Communication between cancer patients and healthcare providers is recognized as an important aspe... more Communication between cancer patients and healthcare providers is recognized as an important aspect of these patients' health-related quality of life (HRQOL). Nevertheless, no study has examined whether perceived communication between physicians and breast cancer patients is a determining factor in their HRQOL along the disease's trajectory. This longitudinal study aimed to ascertain whether such communication influenced the HRQOL of such women at three points in time. The sample consisted of 120 French-speaking women with stage I or II breast cancer aged 18 years or over (mean = 55 years) who underwent a lumpectomy with adjuvant treatment. The women filled out questionnaires at three different times: around the time of diagnosis, halfway through radiotherapy and at follow-up. Either at the hospital or at home, they completed demographic and medical data questionnaires, the Medical Outcomes Study-Social Support Survey, an HRQOL questionnaire (EORTC QLQ-C30/BR23) and the Medical Communication Competence Scale. Generalized estimated equations analyses indicated that the women's perceptions of their own communication skills towards physicians had a greater impact on their HRQOL than the women's perception of physicians' communication skills. The women had better global health and better role, emotional, cognitive and sexual functioning as well as fewer side effects and symptoms during radiotherapy and at follow-up when they perceived themselves as competent communicators at diagnosis and during radiotherapy. The results underscore the importance for breast cancer patients of being proactive in information seeking and in the socio-emotional aspect of their relationship with physicians to enhance their HRQOL.
As part of a national strategy for reaching Millennium Development Goals 4 and 5 in Morocco, an a... more As part of a national strategy for reaching Millennium Development Goals 4 and 5 in Morocco, an action plan covering three systems (sociocultural, educational and professional) was developed to strengthen midwives' professional role in order to contribute to high quality maternity care. This study aimed to understand the implementation process by identifying the characteristics of this intervention and the dimensions of the three-systems which could act as barriers to/facilitators of the implementation process. We used a conceptual framework that builds on Hatem-Asmar's model that describes change in a health professional role; and on the Consolidated Framework for Implementation Research for our analysis. An embedded case study with three levels of analysis was conducted during June and July 2010. Data were collected through 11 semi-structured interviews, 20 focus groups, training session observations and documents. A purposive sample of 106 multi-stakeholders from two Moroccan regions (health professionals, academic staff, students, medical administrative officers and health programmers) and one international consultant were recruited. A thematic analysis was conducted using QDA Miner. Data showed a failure to carry out the plan as intended. Seventeen barriers and seven facilitators were identified. Misalignment of the values, methods, actors and targets of the sociocultural system with the values, methods and actors of the educational and professional systems, on one hand, and with the intervention, on the other hand, were likely the greatest impediments to implementing the plan. The bureaucratic structure and lack of readiness of the sociocultural system were among the most influential barriers to: dissemination of information, involvement of key actors in the process and readiness of the educational system. The main facilitators were the values promoted related to human rights, and the national and international policies to strengthen midwifery and reduce maternal mortality. The plan was perceived as beneficial, but complex and externally driven. The findings suggest that successful implementation requires redesigning the implementation strategy to adapt to the factors identified in our study. The results would be very useful to health planners seeking the expansion of such an intervention to other developing countries looking to strengthen midwives' role and to improve maternity health care services.
The Casablanca project explored how media space concepts could be incorporated into households an... more The Casablanca project explored how media space concepts could be incorporated into households and family life. This effort included prototypes built for the researchers' own home use, field studies of households, and consumer testing of design concepts. A number of previously unreported consumer preferences and concerns were uncovered and incorporated into several original prototypes, most notably ScanBoard and the Intentional
Proceedings of the SIGCHI conference on Human factors in computing systems - CHI '01, 2001
The Casablanca project explored how media space concepts could be incorporated into households an... more The Casablanca project explored how media space concepts could be incorporated into households and family life. This effort included prototypes built for the researchers' own home use, field studies of households, and consumer testing of design concepts. A number of previously unreported consumer preferences and concerns were uncovered and incorporated into several original prototypes, most notably ScanBoard and the Intentional
The stigma and style of Trifolium repens L. was successfully by-passed, and viable seed was obtai... more The stigma and style of Trifolium repens L. was successfully by-passed, and viable seed was obtained by placing pollen on a perforation made in either the ovary wall or in the base of the style. The application of pollen to the stump of the style also succeeded in producing viable seed. The presence of the calyx and corolla facilitated seed set in cultured florets. An incision made along the entire length of the ovary to permit pollen entry resulted in necrosis of the floret. Perforation of the ovary did not affect the yield of seeds obtained from stigmatic pollinations. Growth of pollen tubes was observed on wounded tissues and also within the style and cavity of the ovary. A mean yield of 20 embryos was obtained per 100 florets in non-stigmatic pollinations, whereas with stigmatic pollinations in vitro the yield was 148. Nonstigmatic pollinations also gave seeds when T. repens was self pollinated, which showed that the gametophytic system of self-incompatibility (SI) could be by-passed. With one genotype, self-pollination via the stigma failed, whereas embryos were obtained via non-stigmatic pollinations.
A case study of the use and impacts of the NLS computer message system was performed by the Busin... more A case study of the use and impacts of the NLS computer message system was performed by the Business Planning Group of Bell Canada. The author presents the results of the study, and compares the Group's findings with existing research on computer- mediated communications systems. Preliminary conclusions are drawn concerning the impact of such systems on the work habits of user groups.
... N. Leduc 1'2, M. Monnier 1, and GC Douglas 2 1 Laboratoire d'Histophysiologie Veget... more ... N. Leduc 1'2, M. Monnier 1, and GC Douglas 2 1 Laboratoire d'Histophysiologie Vegetale, Universit6 Pierre et Marie Curie, 12, rue Cuvier, F-75005 ... Pollen grains at anthesis were stained with a 2.5 gg/ml solution of 4,6-dia-mino-2-phenyl-indole (DAPI) to reveal vegetative and ...
Radicle emergence and reserves mobilization are two distinct programmes that are thought to contr... more Radicle emergence and reserves mobilization are two distinct programmes that are thought to control germination. Both programs are influenced by abscissic acid (ABA) but how this hormone controls seed germination is still poorly known. Phenotypic and microscopic observations of the embryo axis of Medicago truncatula during germination in mitotic inhibition condition triggered by 10 microM oryzalin showed that cell division was not required to allow radicle emergence. A suppressive subtractive hybridization showed that more than 10% of up-regulated genes in the embryo axis encoded proteins related to cell-wall biosynthesis. The expression of alpha-expansins, pectin-esterase, xylogucan-endotransglycosidase, cellulose synthase, and extensins was monitored in the embryo axis of seeds germinated on water, constant and transitory ABA. These genes were overexpressed before completion of germination in the control and strongly inhibited by ABA. The expression was re-established in the ABA transitory-treatment after the seeds were transferred back on water and proceeded to germination. This proves these genes as contributors to the completion of germination and strengthen the idea that cell-wall loosening and remodeling in relation to cell expansion in the embryo axis is a determinant feature in germination. Our results also showed that ABA controls germination through the control of radicle emergence, namely by inhibiting cell-wall loosening and expansion.
Harmful effects of short postpartum hospital stays include dehydration and malnutrition of breast... more Harmful effects of short postpartum hospital stays include dehydration and malnutrition of breastfed infants. These may be prevented by adequate breastfeeding frequency; however, rigorous research to determine the relative effectiveness of various follow-up strategies in supporting breastfeeding frequency is absent. This study addressed the question, "Is there a difference in breastfeeding frequency or infant weight gain for singleton infants discharged within 36 hours' postpartum who received either community nurse (home visit) or hospital nurse (clinic) follow-up?" A randomized, controlled trial was conducted at a university teaching hospital (3700 births/y) and affiliated community health centers. A consecutive sample of 586 healthy mother-infant pairs were recruited from January 1997 to September 1998 before discharge; 513 (87.5%) contributed data on 1 or more outcomes. Forty-eight-hour postpartum telephone contact and day 3 nurse contact in the home (experimental) or at the hospital (control) were provided. The main outcomes measured were breastfeeding frequency and infant weight gain assessed at 2 weeks' postpartum by maternal diary and weight at home by research assistants, masked to group allocation. No clinically important or statistically significant group differences were found in daily breastfeeding frequency (mean difference experimental minus control = 0.1 feeds [95% confidence interval: -0.1-0.3]) or daily rate of infant weight gain (-1.1 g [-2.5-0.3]) based on intention-to-treat analyses. Follow-up by nurses after short postpartum hospital stays, in either the home or a hospital-based clinic, of healthy infants discharged at <36 hours seems associated with satisfactory infant breastfeeding outcomes.
Communication between cancer patients and healthcare providers is recognized as an important aspe... more Communication between cancer patients and healthcare providers is recognized as an important aspect of these patients' health-related quality of life (HRQOL). Nevertheless, no study has examined whether perceived communication between physicians and breast cancer patients is a determining factor in their HRQOL along the disease's trajectory. This longitudinal study aimed to ascertain whether such communication influenced the HRQOL of such women at three points in time. The sample consisted of 120 French-speaking women with stage I or II breast cancer aged 18 years or over (mean = 55 years) who underwent a lumpectomy with adjuvant treatment. The women filled out questionnaires at three different times: around the time of diagnosis, halfway through radiotherapy and at follow-up. Either at the hospital or at home, they completed demographic and medical data questionnaires, the Medical Outcomes Study-Social Support Survey, an HRQOL questionnaire (EORTC QLQ-C30/BR23) and the Medical Communication Competence Scale. Generalized estimated equations analyses indicated that the women's perceptions of their own communication skills towards physicians had a greater impact on their HRQOL than the women's perception of physicians' communication skills. The women had better global health and better role, emotional, cognitive and sexual functioning as well as fewer side effects and symptoms during radiotherapy and at follow-up when they perceived themselves as competent communicators at diagnosis and during radiotherapy. The results underscore the importance for breast cancer patients of being proactive in information seeking and in the socio-emotional aspect of their relationship with physicians to enhance their HRQOL.
As part of a national strategy for reaching Millennium Development Goals 4 and 5 in Morocco, an a... more As part of a national strategy for reaching Millennium Development Goals 4 and 5 in Morocco, an action plan covering three systems (sociocultural, educational and professional) was developed to strengthen midwives' professional role in order to contribute to high quality maternity care. This study aimed to understand the implementation process by identifying the characteristics of this intervention and the dimensions of the three-systems which could act as barriers to/facilitators of the implementation process. We used a conceptual framework that builds on Hatem-Asmar's model that describes change in a health professional role; and on the Consolidated Framework for Implementation Research for our analysis. An embedded case study with three levels of analysis was conducted during June and July 2010. Data were collected through 11 semi-structured interviews, 20 focus groups, training session observations and documents. A purposive sample of 106 multi-stakeholders from two Moroccan regions (health professionals, academic staff, students, medical administrative officers and health programmers) and one international consultant were recruited. A thematic analysis was conducted using QDA Miner. Data showed a failure to carry out the plan as intended. Seventeen barriers and seven facilitators were identified. Misalignment of the values, methods, actors and targets of the sociocultural system with the values, methods and actors of the educational and professional systems, on one hand, and with the intervention, on the other hand, were likely the greatest impediments to implementing the plan. The bureaucratic structure and lack of readiness of the sociocultural system were among the most influential barriers to: dissemination of information, involvement of key actors in the process and readiness of the educational system. The main facilitators were the values promoted related to human rights, and the national and international policies to strengthen midwifery and reduce maternal mortality. The plan was perceived as beneficial, but complex and externally driven. The findings suggest that successful implementation requires redesigning the implementation strategy to adapt to the factors identified in our study. The results would be very useful to health planners seeking the expansion of such an intervention to other developing countries looking to strengthen midwives' role and to improve maternity health care services.
The Casablanca project explored how media space concepts could be incorporated into households an... more The Casablanca project explored how media space concepts could be incorporated into households and family life. This effort included prototypes built for the researchers' own home use, field studies of households, and consumer testing of design concepts. A number of previously unreported consumer preferences and concerns were uncovered and incorporated into several original prototypes, most notably ScanBoard and the Intentional
Proceedings of the SIGCHI conference on Human factors in computing systems - CHI '01, 2001
The Casablanca project explored how media space concepts could be incorporated into households an... more The Casablanca project explored how media space concepts could be incorporated into households and family life. This effort included prototypes built for the researchers' own home use, field studies of households, and consumer testing of design concepts. A number of previously unreported consumer preferences and concerns were uncovered and incorporated into several original prototypes, most notably ScanBoard and the Intentional
The stigma and style of Trifolium repens L. was successfully by-passed, and viable seed was obtai... more The stigma and style of Trifolium repens L. was successfully by-passed, and viable seed was obtained by placing pollen on a perforation made in either the ovary wall or in the base of the style. The application of pollen to the stump of the style also succeeded in producing viable seed. The presence of the calyx and corolla facilitated seed set in cultured florets. An incision made along the entire length of the ovary to permit pollen entry resulted in necrosis of the floret. Perforation of the ovary did not affect the yield of seeds obtained from stigmatic pollinations. Growth of pollen tubes was observed on wounded tissues and also within the style and cavity of the ovary. A mean yield of 20 embryos was obtained per 100 florets in non-stigmatic pollinations, whereas with stigmatic pollinations in vitro the yield was 148. Nonstigmatic pollinations also gave seeds when T. repens was self pollinated, which showed that the gametophytic system of self-incompatibility (SI) could be by-passed. With one genotype, self-pollination via the stigma failed, whereas embryos were obtained via non-stigmatic pollinations.
A case study of the use and impacts of the NLS computer message system was performed by the Busin... more A case study of the use and impacts of the NLS computer message system was performed by the Business Planning Group of Bell Canada. The author presents the results of the study, and compares the Group's findings with existing research on computer- mediated communications systems. Preliminary conclusions are drawn concerning the impact of such systems on the work habits of user groups.
... N. Leduc 1'2, M. Monnier 1, and GC Douglas 2 1 Laboratoire d'Histophysiologie Veget... more ... N. Leduc 1'2, M. Monnier 1, and GC Douglas 2 1 Laboratoire d'Histophysiologie Vegetale, Universit6 Pierre et Marie Curie, 12, rue Cuvier, F-75005 ... Pollen grains at anthesis were stained with a 2.5 gg/ml solution of 4,6-dia-mino-2-phenyl-indole (DAPI) to reveal vegetative and ...
Radicle emergence and reserves mobilization are two distinct programmes that are thought to contr... more Radicle emergence and reserves mobilization are two distinct programmes that are thought to control germination. Both programs are influenced by abscissic acid (ABA) but how this hormone controls seed germination is still poorly known. Phenotypic and microscopic observations of the embryo axis of Medicago truncatula during germination in mitotic inhibition condition triggered by 10 microM oryzalin showed that cell division was not required to allow radicle emergence. A suppressive subtractive hybridization showed that more than 10% of up-regulated genes in the embryo axis encoded proteins related to cell-wall biosynthesis. The expression of alpha-expansins, pectin-esterase, xylogucan-endotransglycosidase, cellulose synthase, and extensins was monitored in the embryo axis of seeds germinated on water, constant and transitory ABA. These genes were overexpressed before completion of germination in the control and strongly inhibited by ABA. The expression was re-established in the ABA transitory-treatment after the seeds were transferred back on water and proceeded to germination. This proves these genes as contributors to the completion of germination and strengthen the idea that cell-wall loosening and remodeling in relation to cell expansion in the embryo axis is a determinant feature in germination. Our results also showed that ABA controls germination through the control of radicle emergence, namely by inhibiting cell-wall loosening and expansion.
Harmful effects of short postpartum hospital stays include dehydration and malnutrition of breast... more Harmful effects of short postpartum hospital stays include dehydration and malnutrition of breastfed infants. These may be prevented by adequate breastfeeding frequency; however, rigorous research to determine the relative effectiveness of various follow-up strategies in supporting breastfeeding frequency is absent. This study addressed the question, "Is there a difference in breastfeeding frequency or infant weight gain for singleton infants discharged within 36 hours' postpartum who received either community nurse (home visit) or hospital nurse (clinic) follow-up?" A randomized, controlled trial was conducted at a university teaching hospital (3700 births/y) and affiliated community health centers. A consecutive sample of 586 healthy mother-infant pairs were recruited from January 1997 to September 1998 before discharge; 513 (87.5%) contributed data on 1 or more outcomes. Forty-eight-hour postpartum telephone contact and day 3 nurse contact in the home (experimental) or at the hospital (control) were provided. The main outcomes measured were breastfeeding frequency and infant weight gain assessed at 2 weeks' postpartum by maternal diary and weight at home by research assistants, masked to group allocation. No clinically important or statistically significant group differences were found in daily breastfeeding frequency (mean difference experimental minus control = 0.1 feeds [95% confidence interval: -0.1-0.3]) or daily rate of infant weight gain (-1.1 g [-2.5-0.3]) based on intention-to-treat analyses. Follow-up by nurses after short postpartum hospital stays, in either the home or a hospital-based clinic, of healthy infants discharged at <36 hours seems associated with satisfactory infant breastfeeding outcomes.
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