distress Among Nursing Students.

A correlation pilot study was conducted to examine relationships between resilience protective factors and moral distress associated with clinical practica in nursing students. Aggregate moral distress rating was x = 3.67. Two of four resilience protective factor subcategories demonstrated significant inverse correlations with moral distress rating. Inverse correlations were found between social support and moral distress (r = -.27, p < .05) and between goal efficacy and moral distress (r = -.37, p < .01). The findings should help educators prioritize resilience-enhancing educational strategies.

Implementation of mifepristone medical abortion in Canada: pilot and feasibility testing of a survey to assess facilitators and barriers.

BACKGROUND: Direct primary care provision of first-trimester medical abortion could potentially address inequitable abortion access in Canada. However, when Health Canada approved the combination medication Mifegymiso® (mifepristone 200 mg/misoprostol 800 mcg) for medical abortion in July 2015, we hypothesized that the restrictions to distribution, prescribing, and dispensing would impede the uptake of this evidence-based innovation in primary care. We developed and pilot-tested a survey related to policy and practice facilitators and barriers to assess successful initiation and ongoing clinical provision of medical abortion service by physicians undertaking mifepristone training. Additionally, we explored expert, stakeholder, and physician perceptions of the impact of facilitators and barriers on abortion services throughout Canada. METHODS: In phase 1, we developed a survey using 2 theoretical frameworks: Greenhalgh's conceptual model for the Diffusion of Innovations in health service organizations (which we operationalized) and Godin's framework to assess the impact of professional development on the uptake of new practices operationalized in Légaré's validated questionnaire. We finalized questions in phase 2 using the modified Delphi methodology. The survey was then tested by an expert panel of 25 nationally representative physician participants and 4 clinical content experts. Qualitative analysis of transcripts enriched and validated the content by identifying these potential barriers: physicians dispensing the medication, mandatory training to become a prescriber, burdens for patients, lack of remuneration for mifepristone provision, and services available in my community. To assess the usability and reliability of the online survey, in phase 3, we pilot-tested the survey for feasibility. RESULTS: We developed and tested a 61-item Mifepristone Implementation Survey suitable to study the facilitators and barriers to implementation of mifepristone first-trimester medical abortion practice by physicians in Canada. CONCLUSIONS: Our team operationalized Greenhalgh's theoretical framework for Diffusion of Innovations in health systems to explore factors influencing the implementation of first-trimester medical abortion provision. This process may be useful for those evaluating other health system innovations. Identification of facilitators and barriers to implementation of mifepristone practice in Canada and knowledge translation has the potential to inform regulatory and health system changes to support and scale up facilitators and mitigate barriers to equitable medical abortion provision.

Could implementation of mifepristone address Canada's urban-rural abortion access disparity: a mixed-methods implementation study protocol.

INTRODUCTION: In January 2017, mifepristone-induced medical abortion was made available in Canada. In this study, we will seek to (1) understand facilitators and barriers to the implementation of mifepristone across Canada, (2) assess the impact of a 'community of practice' clinical and health service support platform and (3) engage in and assess the impact of integrated knowledge translation (iKT) activities aimed to improve health policy, systems and service delivery issues to enhance patient access to mifepristone. METHODS AND ANALYSIS: This prospective mixed-methods implementation study will involve a national sample of physicians and pharmacists recruited via an online training programme, professional networks and a purpose-built community of practice website. Surveys that explore constructs related to diffusion of innovation and Godin's behaviour change frameworks will be conducted at baseline and at 6 months, and qualitative data will be collected from electronic interactions on the website. Survey participants and a purposeful sample of decision-makers will be invited to participate in in-depth interviews. Descriptive analyses will be conducted for quantitative data. Thematic analysis guided by the theoretical frameworks will guide interpretation of qualitative data. We will conduct and assess iKT activities involving Canada's leading health system and health professional leaders, including evidence briefs, Geographical Information System (GIS)maps, face-to-face meetings and regular electronic exchanges. Findings will contribute to understanding the mechanisms of iKT relationships and activities that have a meaningful effect on uptake of evidence into policy and practice. ETHICS AND DISSEMINATION: Ethical approval was received from the University of British Columbia Children's and Women's Hospital Ethics Review Board (H16-01006). Full publication of the work will be sought in an international peer-reviewed journal. Findings will be disseminated to research participants through newsletters and media interviews, and to policy-makers through invited evidence briefs and face-to-face presentations.

Utilization of computer vision and multispectral imaging techniques for classification of cowpea (Vigna unguiculata) seeds.

BACKGROUND: The traditional methods for evaluating seeds are usually performed through destructive sampling followed by physical, physiological, biochemical and molecular determinations. Whilst proven to be effective, these approaches can be criticized as being destructive, time consuming, labor intensive and requiring experienced seed analysts. Thus, the objective of this study was to investigate the potential of computer vision and multispectral imaging systems supported with multivariate analysis for high-throughput classification of cowpea (Vigna unguiculata) seeds. An automated computer-vision germination system was utilized for uninterrupted monitoring of seeds during imbibition and germination to identify different categories of all individual seeds. By using spectral signatures of single cowpea seeds extracted from multispectral images, different multivariate analysis models based on linear discriminant analysis (LDA) were developed for classifying the seeds into different categories according to ageing, viability, seedling condition and speed of germination. RESULTS: The results revealed that the LDA models had good accuracy in distinguishing 'Aged' and 'Non-aged' seeds with an overall correct classification (OCC) of 97.51, 96.76 and 97%, 'Germinated' and 'Non-germinated' seeds with OCC of 81.80, 79.05 and 81.0%, 'Early germinated', 'Medium germinated' and 'Dead' seeds with OCC of 77.21, 74.93 and 68.00% and among seeds that give 'Normal' and 'Abnormal' seedlings with OCC of 68.08, 64.34 and 62.00% in training, cross-validation and independent validation data sets, respectively. Image processing routines were also developed to exploit the full power of the multispectral imaging system in visualizing the difference among seed categories by applying the discriminant model in a pixel-wise manner. CONCLUSION: The results demonstrated the capability of the multispectral imaging system in the ultraviolet, visible and shortwave near infrared range to provide the required information necessary for the discrimination of individual cowpea seeds to different classes. Considering the short time of image acquisition and limited sample preparation, this stat-of-the art multispectral imaging method and chemometric analysis in classifying seeds could be a valuable tool for on-line classification protocols in cost-effective real-time sorting and grading processes as it provides not only morphological and physical features but also chemical information for the seeds being examined. Implementing image processing algorithms specific for seed quality assessment along with the declining cost and increasing power of computer hardware is very efficient to make the development of such computer-integrated systems more attractive in automatic inspection of seed quality.

Hidden Effects of Seed Quality Breeding on Germination in Oilseed Rape (Brassica napus L.).

Intense selection for specific seed qualities in winter oilseed rape breeding has had an inadvertent negative influence on seed germination performance. In a panel of 215 diverse winter oilseed rape varieties spanning over 50 years of breeding progress in winter-type rapeseed, we found that low seed erucic acid content and reduced seed glucosinolate content were significantly related with prolonged germination time. Genome-wide association mapping revealed that this relationship is caused by linkage drag between important loci for seed quality and germination traits. One QTL for mean germination time on chromosome A09 co-localized with significant but minor QTL for both seed erucic acid and seed glucosinolate content. This suggested either potential pleiotropy or close linkage of minor factors influencing all three traits. Therefore, a reduction in germination performance may be due to inadvertent co-selection of genetic variants associated with 00 seed quality that have a negative influence on germination. Our results suggest that marker-assisted selection of positive alleles for mean germination time within the modern quality pool can help breeders to maintain maximal germination capacity in new 00-quality oilseed rape cultivars.

No. 329-Canadian Contraception Consensus Part 4 of 4 Chapter 9: Combined Hormonal Contraception.

OBJECTIVE: To provide guidelines for health care providers on the use of contraceptive methods to prevent pregnancy and on the promotion of healthy sexuality. OUTCOMES: Overall efficacy of cited contraceptive methods, assessing reduction in pregnancy rate, safety, and side effects; the effect of cited contraceptive methods on sexual health and general well-being; and the availability of cited contraceptive methods in Canada. EVIDENCE: Medline and the Cochrane Database were searched for articles in English on subjects related to contraception, sexuality, and sexual health from January 1994 to December 2015 in order to update the Canadian Contraception Consensus published February-April 2004. Relevant Canadian government publications and position papers from appropriate health and family planning organizations were also reviewed. VALUES: The quality of the evidence is rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care. Recommendations for practice are ranked according to the method described in this report. SUMMARY STATEMENTS: RECOMMENDATIONS.

No 329-Consensus canadien sur la contraception (4e partie de 4) : chapitre 9 ­ contraception hormonale combinée.

OBJECTIF: Mettre à la disposition des fournisseurs de soins des lignes directrices concernant le recours à des méthodes contraceptives pour prévenir la grossesse et la promotion d'une sexualité saine. ISSUES: Efficacité globale des méthodes contraceptives citées : évaluation de l'innocuité, des effets indésirables et de la baisse du taux de grossesse; effet des méthodes contraceptives citées sur la santé sexuelle et le bien-être général; disponibilité des méthodes contraceptives citées au Canada. RéSULTATS: Des recherches ont été effectuées dans MEDLINE et la base de données Cochrane afin d'en tirer les articles en anglais publiés entre janvier 1994 et décembre 2015 traitant de sujets liés à la contraception, à la sexualité et à la santé sexuelle, dans le but de mettre à jour le consensus canadien sur la contraception paru de février à avril 2004. Nous avons également passé en revue les publications pertinentes du gouvernement canadien, ainsi que les déclarations de principes issues d'organisations compétentes vouées à la santé et à la planification familiale. VALEURS: La qualité des résultats a été évaluée au moyen des critères décrits par le Groupe d'étude canadien sur les soins de santé préventifs. Les recommandations quant à la pratique sont classées en fonction de la méthode décrite dans le rapport du Groupe. DéCLARATIONS SOMMAIRES: RECOMMANDATIONS.