Water Specific Therapy Halliwick (WSTH) : intérêt de la thérapie dans l’eau pour enfants paralysés cérébraux

The Halliwick method, created in England in 1949 by J. McMillan, engineer, who offered his services at the Halliwick swimming school for young girls cp, is based on the physical properties of water and consists of a program in ten points (TPP) for swimming initiation; WSTH is a learning engine in water which facilitates the management of the movements and activities of daily life on earth. It's in agreement with the normal motor development of the child, the levels of motor evolution (NEM), International Classification of Functioning, disability and health (ICF) proposed by the WHO in 2001 as well as with Huber's positive health (2011). Several scientific studies attest to the efficientness of the Halliwick method and of the WSTH on motor skills. Four field studies, published, compared WSTH to conventional aquatic therapy (CAT), randomized, in children with cp: (1) on spasticity (elbow/wrist/knee/ankle measurement), WSTH shows a decrease HS specifically on the wrist and ankle after WSTH; S results for CAT; (2) on the range of motion, the measurements show a S increase proximally, especially on the UE after WSTH; (3) on the active trunk recovery, the WSTH shows an action THS in th12, S in th8 and c7; NS in CAT; (4) on the head control, the results are, after WSTH, HS in flexion/extension/inclinations and S in rotations; they are NS for CAT.ConclusionThe Halliwick method and the WSTH have been proven to be efficient on motor skills; our 4 field studies show significantly better effects with WSTH – probably thanks to “its rotation points” – than with CAT.     

La passion du soin et du travail psychiques,un paradoxe ?

Is passion, a concept difficult to define, disturbing affect by its double emotional and representative dimension, “a normal pathological state”? It concerns any relation to an “object” that wants to occupy a considerable place in existence. Can a therapist be passionate or be crossed by passion? Whether it is cultural, artistic, sporting, passion can provoke, we know it well, a passionate outburst. How can one accept its necessity while being wary of its destructive side (mystical passion, delusional passion) where the subject ends up getting lost? Etymology may provide a partial response to the polysemy of the word that has created confusion. Passion comes from the Latin “passio” which refers to the fact of suffering, experiencing. The Greek root “pathos” gave pathology whose original meaning is the study of passions and then that of diseases, and also non-medical terms (pathetic…). The semantic confusion has been based on this for centuries. Passion remains difficult to pin down. What maintains my desire, my passion in this solitary work? I need to remain in the unceasing research, in the questioning. Here are the basics inscribed in me: reading, working meetings that bring pleasure to think while maintaining openness to the unconscious by better grasping the counter-transference, belonging to a society to share the same passion of human knowledge and the same desire to heal. Passions remain pervasive and some take up more space than the object of passion. This is one of the many paradoxes. An other: the passion, this “dark complacency to vertigo” (Paul Ricoeur), allows to alienate oneself in the bond to better find oneself, to recreate oneself. We cannot, escape knowledge about ourselves. Beyond its excess, constitutes a real psychic work of elaboration and symbolization. Let us keep alive this passion for psychic care and work. To do this, let us remain confident in our theoretic-clinical commitments as well as in the changes we deem necessary to help those who come to tell us about their suffering. Who are they? Interest in their own mental health is initially acquired for neurotic patients; it is legitimate and useful. With patients working on a psychotic register, this is not the case and we are faced with an obstacle cited by Marcel Sassolas, which is “the distrust developed by these people towards their own psychic activity”. The only real objective of psychiatric care remains the safeguarding and restoration of their psychic activity, knowing full well that being present is a source of danger. What maintains our desire for care and psychic work with the attention we pay to it? The way we work with the richness of the commitments it unders understands – psychoanalysis for me – allows us to understand the human in an exceptional and exciting way. Here are two of my tools. First empathy. It is a dialectic between understanding and feeling that manifests, occurs, in an unseeded manner at the level of the preconscious of one (therapist) or the other (patient). My other tool is this therapeutic device that is co-work (shared associative movement). Daniel Widlöcher's co-thought… The latter has taken up the Freudian concept of “induction of thought”. This allows him to link empathy, through “the transfer of thought”, to the associative and representational co-thinking of the therapist and the patient. What is this co-work? In psychoanalytic relaxation, for example, we know that a particular word, a phrase, a phoneme can have, for the relaxer, an emotional impact that is inscribed in his thought (reverie) and in his body (sensation). Passion allows creative psychic care by producing from living. It strengthens our need for new projects that boost our motivation and confidence. It maintains our desire to be at the heart of psychic work and that of transmitting that strength. Creativity is not the ability to create a work, it is the ability to creatively live a meaningful life (Winnicott). It is vitality in the service of self-building. Stay alive and passionate, even late in practice, not because of knowledge, experience, but because of the uninterrupted work in self-discovery. To conclude? I consider that a living therapeutic process, that is, subjective appropriation, implies a passionate character in the therapist who offers a place for what is to be deposited there. We are often in paradoxical situations. To better understand its scope, I rely on the Oxford Dictionary's definition: a paradox is an assertion that seems absurd, though maybe truly well-founded. It's all in the maybe. Isn’t the psyche that heals the psyche the passion of dialogue with our unconscious?     

Patterns and Correlates of Self-Reported Physical Activity in a Cohort of Racially Diverse Pregnant Adolescents

Study ObjectiveRegular physical activity (PA) during pregnancy decreases the risk of gestational hypertension and preeclampsia. Currently, little is known about the PA of pregnant adolescents. Our intent was to characterize the PA behaviors of a group of racially diverse, low-income pregnant teens and to identify potential determinants of PA.Design, Setting, Participants, and InterventionsA cohort of 157 racially diverse pregnant adolescents (13-18 years of age) completed up to 3 previous day PA recalls as part of a larger prospective longitudinal study on determinants of maternal and fetal bone health. Subjects self-reported activities from 7 AM to 11:30 PM, choosing from a list of 37 activities including a category for “other.” Subjects recorded activities in 30-minute intervals.Main Outcome MeasuresEstimated metabolic equivalent task (MET) values were assigned to each activity and summed for a measure of total daily PA in MET min/d. Determinants of PA were evaluated using a stepwise linear mixed effect model.ResultsThe average calculated MET min/d was 1478 ± 130. Significant determinants of MET min/d included race (P = .007), maternal age at conception (P = .042), gestational age (P = .002), and attending school (P < .001). Black teens were less physically active than white teens, and older teens were more active than younger teens; activity decreased throughout gestation, and teens currently attending school were more active.ConclusionPA is low across gestation and pregnant teens spent more than half of their monitored time in sedentary activities. Targeted interventions are needed to achieve current PA goals in this pediatric obstetric population.     

Objective and subjective measures of the neighbourhood environment: Associations with frailty levels

ObjectivesThe aim of this study was to investigate whether perceptions of the neighbourhood environment (NE) and objective measures of the NE were associated with frailty in older adults.MethodsA cross-sectional study in Adelaide, Australia, recruited a sample of 115 community-dwelling adults aged ≥60 years. Respondents’ perceptions of their NEs were assessed using the Neighbourhood Environment Walkability Scale (NEWS). An objective assessment of these NEWS survey questions was conducted using seven variables: residential density, land use mix diversity, street connectivity, accessibility, seasonal persistent green cover, road crash density and crime rate. Frailty was evaluated using the FRAIL (fatigue, resistance, ambulation, illnesses and loss of weight) scale. Multivariable linear regression analyses were employed to assess the associations between NEWS and frailty, and to assess the associations between objective neighbourhood variables and frailty.ResultsFrail and pre-frail older adults were more likely to live in areas with lower residential density, lower density of road crashes, and higher accessibility than robust participants. Additionally, a poorer perception of the overall environment, worse land-use mix and accessibility and worse crime safety were associated with frailty and pre-frailty after adjustment of covariates and objective GIS variables.DiscussionNeighbourhood characteristics, both objective and perceived, are associated with frailty levels in older adults, and that strategies to tackle frailty must consider the impact of the neighbourhood environment.     

Men with impaired glucose tolerance have lower self-rated health than men with impaired fasting glucose

AimPrevious studies have shown that individuals with impaired glucose tolerance (IGT) have lower self-rated health than normoglycaemic individuals. The aim of this study was to examine differences in self-rated health between individuals with IGT and those with impaired fasting glucose (IFG) and to consider the potentially mediating effect of physical activity.MethodsIn 2002–2005, a total of 2816 individuals were randomly selected for a population-based study in Sweden. All participants performed an oral glucose tolerance test (OGTT). Fasting venous blood samples were drawn, and questionnaires concerning lifestyles were completed. Self-rated health (SRH) and leisure time physical activity (LTPA) were reported on a five-graded and four-graded scale, respectively. A total of 213 individuals with IGT and 129 with IFG were detected.ResultsIGT, but not IFG, was associated with low self-rated health. The difference in self-rated health was seen particularly in men when adjusted for age and BMI (OR = 2.13, CI: 1.13–4.02, p = 0.020). The results became insignificant when including physical activity in the model (OR = 1.8, CI: 0.91–3.58, p = 0.094).ConclusionThe low self-rated health adds further weight to the risk profile in men with IGT and stresses the importance of early detection and lifestyle interventions.     

Bioactive A-ring rearranged limonoids from the root barks of Walsura robusta

Screening active natural products, rapid identification, and accurate isolation are of great important for modern natural lead compounds discovery¹. We hereby reported the isolation of seven new neotecleanin-type limonoids (17), seven new limonoids with 5-oxatricyclo[5.4.0.11., 4.]hendecane ring system (814), and two new precursors (1516) together with four known limonoids (1720) from the root barks of Walsura robusta. Their structures, including their absolute configurations, were elucidated based on analyses of HR-ESI-MS, 1D/2D NMR, ECD spectrum calculations and single-crystal X-ray diffraction techniques. Compounds 2, 8, 9, 11, 13, 14, 18 showed significant anti-inflammatory activities in LPS-induced RAW 264.7 cell line, BV2 microglial cells, and Propionibacterium acnes-stimulated THP-1 human monocytic cells. Walrobsin M (11) exhibited anti-inflammatory activity with IC₅₀ value of 7.96±0.36 μmol/L, and down-regulated phosphorylation levels of ERK and p38 in a dose-dependent manner.