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Le CIRANO et le Centre de recherches mathématiques sont partenaires d’En avant math !, une initiative d’envergure nationale pour promouvoir les mathématiques et accroître la numératie. Depuis trois ans, plusieurs travaux ont permis d'identifier des pistes de solutions afin d'assurer le développement d'une main-d'œuvre hautement qualifiée en mathématiques appliquées et favoriser une meilleure adéquation entre les compétences des personnes et les besoins du marché du travail, particulièrement dans les secteurs des sciences, de la technologie, de l'ingénierie et des mathématiques (STIM). Les auteurs présentent ici les principaux enseignements et recommandations qui se dégagent des travaux de la première phase d’En avant math !.

Ce rapport présente une revue de littérature visant à mieux cerner la notion de numératie pour en extraire ses principaux attributs. Cette revue permet une meilleure compréhension de ce qu’est la numératie et amène une réflexion nouvelle qui peut servir à orienter le design de ressources pour la numératie tout en mettant en valeur les caractéristiques et les spécificités de la culture mathématique du Québec.

Le présent rapport porte sur les résultats de l’analyse des expériences en numératie de cinq pays: le Royaume-Uni, l’Australie, le Canada avec deux juridictions, le Québec et l’Ontario, Singapour et la France. Le récit de chaque expérience en numératie est articulé autour des cadres, institutions, programmes et projets ainsi que les ressources dont le pays s’est doté. Pour ce faire, nous avons consulté divers documents, articles, rapports d’études, sites web officiels, etc. Ce projet nous a permis de dresser un portrait des différentes approches et des différentes interventions adoptées par certains pays pour appréhender une problématique complexe et une compétence de plus en plus définie comme une compétence de base et essentielle.

Highlight Musculoskeletal cystic echinococcosis can present as an isolated disease mimicking neoplasia. Along with albendazole therapy, complete excision avoiding cyst rupture is essential to prevent disease dissemination and hypersensitivity reactions. Conventional epidemiology and molecular typing can help differentiate between domestic and sylvatic strains of echinococcosis in the traveler and migrant population.

Mycobacterium africanum is an important cause of human tuberculosis and is found almost exclusively in West Africa. We identified a cluster of patients in Montreal, Canada, with M africanum disease that share identical genotypic signatures by mycobacterial interspersed repetitive unit-variable number tandem repeat (MIRU-VNTR) typing and a putative epidemiological link, thus providing evidence of possible local transmission of M africanum in Montreal over a 10-year period.

Background Whole genome sequencing (WGS) studies can enhance our understanding of the role of patients with asymptomatic Clostridium difficile colonization in transmission. Methods Isolates obtained from patients with Clostridium difficile infection (CDI) and colonization identified in a study conducted during 2006 - 2007 at six Canadian hospitals underwent typing by pulsed-field gel electrophoresis, multilocus sequence typing, and WGS. Isolates from incident CDI cases not in the initial study were also sequenced where possible. Ward movement and typing data were combined to identify plausible donors for each CDI case, as defined by shared time and space within predefined limits. Proportions of plausible donors for CDI cases that were colonized, infected, or both were examined. Results Five hundred and fifty-four isolates were sequenced successfully, 353 from colonized and 201 from CDI cases. The NAP1/027/ST1 strain was the most common strain, found in 124 (62%) of infected and 92 (26%) of colonized patients. A donor with a plausible ward link was found for 81 CDI cases (40%) using WGS with a threshold of ≤2 single nucleotide variants to determine relatedness. Sixty-five (32%) CDI cases could be linked to both infected and colonized donors. Exclusive linkages to infected and colonized donors were found for 28 (14%) and 12 (6%) CDI cases, respectively. Conclusion Colonized patients contribute to transmission, but CDI cases are more likely linked to other infected patients than colonized patients in this cohort with high rates of NAP1/027/ST1 strain, highlighting the importance of local prevalence of virulent strains in determining transmission dynamics.

Background Clostridium difficile (CD) is the leading cause of health care–associated diarrhea and can result in asymptomatic carriage. Rates of asymptomatic CD colonization on hospital admission range from 1.4%-21%. The objective of this study was to evaluate host and bacterial factors associated with colonization on admission. Methods The Consortium de recherche quebecois sur le Clostridium difficile study provided data for analysis, including demographic information, known risk factors, and potential confounding factors, prospectively collected for 5,232 patients from 6 hospitals in Quebec and Ontario over 15 months from 2006-2007. Stool or rectal swabs were obtained for culture on admission. Pulsed-field gel electrophoresis was performed on the isolates. The presence of antibody against CD toxins A and B was measured. Results There were 212 (4.05%) patients colonized with CD on admission, and 5,020 patients were not colonized with CD. Multivariate logistic regression analysis showed that hospitalization within the last 12 months, use of corticosteroids, prior CD infection, and presence of antibody against toxin B were associated with colonization on admission. Of patients colonized on admission, 79.4% had non-NAP1, non-NAP2 strains. Conclusion There are identifiable risk factors among asymptomatic CD carriers that could serve in their detection and provide a basis for targeted screening.

Clostridium difficile infection is the leading cause of health care-associated diarrhea, and the bacterium can also be carried asymptomatically. The objective of this study was to identify host and bacterial factors associated with health care-associated acquisition of C. difficile infection and colonization.We conducted a 15-month prospective study in six Canadian hospitals in Quebec and Ontario. Demographic information, known risk factors, potential confounding factors, and weekly stool samples or rectal swabs were collected. Pulsed-field gel electrophoresis (PFGE) was performed on C. difficile isolates to determine the genotype. Levels of serum antibodies against C. difficile toxins A and B were measured.A total of 4143 patients were included in the study; 117 (2.8%) and 123 (3.0%) had health care-associated C. difficile infection and colonization, respectively. Older age and use of antibiotics and proton-pump inhibitors were significantly associated with health care-associated C. difficile infection. Hospitalization in the previous 2 months; use of chemotherapy, proton-pump inhibitors, and H(2) blockers; and antibodies against toxin B were associated with health care-associated C. difficile colonization. Among patients with health care-associated C. difficile infection and those with colonization, 62.7% and 36.1%, respectively, had the North American PFGE type 1 (NAP1) strain.In this study, health care-associated C. difficile infection and colonization were differentially associated with defined host and pathogen variables. The NAP1 strain was predominant among patients with C. difficile infection, whereas asymptomatic patients were more likely to be colonized with other strains. (Funded by the Consortium de Recherche sur le Clostridium difficile.).

Background. An increase in the incidence and severity of Clostridium difficile-associated disease in Quebec and the United States has been associated with a hypervirulent strain referred to as North American pulsed-field type 1 (NAP1)/027. Methods. In 2005, a prospective study was conducted in 88 Quebec hospitals, and 478 consecutive nosocomial isolates of C. difficile were obtained. The isolates were subjected to pulsed-field gel electrophoresis (PFGE) typing, antimicrobial susceptibility testing, and detection of binary toxin genes and tcdC gene deletion. Data on patient age and occurrence of complications were collected. Results. PFGE typing of 478 isolates of C. difficile yielded 61 PFGE profiles. Pulsovars A (57%), B (10%), and B1 (8%) were predominant. The PFGE profile of pulsovar A was identical to that of strain NAP1. It showed 67% relatedness with 15 other PFGE patterns, among which 11 had both binary toxin genes and a partial tcdC deletion but different antibiotic susceptibility profiles. Pulsovars B and B1 were identical to strain NAP2/ribotype 001. In hospitals showing a predominant clonal A or B-B1 PFGE pattern, incidence of C. difficile-associated disease was 2 and 1.3 times higher, respectively, than in hospitals without any predominant clonal PFGE pattern. Severe disease was twice as frequent among patients with strains possessing binary toxin genes and tcdC deletion than among patients with strains lacking these virulence factors. Conclusions. This study helped to quantify the impact of strain NAP1 on the incidence and severity of C. difficile-associated disease in Quebec in 2005. The identification of the geographic dissemination of this predominant strain may help to focus regional infection-control efforts. Several studies conducted in Quebec and the United States reported a recent increase in the incidence of Clostridium difficile-associated diarrhea (CDAD), with an accompanying increase in the proportion of patients having severe complications and experiencing frequent relapses (1-4). These outbreaks were associated with a predominant strain referred to as North American

In the spring of 2000, the Inuit community and the Kativik School Board were pondering the difficulties encountered by students in mathematics and the measures that could be taken to help these students. One significant fact that it seemed might help explain these difficulties was that Inuit students learn Inuit mathematics (for example, a base‐20 numeral system) in their own language in the first three years of their schooling and then go on to study in either French or English. A collaboration between researchers, teachers from the Inuit community, and curriculum developers was established. In this article, we present facets of the environment, language, and culture of the Inuit that influenced the development of the Inuit numeration system, their ways of measuring (length, distance, time, etc.), and their great aptitude in spatial representations. We then discuss the current collaborative project that aims at the development of teaching situations adapted to Inuit classrooms.

Les auteurs exposent les composantes d'un modèle de recherche collaborative lié à une certaine façon de faire de la recherche «avec» plutôt que «sur» les praticiens. C'est sous l'angle de la double fonction de recherche et de formation, à concilier dans la démarche collaborative, que leur modèle est abordé. Le texte situe historiquement l'émergence de l'idée de collaboration de recherche en éducation et présente les trois facettes complémentaires du modèle: a) une définition conceptuelle du modèle conduit à préciser le sens donné aux notions de recherche et de formation; b) le modèle est illustré par une description de cinq projets différents basés sur une démarche collaborative commune; c) une lecture transversale des cinq projets conduit à discuter des composantes du modèle., The authors present the components of a collaborative research model related to research «with» rather that «about» educators. This model is presented within the dual function of research and training that is part of the collaborative process. This article presents a historical review of the emergence of collaborative research in education and three aspects of the model: a) a conceptual definition of the model which explains the concepts of training and research; b) the model is illustrated through a description of five projects using a common collaborative process; c) an examination of these five projects which leads to a discussion of the model's components., Los autores exponen los componentes de un modelo de investigación llamado «colaborativo», el cual tiene como objetivo realizar estudios «con» docentes y no «sobre» ellos. El modelo elaborado toma en cuenta la doble función de investigación y de formación que debe tener toda perspectiva colaborativa. El texto situa historicamente la emergencia de la idea de colaboración en la investigación y presenta tres facetas complementarias del enfoque: a) una definición conceptual que conduce a clarificar el sentido dado a las nociones de investigación y de formación; b) una descripción de cinco proyectos diferentes basados en una concepción colaborativa común; c) una lectura transversal de los cinco proyectos que permite analizar los componentes del modelo propuesto., Die Autoren stellen in ihrem Beitrag die verschiedenen Bauelemente eines auf Kollaboration ausgerichteten Forschungsmodells vor, dessen Ziel es ist, nicht «über», sondern «mit» den Praktikanten zu arbeiten. Das Modell wird vor allem unter dem Aspekt einer doppelten Funktion (nämlich Forschung und Ausbildung) betrachtet, die im Rahmen der Zusammenarbeit erfüllt werden soll. Zunächst erinnern die Autoren an die historischen Anfänge, an das Aufkommen der Idee einer Zusammenarbeit in der Bildungsforschung; dann werden drei weitere Charakteristika des Modells hervorgehoben: a) eine konzeptuelle Definition des Modells führt zu einer Präzisierung der Begriffe «Forschung» und «Ausbildung», b) das Modell wird konkretisiert an Hand von fünf Projekten, die auf Zusammenarbeit basieren, c) eine Diagonallektüre der fünf Projekte führt zu einer Diskussion über die verschiedenen Bauelemente des Modells.

New broth-based detection systems have higher recovery rates of mycobacteria from clinical specimens than traditional cultures on solid media. The clinical significance of this higher sensitivity rate is largely unknown. We prospectively evaluated the performances of two liquid media detection systems (the MB/BacT system and the BACTEC 460 TB system) and an egg-based Lowenstein-Gruft solid medium (LG) on the recovery rates of mycobacteria from 849 clinical specimens. Mycobacteria (other then M. gordonae) were detected in 51 (6.0%) specimens. In 12/51 (23%) specimens, mycobacteria (five mycobacterium tuberculosis (MtB) and seven non-M tuberculosis complex (MOTT) were recovered only from the broth-based systems. Review of the patients' clinical charts revealed that failure of LG to recover Mtb were due to nonmycobacterial overgrowth and antibiotic treatment. The recovered MOTT were all clinically nonsignificant. Higher sensitivity of broth-based mycobacteria detection systems is largely due to their capability to recover mycobacteria from treated tuberculous patients or from partially decontaminated specimens. The high recovery rates of nonclinically significant MOTT could potentially increase inappropriate use of antibiotics.

Fit factor studies for an air-supplied blouse (blouse) and an air hood respirator (air hood) were conducted by Lawrence Livermore National Laboratory. Nine test subjects were used to test the blouse. Three subjects were used to test the air hood. Exercises conducted in the test chamber included touching toes, raising both arms overhead, squatting, twisting at the torso while holding a rod, and running in place. Both the air hood and blouse were tested with 8 ft3/min air supply. Both respirators were worn in a test chamber. The blouse provided a fit factor of greater than 40,000. The air hood, for nearly all tests, also provided a fit factor greater than 40,000 when worn correctly. Fit factors were also measured for improperly worn air hoods.

Primary renal mucormycosis is a rare infection capable of acute illness with sepsis. Few cases have been reported. We report a case of an acute primary renal mucormycosis and review the published reports. The incidence of primary renal mucormycosis has risen in recent years. The most frequently reported underlying predisposing disorders are human immunodeficiency virus infection, intravenous drug abuse, and diabetes mellitus. Primary renal mucormycosis should be suspected in patients with an immunocompromising illness or particular risk factors, when persistent flank pain and fever with sterile urine not responding to appropriate antibiotics are associated with enlarged heterogeneous kidneys.

Clostridium difficile isolates from a 2004 outbreak in Québec, Canada, were all found to be susceptible to metronidazole, vancomycin, rifampin, and meropenem but resistant to bacitracin, cefotaxime, ciprofloxacin, and levofloxacin, and most (>80%) were resistant to ceftriaxone, clarithromycin, gatifloxacin, and moxifloxacin. The predominant NAP1 isolates were susceptible to clindamycin, while the NAP2 isolates were resistant.

In his final works, Piaget suggested formalizing the developmental processes operating in different fields in terms of the mathematical theory of morphisms and categories. This new approach is used to

In the world of infectious diseases, the confidence of the 1960s and 1970s has given way to a stark realization that our mastery of the microbial world is not absolute — as the emergence of SARS and of avian influenza has illustrated. The current outbreak of Clostridium difficile associated

During the past few years, the incidence of invasive group A Streptococcus (GAS) infection has been increasing. However, there are presently no clear recommendations regarding antibiotic prophylaxis for close contacts of index patients. The aims of this study were 1) to determine the prevalence of carriage of the same GAS strain as the patient's among contacts of patients with invasive infections and 2) to assess the importance of exposure duration. From March 1995 to March 1996, the authors prospectively included in the study all patients with invasive GAS infection, as defined by the Working Group on Severe Streptococcal Infections, who came to Hopital Maisonneuve-Rosemont in Montreal, Quebec, Canada. An epidemiologic investigation was systematically carried out for each index case. Contacts were divided into two groups: those who had spent 24 hours or more with the index patient during the week preceding the beginning of his or her illness and those who had spent 12-24 hours with the index patient during that week. Strains of GAS were examined by serotyping (proteins M and T and the presence or absence of the serum opacity factor) and by characterization of streptococcal pyrogenic exotoxins (exotoxins A, B, and C). One hundred and two contacts of 17 index cases with invasive GAS infection were systematically screened. Contacts were considered positive if they carried the same strain of the bacterium and the same streptococcal pyrogenic exotoxin as the index case. Among the contacts who had spent at least 24 hours per week with their respective index cases, 13 out of 48 (27%) were found to be harboring the same serotype of GAS as the index patient (95% confidence interval 14.5-39.5). By comparison, only one of the 54 contacts in the 12- to 24-hour group (1.8%) was found to be carrying the same strain of the bacterium (95% confidence interval 0-5.3). This difference between the two groups was statistically significant (p

2 (2%) patients developed other fungal related problems. One patient developed oral candidiasis treated with micafungin. One patient had splenic leisons (presumed fungal) treated with treatment dose posaconazole and improved. None of these patients had aGVHD at time of IFI diagnosis. None of these patients died of fungal related causes. 4 out of 5 patients were alive at last follow up. One died of relapse. Conclusion: Micafungin followed by posaconazole is effective as primary IFI prophylaxis in unrelated donor HCT.

The aim of this study was to evaluate the performance of a simple and inexpensive homemade urea test (U-test) to detect Helicobacter pylori in upper digestive tract biopsies. We tested and compared the U-test with three other diagnostic methods: the Clo-test, and culture and pathology in 110 patients randomly chosen at the endoscopy clinic. When using culture and/or pathology as the "gold standard," H. pylori was found to exist in 54 patients. Pathology was positive in 50 cases (92.5%), culture in 49 (90.7%), the U-test in 45 (83.3%), and the Clo-test in 43 (79.6%). With regard to culture pathology, the sensitivities of the U-test and the Clo-test were 83.3% and 79.5%, respectively. Specificity was 100% for both methods. The kappa coefficient calculation between the U-test and the Clo-test was 0.98. The results show that the U-test is a reliable, fast, and inexpensive method for detecting H. pylori in upper gastrointestinal biopsies.

For the last several years our studies have been concerned with the social analysis of the development of mathematical knowledge in children.(Bednarz & DufourJanvier, 1988; Dufour-Janvier, Bednarz, 1989; Bedoarx, Poirier & Bacon, 1992; Bednarz, 1991; Bednarz, Janvier, Poirier & Bacon, 1993).

Diabetic foot infections represent a major complication for patients affected by diabetes mellitus. In Ontario, Canada, 45% of all amputations of a lower extremity occur in persons with diabetes.[1] This complication represents a considerable physical, psychological and financial cost. Diabetic foot infections generally involve a mixed bacterial flora, which includes aerobic Gram-positive and Gram-negative bacteria and anaerobic micro-organisms. New quinolones such as trovafloxacin, which has a broad spectrum of activity, may become very useful for treating foot infections in patients with diabetes. Themain objectives of this studywere to determine the in vitro activity of new quinolones against microorganisms isolated from patients with diabetic foot infections, and to compare the activity of new quinolones such as trovafloxacin with antibacterials commonly used in the treatment of such infections.

Cet article a pour objectif d’illustrer un aspect du constructivisme, l’apport des interactions entre pairs dans l’enseignement des mathématiques. L’expérimentation s’est tenue dans une classe d’accueil du deuxième cycle du primaire. Après avoir présenté la problématique de la classe d’accueil et la théorie sous-jacente à l’approche, nous verrons comment, lors d’une séquence d’enseignement sur les fractions, s’est installée une culture de classe basée sur la discussion, l’argumentation, la négociation entre les élèves permettant à ces derniers de développer le sens de la fraction tout en approfondissant leur connaissance du français. Des extraits d’échanges entre élèves viendront illustrer nos propos., This article is intended to illustrate one aspect of constructivism: the contribution of interactions between peers in the teaching of mathematics. The experiment was carried out in an integration class in the second cycle at the elementary level. After introducing the problem at the integration class and the theory underlying the approach, we shall see how, during the teaching of fractions, a class culture was developed, based on discussion, arguments and negociations among the students. This allowed them to comprehend the meaning of fractions while increasing their knowledge of French. Extracts from inter-student exchanges will serve to illustrate our text., Este artículo tiene como objetivo ilustrar un aspecto del constructivismo: la aportación de las interacciones entre pares en la enseñanza de las matemáticas. La experimentación se realizó en una clase de integración de alumnos inmigrantes del segundo ciclo de primaria. Debutaremos presentando la problemática específica de las clases de integración y de la teoría subyacente para después ver cómo, durante un periodo de enseñanza de las fracciones, se instaló un cultura de clase basada en la discusión, la argumentación y la negociación entre los alumnos, lo que les permitió desarrollar el significado de la fracción al mismo tiempo que mejoraban su conocimiento del francés. Algunos extractos de diálogo entre los alumnos ilustrarán nuestro tema.