Land2Lab Project: Reflections on Learning about Mi'kmaw Foodways.

Land2Lab is an evolving community-based intergenerational program that brings together Elders and youth on the land and in the kitchen and lab to share and celebrate Mi'kmaw foodways. Rooted in an Etuaptmumk-Two Eyed Seeing (E-TES) perspective, which acknowledges both Indigenous and Western ways of knowing, the project to date has featured seasonal food workshops, involvement in a children's summer math camp, a food safety training workshop for teens, and the development of an online toolkit. The project was guided by the Mi'kmaw principle of Netukulimk, which reinforces respect for Mother Earth and stewardship of the land, water, and air for subsequent generations. Involvement of community leaders has been key to successful planning and implementation. While technology plays an important role, lessons learned on the land are critical and will inform efforts to include language and ceremony in future programming. Dietitians are encouraged to support Indigenous-led land-based learning in support of the profession's commitment to reconciliation.

Redefining the relationship in digital care: A qualitative study of the Digital Therapeutic Alliance.

Digital therapeutic programs are emerging almost daily, offering the potential to reduce healthcare access inequalities by providing more flexible and accessible care options. However, as with traditional healthcare, the issue of patient engagement is fundamental, and the latest research have reported that fewer than 30% of users complete these programs in their entirety. Hence, many authors emphasize the importance of studying the role of therapeutic alliances specifically adapted to digital care. The therapeutic alliance encompasses the collaborative aspects of the relationship between the therapist and the patient. In this context there is a need to reconceptualize the alliance within the context of digital healthcare as it can enhance engagement, adherence, and the effectiveness of such treatments. The objective of this qualitative study was to identify the components of the digital therapeutic alliance. A thematic analysis has identified three major themes that appear to constitute the digital therapeutic alliance among 44 users of an online program: trust in the program, perception of interactions, and feeling of consideration. These results prompted a discussion of the challenges of digital healthcare, including the terminology to use. The term "digital therapeutic adherence" is proposed, thereby opening up a field for research and clarification of this important concept distinct from traditional alliance.

[Population health intervention research, health technology assessment, health services research and intervention implementation research: Convergences and singularities]. / Recherche interventionnelle en santé des populations, évaluation des technologies de santé, recherche sur les services de santé et recherche sur la mise en œuvre des interventions : convergences et particularités.

In public health, intervention is an object of research and evaluation which, over time, has given rise to numerous approaches. The first part of the article proposes to reposition intervention research in population health and intervention evaluation on a continuum. Although the former has a more cognitive objective and the latter a more pragmatic objective, they are not mutually exclusive. The distinction between these two practices is based on the predominance of the following characteristics: the objectives pursued, the scope of the investigations, the regulatory constraints, the financing obtained, the ethical approaches taken, and the deliverables established. The second part of the article offers a glance different fields and approaches within the continuum between these two poles: Health Technology Assessment, Health Services Research and Implementation Research. While all of them have the study of health interventions at their core, but each has developed through specialisation in one or the other type of intervention, in a particular scope or context, in certain evaluation questions, or in specific approaches. all as gateways to the study of public health intervention, these different approaches are by no means mutually exclusive.

[Stress experience by information and communication technologies among nurses in outpatient care - A qualitative interview study]. / Belastungserleben durch Informations- und Kommunikationstechnologien bei Pflegefachpersonen in der ambulanten Pflege.

Stress experience by information and communication technologies among nurses in outpatient care - A qualitative interview study Abstract: Background: "Work 4.0" is also becoming increasingly prevalent in outpatient care through information and communication technologies (ICT). In addition to a variety of options that ICT offers nursing staff, its use leads to additional stresses. Aims: The aim of the study is to identify relevant stress categories that are caused using ICT and provide an additional influence on the stress experience of employees in outpatient care. Methods: Problem-centred interviews were conducted with eight nurses from three outpatient care organizations as part of a qualitative study. Subsequently, these interviews were transcribed and evaluated using qualitative content analysis according to Mayring. Results: Ten factors were identified that were perceived as stress by ambulatory care employees: for example, insufficient participation and usability, increased documentation effort, information overload. Regarding the employees' ability to work and their health, no relevant impairments could be derived that could be attributed to the identified additional strains. Conclusions: Further analysis of the potential stress situations that could result from ICT use is needed to include this knowledge in primary prevention. It makes sense to establish demand-, participation-, and process-oriented structures in outpatient care organizations. The use of ICT can also be an advantage because, for example, information can be obtained more quickly.

Analysis of microbial community diversity and physicochemical factors in pit mud of different ages based on high-throughput sequencing.

In this study, Illumina MiSeq/NovaSeq high-throughput sequencing technology was used to sequence the terminal DNA fragments of microbial communities in Wuliangye pit mud. The results showed that there were 5 dominant bacterial phyla and 13 dominant bacterial genera in the pit mud, which belonged to 4 phyla, mainly Firmicutes. There were 3 dominant fungal phyla and 5 dominant fungal genera in cellar mud, which belonged to 2 phyla and concentrated in Ascomycota. According to the statistical data, the low pH value cellar pool is more conducive to the enrichment of acid-resistant or acid-biased bacteria, which is the key to flavor formation. In addition, the components of ammonium nitrogen, available phosphorus and available potassium in pit mud need to be replenished in time. In addition, sampling time, fermentation time, temperature, and other external environments also have certain effects on microbial diversity and abundance in the pit. With the use of cellars, various types of microorganisms are constantly evolving to adapt to the environment inside the pits. The succession rule of microbe in pit mud was preliminarily revealed, which provided the basis for improving the quality and technical development of Wuliangye.

[Involvement of employees, residents, and relatives in digital transformation at long-term care institutions for older adults - A cross-sectional survey]. / Einbezug von Mitarbeitenden, Bewohnenden und Angehörigen in die digitale Transformation im stationären Altersbereich.

Involvement of employees, residents, and relatives in digital transformation at long-term care institutions for older adults - A cross-sectional survey Abstract. Background: Long-term care institutions for older adults are currently undergoing a digital transformation process. But who are the decision-makers in this transformation process? AIM: The aim of the study was to determine the role of employees, residents, and their relatives in the provision of the technical solutions used in long-term care institutions. METHODS: The standardized online survey was conducted at 466 long-term care institutions throughout Switzerland. The respective managers were surveyed. RESULTS: The majority of the managers surveyed saw more advantages than disadvantages in the use of technical solutions. Nevertheless, the results also show that while 52 % involve their staff in decisions about the acquisition of technology, only 11 % involve their residents, and 8 % involve the residents' relatives. This involvement depends on how much technology has been used so far and what leeway the managers themselves have in making such decisions. CONCLUSIONS: It is apparent that residents and their relatives are involved very little in decision-making processes. This can mean that the organization's digital transformation ultimately depends on just one person, the manager, and that the wishes of the people who are directly affected by these technical innovations are not considered in such decisions.

[Examination in times of Corona: A cross-sectional study on the use of digital media and the implementation of examinations in nursing education]. / Prüfen in Zeiten von Corona.

Examination in times of Corona: A cross-sectional study on the use of digital media and the implementation of examinations in nursing education Abstract. Background: In the pandemic, performance assessments had to be carried out under new conditions during the school closures. The aim of vocational nursing education is to develop competence to act. So far, there are no empirical findings on learning assessments and final examinations under pandemic conditions. Aim: The study aims to record the mode of performance assessments under the changed conditions. Methods: Written online survey of teachers at nursing schools in Germany. The collected data were analysed descriptively and inferentially using Chi-Square tests, and subjected to an integrative content analysis. Results: 884 nursing schools were contacted, 430 questionnaires from 179 responding schools (school-related response rate: 20,2%) could be evaluated. PCs or laptops are mostly used to check learning levels (n = 222). 205 participants do not use digital media for this purpose. Digital media are also used for the oral (n = 108) and written (n = 116) parts of the final examination; various organisational and hygiene measures are taken for face-to-face examinations. The practical part is often conducted in new formats (OSCE, simulation). Conclusions: Based on the results, it remains unclear to what extent competence orientation of vocational nursing education is implemented with digital support in examinations. The practical examination in particular seems to pose a special challenge for all those involved.

3D printing in pharmaceuticals: An emerging technology full of challenges.

Although in its infancy, when compared with the other sectors, year 2005 marked the rapid evolution of 3 Dimensional printing (3DP) technologies in pharma sector with a huge potential in the dosage form designing and personalisation of the medication. 3DP is an innovative and highly promising way for the instant manufacturing in contrast with the tailored made conventional manufacturing. Various 3DP technologies are categorized into the various areas on the basis of the type of material used, deposition techniques and the solidification/fusion techniques. 3DP technologies have multiple pharmaceutical applications including formulation of the precise and unique dosage forms, medical research, personalization of medicine, tissues engineering and surgical application. In the present article, we have accentuated the comparative merits and demerits of various 3DP technologies used in the pharmaceutical sector. An insight in to the challenges, apropos availability and the choice of the excipients, as well as the printer, regulatory and safety concern of the product is provided.

[Living Lab and technologies for the elderly]. / Living lab et technologies pour les personnes âgées.

The living lab is an approach that encourages the design and development of innovative technological solutions in a process of coconstruction involving users and other key players. Its methodology develops the technologies of the Broca living lab, dedicated to the care of elderly people with cognitive disorders and their carers.

[Use of new technologies in the diagnosis of neurodegenerative pathologies]. / Utilisation des nouvelles technologies dans le diagnostic des pathologies neurodégénératives.

These last ten years, new technologies are more and more used in therapeutic and rehabilitation programms for patients with dementia, and used for the diagnosis of theses diseases, from the signal treatment. A review of litterature shows this growing interest among the scientific communauty for these new technologies.

[Step 1 screening: experimentation in Occitania with nurses and pharmacists]. / Le dépistage step 1 : expérimentation en Occitanie avec les infirmiers et les pharmaciens.

Screening with the step 1 tool is the principal modality of entry into the ICOPE program. This preliminary step is particularly an initiative of primary care health professionals, who are daily caring older people. In Occitania, as part of the deployment of ICOPE program, nurses and pharmacists, were invited to integrate the step 1 in their practices. They benefited, if they wished, from a free webinar training.

[From learning reflective awareness to using screens]. / De l'apprentissage d'une conscience réflexive à l'utilisation des écrans.

The emergence of new technologies in our rapidly changing society has significantly changed the way people live. Children of all ages are surrounded daily by a multitude of screens, such as television, computers, video games, smartphones and digital tablets. In the face of this influx, the aim is to bring children to adopt a reflective consciousness, teaching them to question and relate to reality what they see when they watch a DVD or a programme broadcast on television.

[Technologies and type 1 diabetes: what measures and effects in adolescents?] / Nouvelles technologies et diabète de type 1 chez l'adolescent.

The management of type 1 diabetes in paediatrics has evolved considerably over the last 20 years, mainly through the use of new technologies. The challenge of managing this disease is to achieve good glycaemic control in order to prevent complications while maintaining a good quality of life. What are the current and future means of achieving this?

[The MOOC, a democratization of knowledge]. / Les Mooc, une démocratisation des savoirs.

How can the use of information and communication technologies for education improve learning and enrich knowledge? In what way and how can training systems such as the massive open online course contribute to the acquisition of new knowledge and the construction of professional skills? Within what limits? These questions are now being addressed to trainers and all healthcare professionals.

The Stethoscope in 19th-Century American Practice: Ideas, Rhetoric, and Eventual Adoption.

The stethoscope was invented in 1816 by the French physician R.T.H. Laennec, who, after three years of clinical observations, published his treatise Mediate Auscultation in 1819. In his treatise, Laennec included details of his new method of using the stethoscope to provide physiological and pathological evaluation of patients. American physicians attended lectures and clinics at Paris hospitals and carried this information back to their respective medical schools and practices. This was accomplished by a relatively limited number of elite American physicians who were able to take advantage of travel abroad and whose practices were academically affiliated. However, it is a well-substantiated historical claim that the adoption of the stethoscope by most American physicians was slow. There are many reasons for slow adoption of the stethoscope in America, among which are lack of formal education, including bedside training in the stethoscope, complexity of interpretation of auscultatory information, hesitancy of the patient and physician to have an instrument placed between them, and lack of opportunities for continuing education for physicians after leaving medical school. As the nineteenth century progressed, scientific ideas and rhetoric related to auscultation and the stethoscope became more widespread, reflecting gradual acceptance and adoption of the stethoscope by American practitioners. In this article, I examine the ideas and rhetoric in medical journal articles, advertisements, and medical school textbooks to learn what was thought by physicians to be important in their practice. Advertisement of medical school curricula with mention of specific course work or lectures related to auscultation or the stethoscope is noted, reflecting increased interest in the stethoscope as an adjunct to physical examination. This information introduces evidence to test and bolster the existing historical claims of slow adoption of the stethoscope by addressing in more detail when and why adoption by American physicians became widespread.

The changing nature of aquatic animal production.

Aquaculture will continue to grow, but environmental constraints will interact with changing consumer profiles and regulatory frameworks such that future growth will look somewhat different from the trajectories of the past 30 years. Availability and price of land, fresh water, feeds and energy, and concerns about pollution and the introduction of non-native species will be major constraints to expansion. New technology will evolve in response to these concerns. This new technology will be based on the principle of sustainable intensification so as to reduce the environmental footprint per unit of production and limit volatility in markets precipitated by disease and other production system problems. Markets and consumer demand will be reflected in the economics of the industry under more sophisticated regulatory regimes. More sustainable sources of the proteins and oils in fish diets, improved genetic management, and better health and production systems will continue to underpin the expansion of aquaculture into the 21st century and beyond.

La croissance de l'aquaculture va se poursuivre mais les contraintes environnementales risquent d'interagir avec les mutations des profils des consommateurs et avec l'évolution des cadres réglementaires, de sorte que cette croissance empruntera à l'avenir des voies bien différentes de celles tracées au cours des 30 dernières années. Les principaux obstacles à la croissance concernent la disponibilité et le prix des terres, de l'eau douce, des aliments pour animaux et de l'énergie, les problèmes en lien avec la pollution et l'introduction d'espèces non natives. L'évolution des nouvelles technologies devrait apporter une réponse à ces préoccupations. Ces nouvelles technologies reposeront sur le principe d'une intensification durable de la production afin de réduire l'empreinte écologique par unité de production et de limiter la volatilité accélérée des marchés induite par les maladies ou par d'autres problèmes affectant les systèmes de production. Les exigences des marchés et des consommateurs se répercuteront dans la stratégie économique du secteur en vertu de dispositifs réglementaires plus sophistiqués. Grâce au recours à des sources plus durables de protéines et d'huiles pour l'alimentation des poissons, à une meilleure gestion des ressources génétiques et à des systèmes sanitaires et de production plus performants, l'expansion de l'aquaculture devrait se poursuivre tout au long du xxie siècle et au-delà.

Aunque en el futuro la acuicultura seguirá creciendo, las limitaciones ambientales interactuarán del tal modo con la evolución de las modalidades de consumo y los ordenamientos reglamentarios que este crecimiento se apartará en cierta medida de las trayectorias observadas en los últimos 30 años. La disponibilidad y el precio de terrenos, agua dulce, piensos y energía, junto con las inquietudes por la contaminación y la introducción de especies no autóctonas, limitarán considerablemente la expansión. En respuesta a esas inquietudes surgirá una nueva tecnología basada en el principio de la intensificación sostenible, que servirá para reducir la «huella¼ ecológica por unidad de producción y para poner coto a la volatilidad de los mercados causada por enfermedades u otros problemas del sistema productivo. La demanda de mercados y consumidores incidirá en la economía del sector en forma de ordenamientos reglamentarios más sofisticados. En los primeros compases del siglo XXI, y también más adelante, la expansión de la acuicultura seguirá reposando en el uso de fuentes más sostenibles de proteínas y aceites para alimentar a los peces, en el perfeccionamiento de los procesos de selección genética y en sistemas productivos y sanitarios más eficaces.

[Standard or specific unit costs: Which criteria for choosing an economic evaluation of health strategies in multicentric studies?] / Coûts unitaires standards ou coûts unitaires spécifiques : quels critères de choix pour l'évaluation économique de stratégies de santé dans les études multicentriques ?

The question of what monetary value should be assigned to consumed resources, that is to say the choice of the unit cost, is a major consideration in terms of impact on the cost analysis results. To date, no agreement has been reached regarding this methodological question. The choices made by methodologists and the subsequent impact on the results of the analysis are only rarely put forward. This work addresses the theoretical framework of health strategy evaluations that can be carried out either in the normative framework of the conventional economic approach of well-being, referred to as welfarist, or in that of an approach referred to as extra-welfarist. It also provides elements that help clarify the choice of the hospital unit costs used to calculate the cost of health strategies, so as to reconcile the use of such studies and improve their comparability. What is preferable, opting for specific per hospital unit costs or applying a standard unit cost to all facilities? How should a standard cost be calculated? Is it appropriate to calculate an average of the unit costs, as recommended by certain guidelines? The advantages and the limitations of the various modes of assessing hospital resources in the setting of multicentric trials are discussed.

[Data sources, the data used, and the modality for collection]. / Sources de données, données utilisées et modalité de recueil.

The hospital costing process implies access to various sources of data. Whether a micro-costing or a gross-costing approach is used, the choice of the methodology is based on a compromise between the cost of data collection, data accuracy, and data transferability. This work describes the data sources available in France and the access modalities that are used, as well as the main advantages and shortcomings of: (1) the local unit costs, (2) the hospital analytical accounting, (3) the Angers database, (4) the National Health Cost Studies, (5) the INTER CHR/U databases, (6) the Program for Medicalizing Information Systems, and (7) the public health insurance databases.

[Methods for the analysis and treatment of cost data by micro- and gross-costing approaches]. / Méthodes d'analyse et de traitement des données de coût : approches par « micro-costing ¼ et « gross-costing ¼.

This work addresses the analysis of individual cost data in the setting of interventional or observational studies using statistical analysis software once the costs per patient have been estimated. It is in fact necessary to be able to present and describe data in an appropriate manner in each of the studied health strategies and to test whether the difference in costs observed between treatment groups is due to chance or not. Furthermore, cost analysis differs from conventional statistical analysis in that cost data have a certain number of specific properties, including their use by health decision-makers. This work also addresses the difficulties that generally arise in regard to the distribution of cost; it explains why the mathematical average constitutes the only relevant measure for economists; and it outlines which analyses are required for inter-strategy cost comparisons. It also covers the issue of missing or censored data, features that are inherent to information collected regarding costs and to sensitivity analyses.

[Hospital costs estimation by micro and gross-costing approaches]. / Estimation du coût hospitalier : approches par « micro-costing ¼ et « gross-costing ¼.

Cost analysis has become increasingly commonplace in healthcare facilities in recent years. Regardless of the aim, the first consideration for a hospital costing process is to determine the point of view, or perspective, to adopt. Should the cost figures reflect the healthcare facility's point of view or enlighten perspectives for the public health insurance system? Another consideration is in regard to the method to adopt, as there are several. The two most widely used methods to determine the costs of hospital treatments in France are the micro-costing method and the gross-costing method. The aims of this work are: (1) to describe each of these methods (e.g. data collection, assignment of monetary value to resource consumption) with their advantages and shortcomings as they relate to the difficulties encountered with their implementation in hospitals; (2) to present a review of the literature comparing the two methods and their possible combination; and (3) to propose ways to address the questions that need to be asked before compiling resource consumption data and assigning monetary value to hospital costs. A final diagram summarizes methodologies to be preferred according to the evaluation strategy and the impact on patient care.