Clinical experience in anti-synthetase syndrome: a monocentric retrospective analytical study

OBJECTIVES: Anti-synthetase syndrome (ASS) is a rare autoimmune disorder combining autoantibodies and specific clinical manifestations. One of the particularities of ASS is the pleiomorphic radiological presentation seen at the initial work-up. Evaluating treatment response can also be challenging and requires specific clinical, functional, biological and radiological monitoring. For these reasons, it is fundamental to identify specific radiological and clinical features of ASS for improved diagnosis and therapeutic approaches.METHODS: We retrospectively studied all patients suffering from ASS in the CHU of Liège from 2008 to 2019. We analysed the clinical features, pulmonary function tests (PFTs), computed tomography (CT), and longitudinal evolution with regard to patient treatment.RESULTS: In the whole cohort of 30 patients, we identified 19 with anti-JO1 antibodies, 5 with anti-PL12 antibodies and 6 with anti-PL7 antibodies. The sex ratio was slightly in favour of males. Interestingly, PL-12 syndrome was more likely to be present in younger patients than those associated with other antibodies. Overall, 77% of the overall cohort exhibited specific pulmonary involvement without any significant difference with regard to the severity assessed by PFT at diagnosis. In contrast, the radiological presentation was pleomorphic for anti-JO1 syndrome, and anti-PL12 syndrome exhibited mainly ground-glass opacities (GGOs) and reticular abnormalities, while those with anti-PL7 antibodies showed reticulations and bronchiectasis. Longitudinal CT analysis mainly showed a reduction in consolidations and GGOs with specific therapies.CONCLUSION: In our single-centre retrospective study, we found different profiles for different autoantibodies according to age and radiological appearance.

STochastic Optical Reconstruction Microscopy (STORM) reveals the nanoscale organization of pathological aggregates in human brain

AIMS

Histological analysis of brain tissue samples provides valuable information about the pathological processes leading to common neurodegenerative disorders. In this context, the development of novel high-resolution imaging approaches is a current challenge in neuroscience.

METHODS

To this end, we used a recent super-resolution imaging technique called STochastic Optical Reconstruction Microscopy (STORM) to analyse human brain sections. We combined STORM cell imaging protocols with neuropathological techniques to image cryopreserved brain samples from control subjects and patients with neurodegenerative diseases.

RESULTS

This approach allowed us to perform 2D-, 3D- and two-colour-STORM in neocortex, white matter and brainstem samples. STORM proved to be particularly effective at visualizing the organization of dense protein inclusions and we imaged with a <50 nm resolution pathological aggregates within the central nervous system of patients with Alzheimer's disease, Parkinson's disease, Lewy body dementia and fronto-temporal lobar degeneration. Aggregated Aβ branches appeared reticulated and cross-linked in the extracellular matrix, with widths from 60 to 240 nm. Intraneuronal Tau and TDP-43 inclusions were denser, with a honeycomb pattern in the soma and a filamentous organization in the axons. Finally, STORM imaging of α-synuclein pathology revealed the internal organization of Lewy bodies that could not be observed by conventional fluorescence microscopy.

CONCLUSIONS

STORM imaging of human brain samples opens further gates to a more comprehensive understanding of common neurological disorders. The convenience of this technique should open a straightforward extension of its application for super-resolution imaging of the human brain, with promising avenues to current challenges in neuroscience.

Polarization mechanisms of dielectric materials at a binary liquid interface: impacts on electrowetting actuation

We explored polarization mechanisms at the interface between a dielectric material (an electrolyte) and an insulating liquid, during electrowetting actuation. Native surface charge density due to hydrophobic coating has been measured as an offset voltage for which the contact angle is at its minimum. Surface charge densities as low as 0.023 mC m^-2 have been measured using this method, demonstrating that electrowetting can be used as a probe to measure native surface charge density. This effect strongly differs depending on the kind of polarization and is at the origin of major discrepancies between alternative and direct polarization during electrowetting actuation. A new model describing electrowetting actuation is also proposed, leading to a more predictive description as well as useful recommendations on materials to obtain a stable actuation under DC polarization.

Xurography for microfluidics on a reactive solid

In this paper, we propose a simple method to embed transparent reactive materials in a microfluidic cell, and to observe in situ the dissolution of the material. As an example, we show how to obtain the dissolution rate of a calcite window of optical quality, dissolved in water and hydrochloric acid (HCl). These fluids circulate at controlled flowrates in a channel which is obtained by xurography: double sided tape is cut out with a cutter plotter and placed between the calcite window and a non-reactive support. While the calcite window reacts in contact with the acid, its topography is measured in situ every 10 s using an interference microscope, with a pixel resolution of 4.9 μm and a vertical resolution of 50 nm. In order to avoid inlet influence on the reaction, a thin layer of photoresist is added on the calcite surface at the inlet and outlet. This layer is also used as a non reactive reference surface.

Toward the Rational Design of Galactosylated Glycoclusters That Target Pseudomonas aeruginosa Lectin A (LecA): Influence of Linker Arms That Lead to Low-Nanomolar Multivalent Ligands

Anti-infectious strategies against pathogen infections can be achieved through antiadhesive strategies by using multivalent ligands of bacterial virulence factors. LecA and LecB are lectins of Pseudomonas aeruginosa implicated in biofilm formation. A series of 27 LecA-targeting glycoclusters have been synthesized. Nine aromatic galactose aglycons were investigated with three different linker arms that connect the central mannopyranoside core. A low-nanomolar (Kd =19 nm, microarray) ligand with a tyrosine-based linker arm could be identified in a structure-activity relationship study. Molecular modeling of the glycoclusters bound to the lectin tetramer was also used to rationalize the binding properties observed.

Synchrotron X-ray microtransections: a non invasive approach for epileptic seizures arising from eloquent cortical areas

Synchrotron-generated X-ray (SRX) microbeams deposit high radiation doses to submillimetric targets whilst minimizing irradiation of neighboring healthy tissue. We developed a new radiosurgical method which demonstrably transects cortical brain tissue without affecting adjacent regions. We made such image-guided SRX microtransections in the left somatosensory cortex in a rat model of generalized epilepsy using high radiation doses (820 Gy) in thin (200 μm) parallel slices of tissue. This procedure, targeting the brain volume from which seizures arose, altered the abnormal neuronal activities for at least 9 weeks, as evidenced by a decrease of seizure power and coherence between tissue slices in comparison to the contralateral cortex. The brain tissue located between transections stayed histologically normal, while the irradiated micro-slices remained devoid of myelin and neurons two months after irradiation. This pre-clinical proof of concept highlights the translational potential of non-invasive SRX transections for treating epilepsies that are not eligible for resective surgery.

[Pomalidomide for multiple myeloma]

Once characterized by a very poor outcome, multiple myeloma (MM) now has a significantly prolonged survival, with major improvements allowed by the use of "novel agents": proteasome inhibitors (first-in-class bortezomib) and immunomodulatory compounds (IMiDs; first-in-class thalidomide and lenalidomide). However, the vast majority - if not all - of patients with MM ultimately end up being refractory to all existing drugs, including these efficient novel agents. There is a clear unmet medical need in this situation, which warrants the development of the next generation of proteasome inhibitors and IMiDs, as well as new drug classes. This review focuses on pomalidomide, the next generation IMiD, recently approved by the US FDA and the EMA for patients with relapsed or refractory MM who have received at least two prior therapies, including lenalidomide and bortezomib, and have demonstrated disease progression on their last therapy.

An aptasensor for ochratoxin A based on grafting of polyethylene glycol on a boron-doped diamond microcell

A novel strategy for the fabrication of an electrochemical label-free aptasensor for small-size molecules is proposed and demonstrated as an aptasensor for ochratoxin A (OTA). A long spacer chain of polyethylene glycol (PEG) was immobilized on a boron-doped diamond (BDD) microcell via electrochemical oxidation of its terminal amino groups. The amino-aptamer was then covalently linked to the carboxyl end of the immobilized PEG as a two-piece macromolecule, autoassembled at the BDD surface, forming a dense layer. Due to a change in conformation of the aptamer on the target analyte binding, a decrease of the electron transfer rate of the redox [Fe(CN)6](4-/3-) probe was observed. To quantify the amount of OTA, the decrease of the square wave voltammetry (SWV) peak maximum of this probe was monitored. The plot of the peak maximum against the logarithm of OTA concentration was linear along the range from 0.01 to 13.2 ng/L, with a detection limit of 0.01 ng/L. This concept was validated on spiked real samples of rice.

All-organic electrostrictive polymer composites with low driving electrical voltages for micro-fluidic pump applications

This paper focuses on the improvement of a relaxor ferroelectric terpolymer, i.e., poly (vinylidene fluoride-trifluoroethylene-chlorofluoroethylene) [P(VDF-TrFE-CFE)], filled with a bis(2-ethylhexyl) phthalate (DEHP). The developed material gave rise to a significantly increased longitudinal electrostrictive strain, as well as an increased mechanical energy density under a relatively low electric field. These features were attributed to the considerably enhanced dielectric permittivity and a decreased Young modulus as a result of the introduction of only small DEHP plasticizer molecules. In addition, the plasticizer-filled terpolymer only exhibited a slight decrease of the dielectric breakdown strength, which was a great advantage with respect to the traditional polymer-based electrostrictive composites. More importantly, the approach proposed herein is promising for the future development and scale-up of new high-performance electrostrictive dielectrics under low applied electrical fields through modification simply by blending with a low-cost plasticizer. An experimental demonstration based on a flexible micro-fluidic application is described at the end of this paper, confirming the attractive characteristics of the proposed materials as well as the feasibility of integrating them as micro-actuators in small-scale devices.

Gold coated optical fibers as three-dimensional electrodes for microfluidic enzymatic biofuel cells: Toward geometrically enhanced performance

For the first time, we report on the preliminary evaluation of gold coated optical fibers (GCOFs) as three-dimensional (3D) electrodes for a membraneless glucose/O2 enzymatic biofuel cell. Two off-the-shelf 125 μm diameter GCOFs were integrated into a 3D microfluidic chip fabricated via rapid prototyping. Using soluble enzymes and a 10 mM glucose solution flowing at an average velocity of 16 mm s(-1) along 3 mm long GCOFs, the maximum power density reached 30.0 ± 0.1 μW cm(-2) at a current density of 160.6 ± 0.3 μA cm(-2). Bundles composed of multiple GCOFs could further enhance these first results while serving as substrates for enzyme immobilization.

Layer-specific activity of tissue non-specific alkaline phosphatase in the human neocortex

The ectoenzyme tissue non-specific alkaline phosphatase (TNAP) is mostly known for its role in bone mineralization. However, in the severe form of hypophosphatasia, TNAP deficiency also results in epileptic seizures, suggesting a role of this enzyme in brain functions. Accordingly, TNAP activity was shown in the neuropil of the cerebral cortex in diverse mammalian species. However in spite of its clinical significance, the neuronal localization of TNAP has not been investigated in the human brain. By using enzyme histochemistry, we found an unprecedented pattern of TNAP activity appearing as an uninterrupted layer across diverse occipital-, frontal- and temporal lobe areas of the human cerebral cortex. This marked TNAP-active band was localized infragranulary in layer 5 as defined by quantitative comparisons on parallel sections stained by various techniques to reveal the laminar pattern. On the contrary, TNAP activity was localized in layer 4 of the primary visual and somatosensory cortices, which is consistent with earlier observations on other species. This result suggests that the expression of TNAP in the thalamo-recipient granular layer is an evolutionary conserved feature of the sensory cortex. The observations of the present study also suggest that diverse neurocognitive functions share a common cerebral cortical mechanism depending on TNAP activity in layer 5. In summary, the present data point on the distinctive role of layer 5 in cortical computation and neurological disorders caused by TNAP dysfunctions in the human brain.

Combining microfluidics and electrochemical detection

This paper describes two configurations that integrate electrochemical detection into microfluidic devices. The first configuration is a low-cost approach based on the use of PCB technology. This device was applied to electrochemiluminescence detection. The second configuration was used to carry out amperometric quantification of electroactive species using a serial dilution microfluidic system.

Lutter contre le tabac et promouvoir l'allaitement au Québec : un défi

Quebec's breastfeeding rates are in a deplorable state, and even more so for smoking mothers. Public health providers are trying to increase breastfeeding rates and decrease smoking in this specific target group. Should they prioritise tobacco cessation interventions, or breastfeeding promotion interventions, or give equal priority to both goals at the same time? The authors attempt to scientifically answer this question, through a comprehensive literature review over the last ten years. In general, women who smoke have the tendency be younger, be less educated and more underprivileged than mothers who do not smoke and to breastfeed less often. Smoking mothers who do breastfeed usually wean off breastfeeding earlier than those who do not smoke. Pregnancy is considered an ideal moment to stop smoking, but relapse after giving birth is very high. In light of the range of difficulties faced when trying to quit smoking, health professionals should encourage smoking mothers to breastfeed since the benefits of breastfeeding could actually serve to reduce some of the harmful effects related to tobacco. Nicotine patches can be prescribed to increase the chances for successful tobacco cessation amongst these mothers. To date, few studies have been carried out on nicotine replacement therapies and breastfeeding smokers. More research is needed to evaluate the risks and benefits of nicotine substitutes for this sub-group, in both the short and long term.

Streaming current measurements in zirconia-coated capillaries

The electroosmotic flow created in zirconia-modified capillaries has been previously investigated. In this paper, we compared the electroosmotic data set with streaming current measurements and we related all these data through zeta-potential. Streaming current measurements give an excellent indication on the direction and the value of the electroosmotic mobility of an electrolyte/capillary system for a large set of experimental conditions: 2 < pH < 12, 0 < ACN < 80 %, 10(-4) M < [SO(2- )4 ] < 4 x 10(-2) M. A good correlation between zeta-potential from streaming current measurements and zeta-potential from electroosmotic mobility measurements was observed (r2 = 0.95). However, the values obtained from streaming current were always slightly lower than the one calculated from electroosmotic mobility (slope = 0.86, sigma = 0.06). In zirconia-coated capillaries the zeta-potential can be tuned from -50 to +100 mV depending on the composition of the electrolyte.

Zeta potential determination by streaming current modelization and measurement in electrophoretic microfluidic systems

Electrophoresis in capillary and microfluidic systems, used in analytical chemistry to separate charged species, are quite sensitive to surface phenomena in terms of separation performances. In order to improve theses performances, new surface functionalization techniques are required. There is a need for methods to provide fast and accurate quantification about surface charges at liquid/solid interfaces. We present a fast, simple, and low-cost technique for the measurement of the zeta-potential, via the modelization and the measurement of streaming currents. Due to the small channel cross section in microfluidic devices, the streaming current modelization is easier than the streaming potential measurement. The modelization combines microfluidic simulations based on the Navier-Stokes equation and charge repartition simulations based on the Poisson-Boltzmann equation. This method has been validated with square and circular cross section shape fused-silica capillaries and can be easily transposed to any lab-on-chip microsystems.

[Heart health promotion and preventive practices of Quebec nurses working in local community health centers]

The heart health promotion and prevention practices of nurses working in front-line services in 20 Québec CLSC's are analyzed through a qualitative (n = 47 nurses) and a quantitative approach (n = 177 nurses and n = 3802 patients). The results demonstrate that although nurses state they integrate prevention and promotion in their daily practice, patients report that nurses provide few prevention recommendations. The major challenge for prevention-promotion is to strengthen secondary prevention and, especially, integrate primary prevention and promotion in nurses' daily clinical practice.

The St-Louis du Parc Heart Health Project: a critical analysis of the reverse effects on smoking

OBJECTIVES

Although some school based smoking prevention programmes have shown positive impacts, others have had only short term effects, no effects, and in some cases reverse effects. The St-Louis du Parc Heart Health Project was a five year heart health promotion programme targeting children in eight elementary schools aged 9-12 years in disadvantaged multiethnic neighbourhoods in Montreal. In a controlled, longitudinal evaluation, the programme produced reverse effects on smoking--children exposed to the programme were more likely to initiate and to continue smoking than control children. This article explores hypotheses to explain the reverse effects.

DESIGN

Following work by an in-house committee, a consensus workshop with international experts was conducted to develop hypotheses to explain the reverse effects. This was complemented by an analysis of the programme's concordance with the standard guidelines on the school based prevention of tobacco use, and discussions with experts at the Centers for Disease Control and Prevention.

RESULTS

The programme respected most standard guidelines for smoking prevention programmes with respect to content and mode of delivery. Hypotheses to explain the reverse effects include: an unfavourable environment characterised by strong pro-smoking models and resistance to environmental interventions; heightened sensitivity to smoking among children most exposed to the programme; defence mechanisms among children stimulated by cognitive dissonance or anxiety; unanticipated effects associated with the health educator who delivered the programme; inadequate attention in programme development to the diverse cultural origins of the population targeted; and intervention content inappropriately targeted to children's stages of cognitive development.

CONCLUSION

Elementary school based interventions should aim to develop a clear and coherent social norm about the non-use of tobacco, as a precursor to or in close conjunction with having children as their primary target. Programme design should take key student characteristics into consideration and ensure that the modes of communication are adapted to the targeted group's characteristics. Neighbourhood level interventions should be orchestrated to complement regional, provincial, and national programmes.

A new step towards the lattice reconstruction in 3DAP

The spatial resolution of images produced by 3DAP is known not to be limited by the detector performance but by the physics of field ionisation and field evaporation. This resolution can be expressed by two parameters: the depth resolution and the lateral resolution, which have been shown to achieve, respectively, 0.06 and 0.2nm in an ideal case of a pure metal. By using this model and these values, the resolution along any crystallographic direction can be predicted. In addition, it is possible to predict the suitable sites of analysis where a given type of atomic planes can be resolved. Furthermore, it is shown that three types of planes with non-coplanar directions can be imaged in 3D reconstructed volumes. Thus, the reconstruction of the original tungsten lattice can be achieved with the use of Fourier Transform image analysis techniques. It is shown that the reliability of the method can be achieve the value of 90%.

Neuronal response to local electrical stimulation in rat thalamus: physiological implications for mechanisms of deep brain stimulation

High-frequency deep brain stimulation (DBS) of sensorimotor thalamus containing "tremor cells" leads to tremor arrest in humans with parkinsonian and essential tremor. To examine the possible underlying mechanism(s), we recorded in vitro intracellular responses of rat thalamic neurons to local intrathalamic stimulation. Such simulated DBS (sDBS) induced a sustained membrane depolarization accompanied by an increase in apparent membrane conductance in both motor and sensory neurons. With stimulation frequency above approximately 100 Hz, the sDBS-induced depolarization most typically led to repetitive neuronal firing or less frequently resulted in a complete blockade of action potential genesis. When regular intracellular current pulses were injected into cells to mimic "tremor" activity, such rhythmic discharges were invariably disrupted or abolished by the random spike firing induced during high-frequency sDBS. Low-frequency sDBS left rhythmicity unaffected.We conclude that clinical thalamic DBS may lead to a neuronal de-rhythmicity and tremor stoppage through masking and/or blocking rhythmic firing of tremor cells.

Au coeur de la vie: the Quebec Heart Health Dissemination Project

"Au coeur de la vie" is a research project which aims to evaluate the impact of a heart health dissemination program on primary and secondary prevention practices in local community clinics in the province of Quebec, Canada. Because the project starts in 2001 and no data has been collected to date this paper presents the theoretical model, the objectives of the program, the description of the dissemination procedures, and a brief overview of the evaluation.

Evidence against a major role of plasmalogens in the resistance of astrocytes in lactic acid-induced oxidative stress in vitro

Astrocytes are known to play a key role in buffering extracellular pH variations and, in addition, they are particularly resistant to oxidative stress and subsequent lipid peroxidation. This great resistance may be ascribed to the presence of high concentrations of certain antioxidants, but another explanation may be the presence of a high quantity of plasmalogens, which are a special group of glycerophospholipids characterized by a vinyl ether bond instead of an ester bond in the sn-1 position of the glycerol backbone. Plasmalogens are sensitive to free radical attack and acidity, and numerous works have supported the hypothesis that they may be antioxidant molecules that protect cells from oxidative stress. The aim of this work was to investigate, on astrocytes in lactic acid-induced oxidative stress (pH 5.5), the behavior of phospholipids and, in particular, plasmalogens. Two main techniques, based on the susceptibility of the vinyl ether bond to hydrolysis, were employed in this study to measure plasmalogen levels. In both cases, the sn-1 vinyl ether linkage was cleaved using mercuric chloride, producing a lysophospholipid that was assessed by phosphorus measurement or using HCl treatment, producing a long-chain fatty aldehyde assayed by gas chromatography/mass spectrometry. On astrocytes in culture, only plasmenylethanolamine (PlmEtn) was evidenced, representing 40% of glycerophosphoethanolamine lipids. When astrocytes were incubated with lactic acid, no modification in the amount of PlmEtn was seen. Furthermore, free aldehydes and aldehydes corresponding to the quantity of intact plasmalogens were similar to those observed on controls. In addition, the constancy of two lipid peroxidation markers, thiobarbituric acid reactive substances and polyunsaturated fatty acids, was clear evidence of the resistance of these cells in lactic acid conditions. In conclusion, our results fail to demonstrate a major role of plasmalogens in the resistance of astrocytes in lactic acid-induced oxidative stress.

Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation

BACKGROUND

A high prevalence of gestational diabetes mellitus and type 2 diabetes has been observed among the Cree of James Bay, Quebec. To address this problem, a diet and activity intervention during pregnancy, which was based on social learning theory, was initiated in 4 Cree communities.

METHODS

A prospective intervention compared dietary, weight and glycemic indicators for 107 control subjects and for 112 women who received the intervention during the course of their pregnancy. A control period in 4 communities (July 1995-March 1996) was followed by an intervention period (April 1996-January 1997) when subjects were offered regular, individual diet counselling, physical activity sessions and other activities related to nutrition.

RESULTS

The intervention and control groups did not differ at baseline regarding their mean age (24.3 years [SD 6.29] v. 23.8 years [SD 5.86]), mean prepregnancy weight (81.0 kg [SD 19.46] v. 78.9 kg [SD 17.54]) and mean gestational age at recruitment (17.1 weeks [SD 7.06] v. 18.5 weeks [SD 6.92]). The intervention did not result in differences in diet measured at 24-30 weeks' gestation, rate of weight gain over the second half of pregnancy (0.53 kg per week [SD 0.32] v. 0.53 kg per week [SD 0.27]) or plasma glucose level (50 g oral glucose screen) between 24 and 30 weeks (7.21 mmol/L [SD 2.09] v. 7.43 mmol/L [SD 2.10]). Mean birth weights were similar (3741 g [SD 523] v. 3686 g [SD 686]), as was maternal weight at 6 weeks post partum (88.1 kg [SD 16.8] v. 86.4 kg [SD 19.0]). The only changes in dietary intake were a reduction in caffeine (pregnancy) and an increase in folate (post partum).

INTERPRETATION

This intervention had only a minor impact on diet; finding ways of encouraging appropriate body weight and activity levels remains a challenge.

The impact of a community-based heart disease prevention program in a low-income, inner-city neighborhood

OBJECTIVES

This study evaluated the impact of a 4-year, community-based cardiovascular disease prevention program among adults aged 18 to 65 years living in St-Henri, a low-income, innercity neighborhood in Montreal, Quebec.

METHODS

Awareness of and participation in the program were monitored in 3 independent sample telephone surveys. Self-reported behaviors were compared in St-Henri and a nearby comparison community before and after program implementation in both a 3-year repeat independent sample survey and a 5-year longitudinal cohort telephone survey.

RESULTS

Awareness of the program reached 37.4%, but participation was low (2%-3%). There were no secular declines in smoking or high-fat diet; physical inactivity increased in both communities. There were no statistically significant program effects detected in the independent sample surveys, although physical inactivity increased more in the comparison community than in St-Henri. In the longitudinal cohort sample, there was a small, statistically significant increase favoring St-Henri in frequency of cholesterol checkups.

CONCLUSIONS

Despite careful adaptation of the program to the local social context, there were few community-wide program effects. However, several component interventions showed promise in terms of community penetration and impact.

Prevalence and correlates of physical activity behaviors among elementary schoolchildren in multiethnic, low income, inner-city neighborhoods in Montreal, Canada

PURPOSE

To describe the prevalence and correlates of physical inactivity and of participation in organized sports at and outside school among elementary schoolchildren in multiethnic, low income, urban neighborhoods in Montreal, Canada.

METHODS

As part of the evaluation of a school-based heart health promotion program, baseline data on physical activity behaviors and potential correlates of these behaviors, were collected from 2285 students aged 9-13 in all 130 grade 4 to 6 classes in 24 inner-city elementary schools from May to June 1993.

RESULTS

One-fifth of boys (20.5%) and 24.4% of girls were inactive; 40.0% and 33.3% of boys and girls respectively, participated in school sports teams; 82.5% and 74.7% participated in organized sports outside school. Declines in activity levels with age were apparent in both genders. Children who participated in organized sports programs at and outside school, those with higher perceived self-efficacy for physical activity, and those with more parental support for engaging in physical activity were more active. Children of Asian family origin were less active. Socioeconomic status was related to participation in organized sports outside school.

CONCLUSIONS

To reach children in socio-economically disadvantaged areas and to prevent age-related declines in activity levels, interventions promoting physical activity should focus on increasing availability and access to community-based organized sports programs at and outside school. Also they should include components to increase parental support and to improve perceived self-efficacy for physical activity.

[Evaluative research on the distribution of health videocassettes destined for a disadvantaged Montreal population]

The present article describes the implementation and the evaluation of an intervention done in the context of a heart health community and multifactorial program. The intervention aimed to offer six videocassettes on cardiovascular health to a low-income and low-educated clientele through five video-clubs. All videoclubs (n = 5) from St. Henri/Petite Bourgogne agreed to distribute the videocassettes free of charge. Two components were examined: admissibility by videoclubs' owner and clientele's receptivity towards the intervention. Results showed that all videoclubs offered free display and service for the videocassettes. The article also presents a discussion of the feasibility and the possibilities to broaden this type of action.

[A cardiovascular health promotion program for 9-12 year old children and the community of Saint-Louis du Parc/Quebec]

This article presents a programme for cardiovascular health for 9 to 12 years old children, called "Healthy Heart" Saint-Louis du Parc and carried out in low socioeconomic and multiethnic part of Montreal, Quebec, Canada. These five years programme targets were more both spheres: school and community (leisure centre, ethnocultural centre, groceries and other places). We develop the objectives, the conceptual models underlying to the programme, the perspective of work, the infrastructure of the programme: its staff and financing, the partnerships and the structure organising. Then we present the various interventions carried out along the period and so a description of many evaluations. At last, we discuss about the programme continuation.

Prevalence and correlates of overweight among elementary schoolchildren in multiethnic, low income, inner-city neighbourhoods in Montreal, Canada

PURPOSE

Increased understanding of the early determinants of obesity is essential because of the increasing prevalence of obesity in many industrialized countries.

METHOD

As part of the evaluation of a school-based heart health promotion intervention, we measured height, weight, and triceps skinfold thickness at baseline in 2108 students aged 9-12 years (80.5% of eligible students) in 24 inner-city elementary schools located in multiethnic, low income neighbourhoods in Montreal, Canada. Data on student's socio-demographic and lifestyle characteristics were collected in classroom-administered questionnaires, and parents completed an at-home self-administered questionnaire.

RESULTS

Overall, 35.2% of boys and 33.0% of girls were overweight (> or = 85th age and gender-specific percentiles from NHANES 11, for body mass index and triceps skinfold thickness); 15.1% of boys and 13.3% of girls were obese (> or = 95th age and gender-specific percentiles for body mass index and triceps skinfold thickness). Younger age, having lived all one's life in Canada, and being of European or Central American/Caribbean family origin were independent correlates of obesity in boys. Younger age, ever smoked, mother obese and father obese were independent correlates of obesity in girls. Girls of Asian family origin were protected.

CONCLUSIONS

The very high prevalence of overweight students in this low income, multiethnic population suggests an important need for preventive intervention.

Correlates of the sustainability of community-based heart health promotion interventions

OBJECTIVES

This study investigated factors related to the perceived sustainability of 189 heart health promotion interventions initiated by a public health department or research initiative and implemented in a variety of organizations across Canada.

METHODS

Data were collected in a telephone survey of key informants from schools, restaurants, grocery stores, health care facilities, and sports facilities that had implemented a heart health promotion intervention (risk factor screening, courses for smoking cessation, healthy eating or physical activity, support groups to promote healthy lifestyles, environmental modification, dissemination of information) in the past 8 years.

RESULTS

Overall, 43.6% of 189 interventions were perceived to be very permanent, 34.8% were somewhat permanent, and 21.5% were not permanent. Independent correlates of perceived sustainability included intervention used no paid staff (odds ratio (OR) 95% confidence interval (95% Cl) = 3.7 (1.8, 7.5)), intervention was modified during implementation (OR (95% Cl) = 2.7 (1.4, 5.0)), there was a good fit between the local provider and the intervention (OR (95% Cl) = 2.4 (1.2, 5.0)), and there was the presence of a program champion (OR (95% Cl) = 2.3 (1.2, 4.4)).

CONCLUSION

Consideration of these factors by health promotion program planners could increase the potential for sustainability of health promotion interventions implemented in the community.

[Evaluative research on the distribution of health videocassettes destined for a disadvantaged Montreal population]

The present article describes the implementation and the evaluation of an intervention done in the context of a heart health community and multifactorial program. The intervention aimed to offer six videocassettes on cardiovascular health to a low-income and low-educated clientele through five video-clubs. All videoclubs (n = 5) from St. Henri/Petite Bourgogne agreed to distribute the videocassettes free of charge. Two components were examined: admissibility by videoclubs' owner and clientele's receptivity towards the intervention. Results showed that all videoclubs offered free display and service for the videocassettes. The article also presents a discussion of the feasibility and the possibilities to broaden this type of action.

Sputum eosinophilia is more closely associated with airway responsiveness to bradykinin than methacholine in asthma

Hyperresponsiveness of the airways to various spasmogenic stimuli is a characteristic feature of bronchial asthma. However, the association between the different stimuli to which asthmatic airways are hyperresponsive and airways inflammation is not completely understood. We have investigated the relationship between airway inflammation and airway hyperresponsiveness in asthma, as assessed by bronchoprovocation tests to methacholine and bradykinin, two well defined bronchoconstrictor agonists. Sputum induction by hypertonic saline and methacholine and bradykinin challenges were performed in 14 nonsmoking subjects with mild-to-moderate asthma. Airway responsiveness to either agonist did not correlate with sputum neutrophils, lymphocytes, and macrophages. Whilst the absolute number of eosinophilia failed to be significantly related to methacholine responsiveness (r=-0.47; p=0.09), it correlated markedly and significantly with provocative concentration of methacholine causing a 20% fall in forced expiratory volume in one second (r=0.72; p<0.01). When expressed as % of total cell counts, sputum eosinophils correlated with both types of responsiveness (r=-056; p=0.04 and r=-0.76, p<0.001, respectively). Although the concentration of eosinophil cationic protein (ECP) in the sputum correlated with the absolute numbers of eosinophils (r=0.62; p<0.02), no correlation was found between ECP levels and the airway responsiveness to any of the agonists tested. In subjects with mild-to-moderate asthma, airway responsiveness to bradykinin is more strongly associated with the magnitude of eosinophilic inflammation in the airways than methacholine. This finding underlines the selectivity of diverse agonists in assessing airway hyperresponsiveness and cellular inflammation in asthma.

One-year predictors of smoking initiation and of continued smoking among elementary schoolchildren in multiethnic, low-income, inner-city neighbourhoods

OBJECTIVE

To identify one-year predictors of smoking initiation among never-smokers, and of continued smoking among ever-smokers.

DESIGN

Two sequential cohorts of grade 4 and 5 children. Data were collected as part of Coeur en sante St Louis du Parc, a non-randomised controlled trial to evaluate the impact of a school-based heart health promotion programme.

SETTING

24 inner-city elementary schools located in multiethnic, low-income neighbourhoods in Montreal.

SUBJECT

1824 schoolchildren aged 9-12 years with baseline and one-year follow-up data.

MAIN OUTCOME MEASURES

Changes in smoking behaviour over a year; the ability of baseline data to predict smoking initiation and continued smoking a year later was investigated in logistic regression analyses.

RESULTS

The prevalence of ever-smoking was 21.1% at baseline and 30.2% at one-year follow up. One in six never-smokers initiated smoking; one in three ever-smokers continued smoking. Predictors of initiation included age (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.3 to 2.0), male gender (OR = 1.5 (95% CI = 1.1 to 2.0)), friends who smoke (OR = 2.3 (95% CI = 1.7 to 3.3)), sibling(s) who smoke (OR = 1.9 (95% CI = 1.2 to 3.1)), father/mother who smokes (OR = 2.2 (95% CI = 1.6 to 3.0)), and frequent high fat/"junk food" consumption (OR = 1.6 (95% CI = 1.1 to 2.1)). Age and friends who smoke were also independent predictors of continued smoking in both genders. In addition, in boys, current smokers at baseline were 2.6 times (95% CI = 1.4 to 5.0) more likely to continue smoking than past smokers. In girls, being overweight was associated with continued smoking (OR = 3.5 (95% CI = 1.6 to 7.6)).

CONCLUSIONS

Smoking prevention programmes should address parental and sibling influences on smoking, in addition to refusal skills training. Among girls, weight-related issues may also be important.

Prevalence and correlates of early smoking among elementary schoolchildren in multiethnic, low-income inner-city neighborhoods

PURPOSE

The prevalence and correlates of early smoking were investigated among schoolchildren in grades 4-6 living in multiethnic, low-income neighborhoods in Montreal.

METHODS

As part of the evaluation of a school-based heart health promotion program, baseline data on the prevalence of early smoking were collected from 2285 students aged 9-13 years in 24 inner-city elementary schools during May-June 1993.

RESULTS

Overall, 28.7% of boys and 20.3% of girls had smoked. Girls began trying later than boys, but by age 13 the prevalence of experimental or regular smoking by girls overtook that of boys. Univariately, ever smoking varied considerably by family origin, from 2.1% among Vietnamese girls, to 35.8% among Portuguese boys. In multivariate analysis, age, perceived smoking habits of friends, and smoking by family members, were strong correlates of smoking. Being of Asian family origin was negatively associated with smoking. None of the indicators of social class were significantly associated with ever smoking.

CONCLUSIONS

Smoking prevention should begin with children even younger than age 9 in multiethnic, low-income, inner-city neighborhoods. With the exception of a lower prevalence of smoking among Asian children, ethnicity and social class were not strong influences on early smoking behavior in this population.