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Kalubi J, Bertrand Y, Dagenais B, Houde R, Marcoux S, Bujold M. Graduate students’ mental health: Exploring experiences of isolation and loneliness. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
A student psychological health survey, conducted in 2015-2016 among over 10,000 students at the University of Montreal (UdeM), gives an alarming picture of psychological distress associated to feelings of loneliness. The objective of this phenomenological study is to better understand the experience of isolation from the perspective of UdeM graduate students.
Methods
As part of a qualitative methods course, five semi-directed interviews and a focus group (n = 8) were conducted with graduate students and a psychologist from UdeM. Hybrid thematic analysis of verbatim and inter-rater debriefing were conducted using NVivo 11 software.
Results
Thematic analysis illustrates that most graduate students feel isolated at some point during their studies, but also that the impact and the meaning of this loneliness feeling is variable. It can be perceived positively when it is sought, temporary and/or allows one to be more productive. It can be perceived negatively when it is involuntary, constant over time and/or does not improve academic effectiveness. Personality, academic and social contexts, as well as support by peers and supervisors appear to modify feelings of isolation.
Conclusions
This study demonstrates the importance of context for graduate students' feelings of isolation. Further research is needed to move towards saturation of perspectives around this phenomenon.
Key messages
Graduate students reported that the experience and the repercussions of isolation may differ in whether it is sought or involuntary. Factors that seem to influence the feeling of loneliness include academic context and supervisor support. Further research is needed to discriminate the impact of these different contextual factors.
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Affiliation(s)
- J Kalubi
- École de santé publique, Université de Montréal, Montreal, Canada
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montreal, Canada
- Centre de recherche en santé publique, Université de Montréal et CIUSSS Centre-Sud-de-l’Île-de-Montréal, Montreal, Canada
| | - Y Bertrand
- École de santé publique, Université de Montréal, Montreal, Canada
- Centre de recherche du centre hospitalier de l’Université de Montréal, Montreal, Canada
| | - B Dagenais
- Département de nutrition, Université de Montréal, Montreal, Canada
| | - R Houde
- École de santé publique, Université de Montréal, Montreal, Canada
- Faculté de médecine, Université de Montréal, Montreal, Canada
| | - S Marcoux
- Faculté de médecine, Université de Montréal, Montreal, Canada
| | - M Bujold
- École de santé publique, Université de Montréal, Montreal, Canada
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Bujold M, El Sherif R, Bush PL, Johnson-Lafleur J, Doray G, Pluye P. Ecological content validation of the Information Assessment Method for parents (IAM-parent): A mixed methods study. Eval Program Plann 2018; 66:79-88. [PMID: 29053984 DOI: 10.1016/j.evalprogplan.2017.09.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 08/23/2017] [Accepted: 09/29/2017] [Indexed: 06/07/2023]
Abstract
This mixed methods study content validated the Information Assessment Method for parents (IAM-parent) that allows users to systematically rate and comment on online parenting information. Quantitative data and results: 22,407 IAM ratings were collected; of the initial 32 items, descriptive statistics showed that 10 had low relevance. Qualitative data and results: IAM-based comments were collected, and 20 IAM users were interviewed (maximum variation sample); the qualitative data analysis assessed the representativeness of IAM items, and identified items with problematic wording. Researchers, the program director, and Web editors integrated quantitative and qualitative results, which led to a shorter and clearer IAM-parent.
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Affiliation(s)
- M Bujold
- Department of Family Medicine, McGill University, 5858 Cote-des-Neiges, 3rd Floor, Suite 300, Montreal, QC, H3S 1Z1, Canada.
| | - R El Sherif
- Department of Family Medicine, McGill University, 5858 Cote-des-Neiges, 3rd Floor, Suite 300, Montreal, QC, H3S 1Z1, Canada.
| | - P L Bush
- Department of Family Medicine, McGill University, 5858 Cote-des-Neiges, 3rd Floor, Suite 300, Montreal, QC, H3S 1Z1, Canada
| | - J Johnson-Lafleur
- Division of Social and Transcultural Psychiatry, McGill University, CSSS de la Montagne, 7085 Hutchison, Bureau 204, H3N 1Y9, Montreal, QC, Canada.
| | - G Doray
- Naître et grandir, Fondation Lucie et André Chagnon, 2001 McGill College, Bureau 1000, H3A 1G1, Montreal, Quebec, Canada.
| | - P Pluye
- Department of Family Medicine, McGill University, 5858 Cote-des-Neiges, 3rd Floor, Suite 300, Montreal, QC, H3S 1Z1, Canada.
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Mokrane S, Bujold M. [Drug-therapy: misunderstanding and omission, in patientdoctor communication]. Rev Med Brux 2017; 38:385-391. [PMID: 28981246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Patient-doctor communication is fraught with misunderstanding and omission, especially around the drug therapy. In this article we mobilize health anthropology to illustrate this phenomenon. Beyond the biomedical effect, the drug is also an object of meaning: it objectifies the disease and is appealing but also raising uncertainities. It simultaneously promises a certain autonomy and a dependency on the doctor. Drug prescription also serves as a communication tool between the suffering patient and the caring doctor. If the prescription can be source of disagreement, it could present an opportunity for the doctor to explore the patient's illness representation, and the potential obstacles to negotiated therapeutic adherence between the partners of the therapeutic relationship.
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Affiliation(s)
- S Mokrane
- Département de Médecine générale, ULB
| | - M Bujold
- Département de Médecine familiale, Université McGill, Montréal
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Burns JC, Song Y, Bujold M, Shimizu C, Kanegaye JT, Tremoulet AH, Franco A. Immune-monitoring in Kawasaki disease patients treated with infliximab and intravenous immunoglobulin. Clin Exp Immunol 2014; 174:337-44. [PMID: 23901839 DOI: 10.1111/cei.12182] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2013] [Indexed: 11/29/2022] Open
Abstract
The expansion of regulatory T cells (Treg ) controls inflammation in children with acute Kawasaki disease (KD). Blockade of tumour necrosis factor (TNF)-α is an emerging therapy for KD patients with refractory inflammation, but there is concern that this therapy could impede the host immune regulation. To define the effect of TNF-α blockade, we conducted ex-vivo immune-monitoring in KD subjects who participated in a randomized, double-blind, placebo-controlled clinical trial of the addition of infliximab to standard intravenous immunoglobulin (IVIG) therapy. We enumerated circulating myeloid and plasmocytoid dendritic cells (DC), regulatory T cells (Treg ) and memory T cells (Tmem ) in 14 consecutive, unselected KD patients (seven treated with IVIG, seven with IVIG + infliximab) at three time-points: (i) acute phase prior to treatment, (ii) subacute phase and (iii) convalescent phase. Myeloid DC (mDC), but not plasmacytoid DC (pDC), were numerous in the peripheral blood in acute KD subjects and decreased in the subacute phase in both IVIG(-) and IVIG (+) infliximab-treated groups. The co-stimulatory molecule for antigen presentation to T cells and CD86 decreased in mDC from acute to subacute time-points in both treatment groups, but not in the single patient who developed coronary artery aneurysms. We also defined tolerogenic mDC that expand in the subacute phase of KD not impaired by infliximab treatment. Treg and Tmem expanded after treatment with no significant differences between the two groups. Treatment of KD patients with infliximab does not adversely affect generation of tolerogenic mDC or the development of T cell regulation and memory.
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Affiliation(s)
- J C Burns
- Department of Pediatrics, School of Medicine, University of California San Diego and Rady Children's Hospital, La Jolla, CA, USA
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Seregin SS, Appledorn DM, Patial S, Bujold M, Nance W, Godbehere S, Parameswaran N, Amalfitano A. beta-Arrestins modulate Adenovirus-vector-induced innate immune responses: differential regulation by beta-arrestin-1 and beta-arrestin-2. Virus Res 2009; 147:123-34. [PMID: 19896992 DOI: 10.1016/j.virusres.2009.10.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 10/28/2009] [Accepted: 10/29/2009] [Indexed: 12/01/2022]
Abstract
Adenovirus (Ad)-based vectors have been utilized in human gene transfer clinical trials since 1993. Unfortunately, innate immune responses directed against the Ad capsid and/or its genetic cargo can significantly limit the usage of Ad vectors. Previous studies have demonstrated that several signaling pathways are triggered by Ads, inclusive of TLR-dependent pathways. The G-protein-coupled receptor adaptors beta-arrestin-1 (beta-Arr1) and beta-arrestin-2 (beta-Arr2) are known to have pivotal roles in regulating TLR4 triggered signaling and inflammatory responses. In this study, we examined the role of beta-arrestins in Ad5-vector-induced inflammatory responses. Our studies reveal that both beta-arrestins are capable of modulating Ad5-vector-induced inflammatory responses in vivo and in vitro. Importantly, our studies divulge another level of complexity to these responses, as our results demonstrate beta-Arr1 to be a positive regulator, and beta-Arr2 a negative regulator of Ad5 induced innate immune responses. These data may allow gene therapy biologists to more accurately study the mechanisms underlying Ad5-vector-induced immune responses, and may also direct future efforts to modulate these mechanisms to improve the safety and/or efficacy of this important gene transfer vector.
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Affiliation(s)
- Sergey S Seregin
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI 48824, United States
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Seregin SS, Aldhamen YA, Appledorn DM, Schuldt NJ, McBride AJ, Bujold M, Godbehere SS, Amalfitano A. CR1/2 is an important suppressor of Adenovirus-induced innate immune responses and is required for induction of neutralizing antibodies. Gene Ther 2009; 16:1245-59. [PMID: 19554032 PMCID: PMC4039027 DOI: 10.1038/gt.2009.77] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Human complement receptors 1 and 2 are well described as important regulators of innate and adaptive immune responses, having pivotal roles in regulating complement activation (CR1) and B cell maturation/survival. In contrast, the role of the murine homologues of CR1 and CR2 (mCR1/2) have been primarily defined as modulating activation of the adaptive immune system, with very little evidence available about the role of mCR1/2 in regulating the innate immune responses to pathogens. In this manuscript, we confirm that mCR1/2 plays an important role in regulating both the innate and adaptive immune responses noted after Adenovirus (Ad) mediated gene transfer. Our results uncovered a novel role of mCR1/2 in down-regulating several, complement dependent innate immune responses. We also unveiled the mechanism underlying the complement dependent induction of neutralizing antibodies to Ad capsids as a CR1/2 dependent phenomenon that correlates with B-cell activation. These results confirm that Ad interactions with the complement system are pivotal in understanding how to maximize the safety or potency of Ad mediated gene transfer for both gene therapy and vaccine applications.
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Affiliation(s)
- S S Seregin
- Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, USA
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Caron NJ, Torrente Y, Camirand G, Bujold M, Chapdelaine P, Leriche K, Bresolin N, Tremblay JP. Intracellular delivery of a Tat-eGFP fusion protein into muscle cells. Mol Ther 2001; 3:310-8. [PMID: 11273772 DOI: 10.1006/mthe.2001.0279] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The Tat protein from HIV-1, when fused with heterologous proteins or peptides, can traverse biological membranes in a process called "protein transduction," delivering its cargo into cells. A Tat-eGFP fusion protein was purified from bacteria to study the transduction kinetics of Tat fusion proteins into cultured myoblasts and in the muscle tissue. Correctly folded Tat-eGFP reaches a maximum intracellular level in nearly 30 min, while its endogenous fluorescence is first detected only after 14 h. The nuclear localization signal from the basic domain of Tat was not sufficient to confer nuclear localization to Tat-eGFP, suggesting that the nuclear import pathway used by the exogenously added Tat-eGFP might be sensitive to the folding state of eGFP. In mice, the direct delivery to the muscle tissue using subcutaneous injections or the intra-arterial pathway led to few positive fibers in the muscle periphery or surrounding the blood vessels. Muscles injected with Tat-eGFP showed intense labeling of the extracellular matrix (ECM), suggesting that, although Tat fusion proteins can transduce muscle fibers, their binding by components of the ECM surrounding myofibers could interfere with the intracellular transduction process.
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Affiliation(s)
- N J Caron
- Unité de Recherche en Génétique Humaine, Centre de Recherche du Centre Hospitalier de l'Université laval, Ste-Foy, Quebec, Canada G1V 4G2
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