1,721,031 research outputs found
Transcultural adaptation and validation of the Pediatric Stroke Outcome Measure - summary of impressions (PSOM-SOI) into French
No full textObjectiveTo translate and validate a French version of the Pediatric Stroke Outcome Measure - summary of impressions (PSOM-SOI), for application in a population of French children after neonatal arterial ischemic stroke (NAIS). The PSOM measures deficiency of body functions and structures. On completion of this examination, the PSOM-SOI was developed containing and scoring 5 subscales: right sensorimotor, left sensorimotor (each with subcategories), language production, language comprehension and cognitive/behavioral.Materials/patients and methodsThe PSOM-SOI was translated into French and then, interobserver agreement of the tool was measured using weighted kappa in a multicenter cohort study of children 7 years after neonatal arterial ischemic stroke (NAIS). 2 raters scored retrospective PSOM-SOI from medical records and validated scales for each subscales.Results69 children (mean age = 7.0 years) were recruited. Interobserver agreement was substantial for items B and C, i.e. production and comprehension language deficits [k = 0.71 (95% CI = 0.57 to 0.83); k = 0.70 (95% CI = 0.55 to 0.82) respectively]; moderate for items A and D, i.e. sensorimotor and cognitive/behavioural deficits [k = 0.47 (95% CI = 0.34 to 0.60); k = 0.52 (95% CI = 0.36 to 0.67) respectively] and slight for the total score [k = 0.19 (95% CI = 0.08 to 0.30)].Discussion/conclusionThe PSOM-SOI can be used to reliably grade neurological examination for children following a stroke, besides raters with different level of clinical experience. However, additional development and validation work is required using a clinical exam to improve the prospective validation of the complete PSOM
Additional validation study and French cross-cultural adaptation of the Pediatric Stroke Outcome Measure–Summary of Impressions (PSOM-SOI)
No full textBackground: The Pediatric Stroke Outcome Measure-Summary of Impressions (PSOM-SOI) measures neurological function across right and left sensorimotor domains (Item A), language production (Item B), language comprehension (Item C), and cognition/behaviour (Item D). Objective: This study was a cross-cultural adaptation into French of the PSOM-SOI and an assessment of its reliability and limitations of use. Material and Methods: The translation and adaptation of the PSOM-SOI was followed by the assessment of its reliability in a cohort of 69 children with diagnosed acute neonatal arterial ischemic stroke. Three independent raters retrospectively scored the PSOM-SOI based on data from in-person neurological examination and results of standardized tests performed at age 7 in the cohort database. Comparison 1 (C1) involved a less experienced rater and an experienced rater and comparison 2 (C2) involved 2 experienced raters. Inter-rater reliability (IRR) was measured with Kappa coefficients. Results: The cross-cultural adaptation was easily performed, and no rater had difficulties using the French PSOM-SOI. The IRR was better in C1 than C2. For Item A, the agreement in C1 (κ = 0.47) and C2 (κ = 0.44) was moderate. The C1 agreement was substantial for Items B (κ = 0.71) and C (κ = 0.70); the C2 agreement was fair for Item B (κ = 0.23) and slight for Item C (κ = 0.16). For Item D, the agreement was moderate in C1 (κ = 0.52) and fair in C2 (κ = 0.35). In all but one comparison, agreement or minor disagreement (≤ 0.5 points) was obtained for more than 90% of the item scores. Regarding the total score, agreement for normal function (≤ 0.5) versus abnormal function (> 0.5) was achieved for 90% in C1 and 67% in C2. Conclusion: The IRR of the French PSOM-SOI gave variable results depending on the item and rater's experience, but the extent of disagreements was minor for individual items and total score. Additional prospective validation studies using the French PSOM-Short Neurological Exam to score the PSOM-SOI are needed. A dichotomised total score (cut-off ≤ 0.5) could be used to define normal function versus poor outcome.</p
Oculomotricity following moderate to severe traumatic brain injury in children and adults : prevalence of disorders and symptoms : Results of the SiMPly Rehab study
No full textLe traumatisme crânien (TC) est un problème majeur de santé publique. Les troubles oculomoteurs, vestibulo-oculaires et de l’équilibre sont fréquents après un TC léger, mais ont été très peu étudiés après TC modéré ou sévère. Cette thèse s’inscrit au sein d’un consortium international (Canada, Israël, France). L’objectif principal était d’évaluer cliniquement l’existence de troubles oculomoteurs (alignement oculaire, qualité de la poursuite et des saccades, convergence et vision stéréoscopique) et des symptômes associés, à la phase initiale d’un TC modéré ou sévère de l’enfant et de l’adulte. Les objectifs secondaires étaient d’étudier (1) les facteurs (démographiques, médicaux, sévérité du TC) associés à la présence de ces troubles, (2) la congruence entre troubles et symptômes. Les résultats portent sur les 59 patients français (95% TC sévères, 76% sexe masculin, 46% enfants, âge au TC 20 ans (DS=9 ; 6-55), durée coma 8 jours (DS=7), délai post-TC 109 jours (DS=44), troubles moteurs 39%). Des troubles oculomoteurs étaient présents chez tous les patients sauf 2 (83% altération saccades, 67% anomalie de poursuite oculaire avec intrusion de saccades, 55% insuffisance convergence, 42% défaut d’alignement oculaire, 20% anomalie de vision stéréoscopique). La fréquence des plaintes visuelles était faible. Très peu d’associations statistiquement significatives entre les anomalies oculomotrices, la symptomatologie et les questionnaires ont été retrouvées. En conclusion, une atteinte de l’oculomotricité est très fréquente après un TC sévère, contrastant avec une symptomatologie faible. Un dépistage systématique et la prise en charge de ces troubles sont donc nécessaires.Traumatic Brain Injury (TBI) is a major public health issue. Oculomotor, vestibulo-ocular and balance disorders are common following mild TBI, but have been poorly studied after moderate or severe TBI. This thesis is part of an international multicentric project involving three countries (Canada, Israel, France). The main objective of this thesis was to clinically evaluate the existence of oculomotor disorders (ocular alignment, quality of smooth pursuit and saccades, convergence and stereoscopic vision) and associated symptoms in the initial phase after moderate to severe TBI in children and adults. Secondary objectives were to study (1) the factors (demographic, medical, TBI severity) associated with the presence of these disorders, (2) the congruence between disorders and symptoms. The results of this thesis concern the 59 French patients (95% severe TBI, 76% male, 46% children, age at injury 20 years (SD=9; 6-55), length of coma 8 days (SD=7), time since injury 109 days (SD=44)). Results of the oculomotor assessment indicated presence of at least one oculomotor deficit in all patients but 2 (83% alteration of saccades, 67% anomaly of smooth pursuit with intrusion of saccades, 55% convergence insufficiency, 42% ocular misalignment, 20% lack of stereoscopic vision). Visual complaints frequency was low. Very few statistically significant associations between oculomotor abnormalities, symptoms and questionnaires were found. To conclude, following severe TBI, oculomotor impairments are very frequent, contrasting with few complaints and symptoms. Thus, systematic screening and management of these disorders are necessary
Quality of survival assessment in European childhood brain tumour trials, for children aged 5 years and over
No full textIntroductionThere is increasing recognition of the long-term sequelae of brain tumours treated in childhood. Five year survival rates now exceed 75% and assessing the quality of survival (QoS) in multiple domains is essential to any comparison of the benefits and harms of treatment regimens.AimThe aim of this position statement is to rationalise assessments and facilitate collection of a common data set across Europe. Sufficient numbers of observations can then be made to enable reliable comparisons between outcomes following different tumour types and treatments.MethodsThis paper represents the consensus view of the QoS working group of the Brain Tumour group of the European Society of Paediatric Oncology regarding domains of QoS to prioritise for assessment in clinical trials. This consensus between clinicians and researchers across Europe has been arrived at by discussion and collaboration over the last eight years.ResultsAreas of assessment discussed include core medical domains (e.g. vision, hearing, mobility, endocrine), emotion, behaviour, adaptive behaviour and cognitive functioning.ConclusionsA ‘core plus’ approach is suggested in which core assessments (both direct and indirect tests) are recommended for all clinical trials. The core component is a relatively brief screening assessment that, in most countries, is a sub-component of routine clinical provision. The ‘plus’ components enable the addition of assessments which can be selected by individual countries and/or tumour-, age-, and location-specific groups. The implementation of a QoS protocol common to all European clinical studies of childhood brain tumours is also discusse
Exploring the use of CO-OP approach with children and teenagers with executive functions deficits following acquired brain injury
No full textLes lésions cérébrales acquises dans l'enfance sont à l'origine de troubles moteurs, cognitifs et comportementaux invalidants, ayant des conséquences sévères sur le développement ultérieur de l'autonomie et des apprentissages. Parmi les troubles cognitifs, les troubles des fonctions exécutives sont parmi les plus fréquents et invalidants, avec des conséquences majeures sur le développement de l'autonomie et le déroulement de la scolarité. A ce jour, peu de méthodes de rééducation des conséquences des troubles des fonctions exécutives chez cette population ont été scientifiquement validées. L'approche métacognitive de résolution de problème Cognitive Orientation to daily Occupational Performance (CO-OP) pourrait être une piste intéressante de rééducation. L’objectif principal de cette thèse était d’évaluer l'amélioration de la performance occupationnelle consécutive à une rééducation par l'approche CO-OP chez des enfants/jeunes présentant des troubles des fonctions exécutives suite à une lésion cérébrale acquise. Les objectifs secondaires se déclinaient en trois volets : (1) Mesurer la généralisation et le transfert des acquis dans la vie quotidienne ; (2) Recueillir l’expérience des proches-aidants dans l’accompagnement du participant dans le processus CO-OP en dehors des sessions de rééducation ; (3) Établir le profil des pratiques éducatives parentales et identifier s’il existe un lien entre ces pratiques et l’engagement des proches. Les travaux menés ont permis de montrer des améliorations significatives, qui se maintiennent dans le temps, dans la réalisation des objectifs choisis par les participants et la perception de la performance et de la satisfaction occupationnelle. Les résultats du deuxième volet de l’étude suggèrent que CO-OP permet le transfert des compétences acquises lors de l’intervention vers de nouvelles activités, non entraînées spécifiquement en rééducation. Le recueil de l’expérience des proches-aidants a mis en lumière la nature évolutive de la maîtrise de CO-OP, tant pour les proches-aidants que pour les jeunes. De plus, l'engagement semble être un facteur clé pour faciliter cette progression, tant pour les jeunes que pour les personnes qui les accompagnent.Acquired brain injury in childhood are the cause of disabling motor, cognitive and behavioral deficits, with severe consequences for the subsequent development of autonomy and learning. Among cognitive deficits, executive function deficits are among the most frequent and disabling, with major consequences for the development of autonomy and the progress of schooling. To date, few methods for rehabilitating the consequences of executive function deficits in this population have been scientifically validated. The metacognitive problem-solving approach Cognitive Orientation to daily Occupational Performance (CO-OP) could be an interesting approach for rehabilitation. The aim objective of this thesis was to evaluate the improvement in occupational performance following rehabilitation using the CO-OP approach in children/youth with executive function deficits following an acquired brain injury. The secondary objectives were threefold: (1) To measure the generalization and transfer of learning into everyday life; (2) To gather the experience of care partners in accompanying the participant in the CO-OP process outside rehabilitation sessions; (3) To profile parental educational practices and identify whether there is a link between these practices and family caregiver involvement. The work carried out showed significant improvements, which were maintained over time, in the achievement of the goals chosen by the participants and in the perception of occupational performance and satisfaction. The results of the second part of the study suggest that CO-OP enables the transfer of skills acquired during the intervention to new activities, not specifically trained in rehabilitation. Gathering the experience of care partners highlighted the evolving nature of CO-OP mastery, for both care partners and youth. Moreover, engagement seems to be a key factor in facilitating this progression, both for the youth and their care partners
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
QOL-17. Biological correlates of quality of survival and neurocognitive outcomes in medulloblastoma; a meta-analysis of the SIOP-UKCCSG-PNET3 and HIT-SIOP-PNET4 trials
No full textVariations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
- …
