Intravascular ultrasound underestimates vessel dimensions.

The information gathered with intravascular ultrasound (IVUS) are of great value in endovascular techniques. The aim of this study was to evaluate the reliability of IVUS when measuring vessel dimensions by comparison with an established reference method. The left carotid artery was exposed in 4 pigs (45-55 kg) and two piezoelectric crystals were sutured on the adventitia in the same cross-sectional plane. The distance between them was measured either by IVUS and by sonomicrometers. The mean distance between the two crystals calculated by the sonomicrometer was 4.7+/-0.4 mm (mean systolic distance was 4.9+/-0.2 mm, mean diastolic distance was 4.6+/-0.1 mm). The mean distance between the two targets calculated by IVUS was 4. 5+/-0.2 mm (mean systolic distance was 4.6+/-0.2 mm and mean diastolic 4.4+/-0.2 mm). Regression analysis of the two series of data shows a R(2)=0.9984. IVUS measurements are an average 5% smaller than sonomicrometer measurements (3.6% up to 8.3%) and the difference is statistically significant ( p <0.05). The underestimation of IVUS measurements will affect the accuracy, and probably the long-term outcome, of endovascular procedures.

General practitioners can evaluate the material, social and health dimensions of patient social status

OBJECTIVE: To identify which physician and patient characteristics are associated with physicians' estimation of their patient social status.DESIGN: Cross-sectional ulticentric survey. SETTING: Fourty-seven primary care private offices in Western Switzerland. PARTICIPANTS: Random sample of 2030 patients ≥ 16, who encountered a general practitioner (GP) between September 2010 and February 2011. MAIN MEASURES: PRIMARY OUTCOME: patient social status perceived by GPs, using the MacArthur Scale of Subjective Social Status, ranging from the bottom (0) to the top (10) of the social scale.Secondary outcome: Difference between GP's evaluation and patient's own evaluation of their social status. Potential patient correlates: material and social deprivation using the DiPCare-Q, health status using the EQ-5D, sources of income, and level of education. GP characteristics: opinion regarding patients' deprivation and its influence on health and care. RESULTS: To evaluate patient social status, GPs considered the material, social, and health aspects of deprivation, along with education level, and amount and type of income. GPs declaring a frequent reflexive consideration of their own prejudice towards deprived patients, gave a higher estimation of patients' social status (+1.0, p = 0.002). Choosing a less costly treatment for deprived patients was associated with a lower estimation (-0.7, p = 0.002). GP's evaluation of patient social status was 0.5 point higher than the patient's own estimate (p<0.0001). CONCLUSIONS: GPs can perceive the various dimensions of patient social status, although heterogeneously, according partly to their own characteristics. Compared to patients' own evaluation, GPs overestimate patient social status.

Concise reviews: in vitro-produced pancreas organogenesis models in three dimensions: self-organization from few stem cells or progenitors.

Three-dimensional models of organ biogenesis have recently flourished. They promote a balance between stem/progenitor cell expansion and differentiation without the constraints of flat tissue culture vessels, allowing for autonomous self-organization of cells. Such models allow the formation of miniature organs in a dish and are emerging for the pancreas, starting from embryonic progenitors and adult cells. This review focuses on the currently available systems and how these allow new types of questions to be addressed. We discuss the expected advancements including their potential to study human pancreas development and function as well as to develop diabetes models and therapeutic cells.

PACIC Instrument: disentangling dimensions using published validation models.

OBJECTIVE: To better understand the structure of the Patient Assessment of Chronic Illness Care (PACIC) instrument. More specifically to test all published validation models, using one single data set and appropriate statistical tools. DESIGN: Validation study using data from cross-sectional survey. PARTICIPANTS: A population-based sample of non-institutionalized adults with diabetes residing in Switzerland (canton of Vaud). MAIN OUTCOME MEASURE: French version of the 20-items PACIC instrument (5-point response scale). We conducted validation analyses using confirmatory factor analysis (CFA). The original five-dimension model and other published models were tested with three types of CFA: based on (i) a Pearson estimator of variance-covariance matrix, (ii) a polychoric correlation matrix and (iii) a likelihood estimation with a multinomial distribution for the manifest variables. All models were assessed using loadings and goodness-of-fit measures. RESULTS: The analytical sample included 406 patients. Mean age was 64.4 years and 59% were men. Median of item responses varied between 1 and 4 (range 1-5), and range of missing values was between 5.7 and 12.3%. Strong floor and ceiling effects were present. Even though loadings of the tested models were relatively high, the only model showing acceptable fit was the 11-item single-dimension model. PACIC was associated with the expected variables of the field. CONCLUSIONS: Our results showed that the model considering 11 items in a single dimension exhibited the best fit for our data. A single score, in complement to the consideration of single-item results, might be used instead of the five dimensions usually described.

L'impact de l'accès à la parentalité sur l'évolution de l'identité conjugale

Cette recherche investigue l'impact de la transition à la parentalité sur l'identité conjugale. Afin de mettre en évidence les bouleversements induits par l'arrivée du premier enfant sur le système-couple, deux groupes de sujets ont constitué notre échantillon : des couples parents d'un premier enfant âgé de 9 à 12 mois et des couples sans enfant mais avec une durée de vie commune équivalente au premier groupe. Chaque couple a été rencontré dans le cadre d'un unique entretien. Leur première tâche a été de décrire leurs vies de couple passée et actuelle au travers de valeurs et devises. Un questionnaire créé pour cette recherche a ensuite permis d'évaluer la représentation des conjoints quant à l'évolution de leur couple, et ce sur la base de cinq dimensions à même de caractériser la manière d'être ensemble des conjoints. Finalement, les jeunes parents ont participé à un entretien semi-directif afin de témoigner des changements personnels et de couple vécus dans le cadre de la transition à la parentalité. Des analyses qualitatives et quantitatives basées sur les données récoltées au travers de nos trois outils révèlent plusieurs résultats. Les conjoints sans enfant décrivent avant tout leur couple comme un cocon au sein duquel deux individus autonomes trouvent refuge et réconfort. Les jeunes parents se démarquent quant à eux par une diminution de leur sentiment d'indépendance, reflet de la nécessaire collaboration propre au co-parentage. Une analyse des entretiens semi-structurés croisée avec l'évaluation du degré de satisfaction conjugale permet le constat suivant : la diminution avérée de la satisfaction conjugale lors de la transition à la parentalité n'est pas strictement associée aux bouleversements conjugaux. Ce déclin lors de l'arrivée et de l'accueil du premier enfant semble en effet être également en lien avec une difficile articulation, chez chaque partenaire, de leurs identités personnelle, conjugale, parentale et socio-professionnelle. - This research investigates the impact of the transition to parenthood on marital identity. To highlight the changes brought about by the arrival of the first child on the couple, two groups of subjects constituted our sample: couples with a first child of 9 to 12 months and childless couples but with a period of cohabitation equivalent to that of the first group. Each couple was interviewed once only. Their first task was to describe their lives as a couple past and present through values and principles. A questionnaire devised for this research was then used to evaluate partners' responses regarding the evolution of their relationship, this based on five criteria to characterise the couples' way of being together. Finally, young parents participated in a semi- structured interview to describe personal changes and those as a couple experienced in the transition to parenthood. Qualitative and quantitative analyses based on data collected through our three tools reveal several results. Spouses without children describe their relationship primarily as a cocoon in which two autonomous individuals find refuge and comfort. Young parents differ in reducing their feelings of independence, reflecting the collaborative needs specific to co-parenting. An analysis of the semi- structured interviews crossed with the assessment of marital satisfaction gives rise to the following observation: the pronounced reduction in marital satisfaction during the transition to parenthood is not strictly associated with marital disruption. This decline upon the arrival of the first child seems to be in line with a difficult balance for each partner between their personal, marital, parental and socio- professional identities.

The Prenatal Lausanne Trilogue Play: A New Observational Assessment Tool of the Prenatal Co-Parenting Alliance

The goal of this study is to present a new observational assessment tool, the prenatal Lausanne Trilogue Play situation (LTP). Expectant parents were asked to role play their first meeting with their baby using a doll, and the videotaped interaction was subsequently coded. Scores were correlated with measures of the couples' marital satisfaction as well as the postnatal family alliance 3 months after the baby's birth. Results showed that the prenatal co-parenting alliance was positively linked to both fathers' marital satisfaction as well as to the postnatal family alliance at 3 months. Thus, the prenatal LTP allows for assessment of the prenatal co-parenting alliance at the interactional level. It predicts the place the parents will afford their baby after birth and can contribute to methods of clinical assessment and prevention.

A further examination of the distinction between dependency-oriented and achievement-oriented parental psychological control: Psychometric properties of the DAPCS with French-speaking late adolescents

Psychological control refers to parental behaviors that intrude on the psychological and emotional development of the child. In 2010, Soenens and colleagues proposed a distinction between two domain-specific expressions of psychological control, that is, Dependency-oriented Psychological Control (DPC) and Achievement-oriented Psychological Control (APC). The aim of this study was to evaluate the factor structure, reliability, and convergent validity of the French form of the Dependency-oriented and Achievement-oriented Psychological Control Scale (DAPCS; Soenens, Vansteenkiste, and Luyten, 2010) in a sample of late adolescents (N = 291, mean age = 21.65). Confirmatory factor analyses confirmed the hypothesized two-factor solution of the DAPCS for paternal as well as for maternal ratings. Moreover, high indices of internal consistency indicated that both subscales produced reliable scores. Further, convergent validity was confirmed by theoretically consistent associations between the DAPCS' subscales and well-established assessments of general parenting style dimensions. Finally, results evidenced gender specific patterns supporting the relevance of domain differentiation in the assessment of psychological control. Overall, the results of this study indicated that the French form of the DAPCS might be a useful instrument to assess two domainspecific types of parental psychological control among French-speaking adolescents.

Spouse similarity in recollections of parenting received : a study in a nonclinical sample

Rapport de synthèse : L'article constituant le présent travail de thèse décrit une recherche portant sur des couples adultes recrutés dans la population générale, décrivant rétrospectivement les attitudes de leurs parents respectifs envers eux au cours de leur enfance. Le rôle joué par les attitudes d'attachement dans les relations adultes, et notamment les relations de couples, est bien démontré. De même, il est établi que les relations établies avec les parents dans l'enfance influencent le type d'attitude d'attachement qui prédominera à l'âge adulte. Dès lors, nous avons investigué l'existence, au sein de ces couples adultes, de souvenirs similaires quant aux attitudes prodiguées par les parents. Pour réaliser cette recherche, nous avons contacté tous les parents des enfants scolarisés en 2e/3e années et en 6e/7e années au sein des écoles de plusieurs communes de la région lausannoise, permettant de constituer un échantillon de 563 couples de parents. Au moyen d'autoquestionnaires, nous avons évalué pour chaque membre du couple : 1) sa description rétrospective des attitudes de ses deux parents envers lui pendant son enfance ; 2) le degré de sa symptomatologie psychiatrique actuelle ; et 3) son évaluation du degré d'ajustement dyadique actuel au sein du couple. La comparaison des scores des époux respectifs sur « l'échelle de lien parental » (PBI : Parental Bonding Instrument) a montré une ressemblance, au sein des couples, concernant la c chaleur et affection » (« Care ») témoignée au cours de l'enfance parle parent de même sexe que le sujet. Les analyses complémentaires effectuées semblent exclure que cette similarité soit due à des facteurs confondant comme l'âge, l'origine culturelle, le niveau socio-économique, ou le degré de symptomatologie psychiatrique. De même, cette similarité ne semble pas être attribuable à une convergence de vue grandissante des conjoints au cours de leur union. Par ailleurs, le degré d'ajustement dyadique s'est révélé être dépendant du degré cumulé de chaleur et d'affection tel que remémoré par chaque conjoint, et non du degré de similarité dans le couple pour ce qui concerne le souvenir de la chaleur et de l'affection reçues. Bien que basée sur des évaluations rétrospectives des attitudes parentales, et ne disposant pas d'une investigation psychiatrique standardisée incluant les critères diagnostiques, cette étude repose néanmoins sur un grand échantillon, recruté dans la population générale. Nos résultats ont notamment des implications concernant la santé des enfants. En effet, en raison de la similarité mise en évidence dans nos résultats, un enfant dont un des parents a reçu peu de chaleur et d'affection dans son enfance a plus de chances que son autre parent aie lui-même également reçu moins de chaleur et d'affection. De ce fait, d'une part l'ajustement dyadique du couple parental sera particulièrement bas, ce qui peut se répercuter sur les enfants du couple. D'autre part, comme les attitudes parentales se transmettent en partie de génération en génération, le même enfant risque d'être exposé, de la part de ses deux parents, à une attitude comportant peu de chaleur et d'affection, ce qui représente un risque de développement ultérieur des pathologies psychiatriques chez cet enfant.

Assessment of parental discipline in daily life.

The use of ecological momentary assessment (EMA) for studying parenting has been rare. We examined the psychometric properties and structural validity of an EMA Parenting Scale based on 32 mothers' reports of their parenting over a period of 10 consecutive days, and explored the acceptance of the scale and compliance with the procedure. The results suggested that the EMA Parenting Scale was well accepted for the assessment of daily parenting, and that it consistently captured the overreactive and lax dimensions of parenting across different episodes of child misbehavior. Moreover, multilevel analyses suggested that the scale was sensitive to change across different parenting episodes, and that it reliably assessed the dimensions at both the personal and situational levels. (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Constructive thinking skills and impulsivity dimensions in conduct and substance use disorders: differences and relationships in an adolescents' sample.

Impact of conduct disorder (CD) and substance use disorder (SUD) on constructive thinking skills and impulsivity was explored. 71 offending adolescents were assessed for CD and SUD. Furthermore, the constructive thinking inventory, the immediate and delayed memory tasks and the UPPS impulsive behaviour scale were administered. Results showed that youths with CD, independently from SUD, presented higher personality impulsivity (urgency) and altered constructive thinking skills (categorical thinking and personal superstitious thinking). Furthermore, trait-impulsivity explained variation in constructive thinking skills. The implications of these results were discussed.

Secular changes of spinal canal dimensions in Western Switzerland: a narrowing epidemic?

STUDY DESIGN: Computed tomography-based anatomical study. OBJECTIVE: To study the secular changes in lumbar spinal canal dimensions. SUMMARY OF BACKGROUND DATA: Development of symptomatic lumbar spinal stenosis, among other factors, is related to the dimensions of the bony canal. The canal reaches its adult size early on in life. Several factors, including protein intake, may influence its final dimensions. As with increases in human stature from improvements of socioeconomic conditions, we hypothesized that adult bony canal size has also grown larger in recent generations. METHODS: This study analyzes computed tomographic reconstructions from 184 subjects performed for either trauma (n = 81) or abdominal pathologies (n = 103) and born either between 1940 and 1949 (n = 88) or 1970 and 1979 (n = 96). The cross-sectional area of the bony canal was digitally measured at the level of the pedicle (i.e., at a level not influenced by degenerative changes) for each lumbar vertebra. Intra- and interobserver reliability was assessed. RESULTS: Intra- and interobserver measurement reliability were excellent (interclass correlation coefficient = 0.87) and good (interclass correlation coefficient = 0.61), respectively. Contrary to our hypothesis, the 1940-1949 generation patient group exhibited larger lumbar canals at all levels as compared with the 1970-1979 group. Statistically this difference was highly significant (P < 0.001) and particularly pronounced in the trauma subgroup. CONCLUSION: Given that human stature evolution has stabilized and adult height is established during the first 2 years of long bone growth, it is possible that antenatal factors are responsible for this surprising finding. Maternal smoking and age may be possible explanations. This finding may have significant implications. An increasing number of patients may emerge with lumbar spinal stenosis as degenerative changes develop, putting a strain on health resources. Further studies in different population groups and countries will be important to further confirm this trend. LEVEL OF EVIDENCE: 3.