Le moment de la crise d'opposition chez l'enfant à risque autistique : un tournant dans la construction psychique

ObjectiveTo contribute to the identification of clinical signs found during the follow-up of children at risk for autism and which reflect a progressive recognition of the other.MethodClinical observation of two autistic children followed from 3 to 5 year-olds in a Part-Time Therapeutic Health Center.ResultsAt the end of the second year of treatment, a discriminate search for the mother's attention and affection is observed, as well as specific reactions to separations and reencounters. Furthermore, when compared with the previous year, the two children present explosive oppositional behaviours which are different from the previous crises of anxious disorganization. This modification of the clinical picture leads us to think that in spite of the absence of verbal language, the rareness of vocalizations and the furtive visual exchanges, a certain recognition of the other in his or her proper characteristics is being built. At the same time it is postulated that this movement is accompanied by a psychic structuring in accordance with the works by A. Bullinger, E. Bick, D. Meltzer and G. Haag.ConclusionThe hypothesis of a pivotal role of the oppositional tantrums will need to be confirmed by other observations made in different clinical contexts.     

Early diagnosis of cancer by imaging: The primary care perspective

The United Kingdom (UK) performs relatively badly in cancer survival, much of which underperformance is attributed to delays in diagnosis. As a result, increased access to cancer diagnostics for general practitioners is proposed. Four cancer sites and their associated tests have been chosen: lung/chest X-ray, colorectal/colonoscopy, ovarian/trans-vaginal ultrasound and brain tumours/MRI scanning. This article elaborates on the need for these, which patients are likely to be chosen for investigation, and the effect this will have on radiology departments.     

Is the Gambling Motives Questionnaire really three-dimensional? A proposition of a four-dimensional Gambling Motives Questionnaire – Revised

The aim of the present study was to improve the weaknesses of the three-dimensional Gambling Motives Questionnaire and to examine the psychometric properties and factor structure of the Gambling Motives Questionnaire-Revised. The Gambling Motives Questionnaire was administered to a sample of 418 gamblers (92% men, mean age 19.5 years). Participants completed the Gambling Motives Questionnaire and an additional item tapping boredom, as well as a variety of measures of gambling behavior and gambling problems as criterion measures. Results showed that the Gambling Motives Questionnaire-Revised is better represented as a four-factor structure tapping the following four gambling motives factors; enhancement, coping, social, and self-gratification, Δχ² Δ(df) = 24.76 (3), p < 0.001. Removing two problematic items from the Gambling Motives Questionnaire and adding an extra item tapping boredom also improved the fit of the Gambling Motives Questionnaire-Revised. The subscales enhancement, social, and coping were all significant predictors of variety of gambling behaviors (p < 0.05), whereas enhancement, coping, and self-gratification predicted frequency of gambling behaviors (p < 0.01). Coping and self-gratification predicted loss of control (p < 0.01), whereas self-gratification predicted gambling problems (p < 0.001). The Gambling Motives Questionnaire – Revised, consisting of the four dimensions enhancement motives, social motives, coping motives and self-gratification motives, is a reliable and valid instrument to measuring gambling motives.     

Sex difference in the association between surrogate markers of insulin resistance and arterial stiffness

AimsTo investigate the predictive capability of insulin resistance surrogate markers for insulin resistance and arterial stiffness based on sex.MethodsWe assessed the association of triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C), visceral adiposity index (VAI), and lipid accumulation product (LAP) with homeostasis model assessment-insulin resistance (HOMA-IR) and brachial–ankle pulse wave velocity (baPWV) in both sexes.ResultsA total of 1720 men and 1098 women were evaluated. HOMA-IR showed good correlation with the TyG index (men: r = 0.47, women: r = 0.45), TG/HDL-C (men: r = 0.45, women: r = 0.41), VAI (men: r = 0.51, women: r = 0.48), and LAP (men: r = 0.55, women r = 0.49) (all p-values < 0.001). These markers positively correlated with increased baPWV in both sexes. The standardized partial regression coefficients were 0.11 and 0.14 for the TyG index, 0.13 and 0.16 for TG/HDL-C, 0.14 and 0.19 for VAI, and 0.12 and 0.17 for LAP in men and women, respectively (all p-values < 0.01; all p-values for sex interaction < 0.05).ConclusionsAll insulin surrogate markers showed good correlation with HOMA-IR in both sexes. These indices were also associated with increased baPWV and the associations were stronger in women than in men.     

The use of cluster analysis to identify different burnout profiles among nurses and care assistants for older adults

The twofold purpose of this study was to identify specific burnout patterns among nurses and care assistants for older people, and to determine whether these profiles differ according to socioprofessional variables.A sample of 279 healthcare professionals completed an online survey comprising the Maslach Burnout Inventory and socioprofessional items. Cluster analysis identified five profiles on a burnout-engagement continuum. Participants with the Engaged profile had low scores on all three burnout dimensions (p < .001), while those with the Burnout profile had high scores on all three dimensions (p < .001). Three intermediate profiles were described. The Disconnected profile was characterized by higher depersonalization (p < .001), the Overextended profile by high emotion exhaustion (p < .001), and the Ineffective profile by low personal accomplishment (p < .001). Less experienced professional caregivers were more prone to burnout in terms of depersonalization (p < .01), while more experienced professional caregivers tended to have an ineffective burnout profile (p < .01). Identifying profiles of burnout symptoms can help to develop personalized interventions.     

Internet-delivered psychoeducation for older adolescents and young adults with autism spectrum disorder (SCOPE): An open feasibility study

BackgroundThere is a paucity regarding interventions in general, and especially internet-delivered treatment options, for adolescents and young adults with autism spectrum disorder (ASD), despite the group´s capacity and willingness to utilize computer-mediated communication. This open feasibility study evaluated the new internet-delivered, psychoeducational intervention, SCOPE (Spectrum COmputerized PsychoEducation), for adolescents and young adults aged 16–25 years with ASD in the normative IQ range.MethodThe participation in SCOPE was facilitated by weekly contacts with disability service professionals (trained coaches) and the intervention consisted of eight ASD-themed modules. In an open feasibility study we evaluated treatment completion, treatment credibility and satisfaction, as well as preliminary efficacy. We assessed feasibility in an outpatient disability services context, regarding both participants’ and coaches’ experiences.ResultsTwenty-three out of the 29 included participants (79%) completed the intervention. The participants’ experience of treatment credibility was increased during the SCOPE web course and the overall satisfaction with the treatment was high. The coaches reported high treatment credibility and good clinical feasibility of the internet-based delivered intervention. The participants’ knowledge of ASD increased significantly from pre-intervention to post-intervention. The increased knowledge of ASD was not associated with negative effects on psychological well-being.ConclusionsOur results suggest that the internet-delivered psychoeducational intervention SCOPE is a feasible intervention and could contribute to youth’s sense of empowerment through increased knowledge of ASD and themselves. An ongoing randomized controlled study will generate further evidence concerning the SCOPE intervention.     

Grey matter volume abnormalities in patients with bipolar I depressive disorder and unipolar depressive disorder:a voxelbased morphometry study

Bipolar disorder and unipolar depressive disorder(UD) may be different in brain structure. In the present study,we performed voxel-based morphometry(VBM) to quantify the grey matter volumes in 23 patients with bipolar I depressive disorder(BP1) and 23 patients with UD,and 23 age-,gender-,and educationmatched healthy controls(HCs) using magnetic resonance imaging. We found that compared with the HC and UD groups,the BP1 group showed reduced grey matter volumes in the right inferior frontal gyrus and middle cingulate gyrus,while the UD group showed reduced volume in the right inferior frontal gyrus compared to HCs. In addition,correlation analyses revealed that the grey matter volumes of these regions were negatively correlated with the Hamilton depression rating scores. Taken together,the results of our study suggest that decreased grey matter volume of the right inferior frontal gyrus is a common abnormality in BP1 and UD,and decreasedgrey matter volume in the right middle cingulate gyrus may be specifi c to BP1.     

Total-and lipid-associated sialic acid in serum and thrombocytes in patients with chronic heart failure

ObjectivesTo investigate and discuss the total-, lipid-associated, and thrombocyte-sialic acid levels in chronic heart failure (CHF) patients.Design and methodsThirty-one chronic heart failure patients and 38 healthy controls were included in the study. Serum total sialic acid (TSA), lipid associated sialic acid (LASA), thrombocyte sialic acid (TrSA) were determined together with the traditional inflammation and prognostic markers.ResultsSerum TSA levels were significantly higher in patient group (3.08 ± 0.33 mmol/L) than control group (2.60 ± 0.17 mmol/L). Serum LASA, homocysteine, high-sensitivity CRP, brain natriuretic peptide and erythrocyte sedimentation rate were also significantly higher in patient group. TrSA levels were not significant between the groups.ConclusionTSA and LASA levels increase in CHF, independent from coronary artery disease. TrSA levels were not found to be a prognostic or valuable marker for CHF patients. Acute phase response and lipid associated portions of SA are thought to be responsible for SA rise in CHF.