Prospective study of acute health effects in relation to exposure to cyanobacteria.

We conducted a study to investigate the relationship between exposure to cyanobacteria and microcystins and the incidence of symptoms in humans living in close proximity to lakes affected by cyanobacteria. The design was a prospective study of residents living around three lakes (Canada), one of which has a water treatment plant supplying potable water to local residents. Participants had to keep a daily journal of symptoms and record contact (full or limited) with the water body. Samples were collected to document cyanobacteria and microcystin concentrations. Symptoms potentially associated with cyanobacteria (gastrointestinal: 2 indices (GI1: diarrhea or abdominal pain or nausea or vomiting; GI2: diarrhea or vomiting or [nausea and fever] or [abdominal cramps and fever]); upper and lower respiratory tract; eye; ear; skin; muscle pain; headaches; mouth ulcers) were examined in relation with exposure to cyanobacteria and microcystin by using Poisson regression. Only gastrointestinal symptoms were associated with recreational contact. Globally, there was a significant increase in adjusted relative risk (RR) with higher cyanobacterial cell counts for GI2 (<20,000 cells/mL: RR=1.52, 95% CI=0.65-3.51; 20,000-100,000 cells/mL: RR=2.71, 95% CI=1.02-7.16; >100,000 cells/mL: RR=3.28, 95% CI=1.69-6.37, p-trend=0.001). In participants who received their drinking water supply from a plant whose source was contaminated by cyanobacteria, an increase in muscle pain (RR=5.16; 95% CI=2.93-9.07) and gastrointestinal (GI1: RR=3.87; 95% CI=1.62-9.21; GI2: RR=2.84; 95% CI=0.82-9.79), skin (RR=2.65; 95% CI=1.09-6.44) and ear symptoms (RR=6.10; 95% CI=2.48-15.03) was observed. The population should be made aware of the risks of gastrointestinal symptoms associated with contact (full or limited) with cyanobacteria. A risk management plan is needed for water treatment plants that draw their water from a source contaminated with cyanobacteria.

A stress-associated protein containing A20/AN1 zing-finger domains expressed in Medicago truncatula seeds.

MtSAP1 (Medicago truncatula stress-associated protein 1) was revealed as a down-regulated gene by suppressive subtractive hybridization between two mRNA populations of embryo axes harvested before and after radicle emergence. MtSAP1 is the first gene encoding a SAP with A20 and AN1 zinc-finger domains characterized in M. truncatula. MtSAP1 protein shares 54% and 62% homology with AtSAP7 (Arabidopsis thaliana) and OsiSAP8 (Oryza sativa) respectively, with in particular a strong homology in the A20 and AN1 conserved domains. MtSAP1 gene expression increased in the embryos during the acquisition of tolerance to desiccation, reached its maximum in dry seed and decreased dramatically during the first hours of imbibition. Abiotic stresses (cold and hypoxia), abscisic acid and desiccation treatments induced MtSAP1 gene expression and protein accumulation in embryo axis, while mild drought stress did not affect significantly its expression. This profile of expression along with the presence of anaerobic response elements and ABRE sequences in the upstream region of the gene is consistent with a role of MtSAP1 in the tolerance of low oxygen availability and desiccation during late stages of seed maturation. Silencing of MtSAP1 by RNA interference (RNAi) showed that the function of the encoded protein is required for adequate accumulation of storage globulin proteins, vicilin and legumin, and for the development of embryos able to achieve successful germination.

Comparison of determinants of research knowledge utilization by practitioners and administrators in the field of child and family social services.

BACKGROUND: An important gap exists between research production and its utilization. Few studies have examined the factors affecting knowledge utilization in the field of child and family social services. METHODS: The objectives of the study are to describe knowledge utilization by child protection administrators and practitioners (N = 477) and to compare factors related to knowledge utilization by these two occupational groups. The study was conducted with an adapted version of the Questionnaire sur l'utilisation des connaissances (Knowledge Utilization Questionnaire). Factor analysis was used to collapse data collected on the questionnaire items. Factor score for each respondent served as independent variables in three separate multivariate regression analyses to explore variables likely to predict research-based knowledge utilization. RESULTS: A minority of respondents (18%) report using on a frequent basis research-based knowledge in their practice. Relational capital between researchers and users and perceived usefulness of research based knowledge were the two factors most strongly related to utilization. There was a specificity in the factors associated with knowledge utilization according to occupational groups in child protection organizations. Use of active knowledge transfer strategies was associated with knowledge utilization by practitioners, while knowledge dissemination efforts played a more significant role for administrators. CONCLUSION: These results encourage both the use of strategies differentiated according to users and the intensification of interactions between users and researchers to foster research knowledge utilization.

Body mass index as a function of length of United States residency among Haitian immigrant children.

OBJECTIVES: 1) To compare Body Mass Index (BMI) percentiles of Haitian-born children and US-born Haitian Children; 2) To assess the relationship between time in the United States and BMI percentiles for Haitian-born children; and 3) To compare BMI percentiles of Haitian-born and US-born Haitian children to other US pediatric populations included in the 2003-2004 National Health and Nutrition Examination Survey (NHANES) data. DESIGN: Retrospective medical chart review of demographic and anthropometric characteristics. SETTING: Center for Haitian Studies, a nonprofit community based organization that provides health care and social services to the Haitian community. PATIENTS: The medical charts from 250 children ages 2-18 who received medical care at CHS between January 1, 2004 and July 30, 2006. MAIN OUTCOME MEASURES: 1) Overweight (> or = 85th to <95th BMI percentile) and 2) Obese (> or = 95th BMI percentile). RESULTS: Thirty percent of Haitian-born and 51% of US-born Haitian children were > or = 85th percentile for BMI. US-born children had higher BMI percentiles than Haitian-born children (81st percentile vs 68th percentile). Among Haitian-born children, BMI percentile increased by 3.7% for each year of US residency. When compared to NHANES data, Haitian-born children were less likely to be overweight than non-Hispanic Blacks, Mexican Americans, and non-Hispanic White children, or for all groups combined (14.9% vs 33.6%, 95% CI 9.8%-22.2%), but were as likely to be obese (14.9% vs 17.7%, 95% CI, 9.8%-22.2%). CONCLUSIONS: Haitian-born children are currently experiencing a 3.7% BMI percentile increase for each year of US residency and are as likely to be overweight as other US minority children making them potentially at increased risk for health consequences associated with obesity.

[The adaptation process of adults who sustained craniocerebral trauma]. / Le processus d'adaptation des adultes présentant des séquelles de traumatisme cranio-cérébral.

BACKGROUND: The adaptation process of adults who had sustained a traumatic brain injury is not well understood. PURPOSE: This qualitative study explores the adaptation process of adults presenting the sequelae of a traumatic brain injury. METHOD: Fifty-three community-dwelling adults with the sequelae of traumatic brain injury participated in an individual interview and answered open-ended questions. RESULTS: The qualitative analysis, inspired by the phenomenological tradition, reports an adaptation process in six stages. The elements which influenced this process as well as the effective coping strategies according to the participant's perception are described. The adaptation process of this clientele is affected primarily by the nature of the cognitive sequelae, as well as the circumstances of the traumatic event. CLINICAL IMPLICATIONS: The realization of significant occupations is one of the key elements of this process, sometimes associated to an important interior transformation from the point of view of personal standards and values.

Assessing a whiplash management model: a population-based non-randomized intervention study.

OBJECTIVE: To evaluate the effectiveness of a multidisciplinary clinical management approach for whiplash-associated disorders (WAD) following a motor vehicle injury in Quebec. METHODS: A clinical management model was implemented in 5 geographic regions of the Province of Quebec, Canada, in 7 hospitals and 19 clinics. A 2-group population-based parallel design was used to assess its effectiveness. All patients with a new whiplash injury seen in these 26 centers between March and September, 2001 were entered into the Whiplash Management Model (experimental group). A reference group included all subjects who had a whiplash injury during this same period but were not seen in these 26 intervention centers. All subjects were followed for up to a year. The outcome variables were time on compensation, time to file closure, and total direct costs. RESULTS: A total of 288 patients with WAD were identified in the experimental group and 1,875 patients in the reference group. The rate of ending of compensation was significantly higher in patients who received the experimental treatment model than those receiving the reference treatment approach (rate ratio, RR: 3.2; 95% confidence interval, CI: 2.8-3.6). The rate of file closure was also significantly higher with the experimental treatment (RR: 1.5; 95% CI: 1.2-1.8). The average cost per patient was significantly reduced with the experimental intervention. CONCLUSION: A coordinated whiplash management approach can lead to earlier return to work and lower costs for patients who have sustained a whiplash injury.

[Perceived self-efficacy is associated with social participation in adults with traumatic brain injury]. / La perception d'efficacité personnelle comme facteur associé à la participation sociale des adultes ayant subi un traumatisme cranio-cérébral.

BACKGROUND: Identification of the factors facilitating the social participation of adults who have sustained a traumatic brain injury can help occupational therapists with the direction for their interventions. Earlier studies centered on identifying the socio-demographic characteristics and the disabilities associated with social participation. PURPOSE: The aim of this study was to examine the association between perceived self-efficacy, a positive concept derived from social cognitive theory and social participation. METHODS: A cross-sectional and correlational research design was used with 53 adults who sustained a traumatic brain injury between 1995 and 2000 and lived in their natural environment. Two measuring tools were used: a self-administered questionnaire evaluating the perceived self-efficacy and a questionnaire evaluating social participation, administered by an examiner through a face-to-face interview. RESULTS: The results indicate that the perceived self-efficacy explains 40% of the variance of the social participation. PRACTICE IMPLICATIONS: This association suggests that social cognitive theory can constitute a reference model for occupational therapists working with this clientele.

Toward an explanatory model of social participation for adults with traumatic brain injury.

OBJECTIVE: To identify resiliency factors that could improve social participation for adults with traumatic brain injury. DESIGN: Cross-sectional single measurement, correlational and exploratory study, including quantitative and qualitative data. PARTICIPANTS: Fifty-three community-dwelling people with sequelae of traumatic brain injury, individually interviewed, which included filling out questionnaires and answering open-ended questions. MAIN MEASURES: Social participation, self-efficacy, and positive mental states. RESULTS: Dynamism, self-efficacy, and will account for 51% of the variance in social participation and are the main resiliency factors. Fatigue is one of the sequelae that pose the greatest challenge to self-efficacy and limit social participation. CONCLUSION: Resiliency factors constitute a target for research and intervention for this population.

Rasch modeling and the measurement of social participation.

Social participation is the main outcome of physical rehabilitation programs. The aim of this study is to improve the measurement of social participation, using an instrument called the Assessment of Life Habits Scale and the Rasch model. The interval level measurement, the dimensionality and the generalizability of the item hierarchy were verified. The data from a large sample of people with spinal cord injury was analyzed and specific results were compared with expert opinions. The main properties of the instrument were satisfactory and the agreement with expert opinion was high. Principal component analysis showed multidimensionality. The item difficulty hierarchy obtained with spinal cord injury experts was different from the one obtained with traumatic brain injury experts, indicating a different difficulty level of items in relation to each population characteristics. We conclude that the instrument is appropriate for the measurement of social participation and suggest ways to improve the instrument.

Evaluating clients' perceptions of the quality of head injury rehabilitation services: development and validation of a questionnaire.

OBJECTIVE: The objective of this research was to develop a tool to assess clients' perception of the quality of head injury rehabilitation services. METHODS AND RESULTS: A questionnaire PQRS-Montreal 1.0 was developed in Montreal, Quebec using a standardized methodology that incorporated a new technique to reach consensus regarding the tool's contents. Five dimensions of care (i.e. ecological approach, client-centred approach, accessibility, quality of the service providers and continuity) and their corresponding standards were identified as pertinent to include in the tool and were subsequently validated by experts. A phase of item generation followed that led to the development of an 87-item prototype of the questionnaire. The questionnaire is to be administered during an interview and employs a 5-point rating scale. DISCUSSION AND CONCLUSION: The implications for the use of PQRS-Montreal 1.0 in the accreditation process of head injury rehabilitation services are discussed, as well as plans for future quantitative research in the development of the tool.

Varieties of social constructionism in social representations theory and research

O artigo põe em discussão diferentes abordagens epistemológicas relativas ao construcionismo social e suas implicações teóricas e metodológicas (AU)