L'accord entre les parents et les enseignants dans l'évaluation des troubles de comportement des élèves du primaire

Cette recherche se propose d'examiner l'évolution des symptômes d'un trouble déficitaire de l'attention/hyperactivité (TDAH), d'un trouble des conduites (TC) et d'un trouble de l'opposition avec provocation (TOP) de l'élève selon l'accord ou le désaccord entre les parents et les enseignants. Elle a aussi comme objectif de déterminer les répercussions d'un consensus inter-informateurs sur la fréquence et la satisfaction des services scolaires. L'échantillon est constitué de 341 élèves québécois âgés de 5 ans 7 mois à 13 ans 5 mois recevant des services d'aide spécialisés. Les parents et le personnel enseignant ont complété le DISC-2.25 . Les résultats posent que l'entente entre informateurs est spécifiquement associée aux deux variables retard scolaire et dépression des parents. L'accord entre informateurs est bénéfique à la trajectoire des enfants 24 mois plus tard surtout dans le cas des symptômes d'un TC et dans une moindre mesure de ceux d'un TOP. La fréquence des services augmente sensiblement pour les enfants avec des symptômes d'un TC lorsqu'il y a une reconnaissance mutuelle de ce trouble par les parents et les enseignants. Pour aucun des trois troubles, le niveau de satisfaction des parents de l'aide reçue n'est influencé par la présence d'une entente entre informateurs. La fréquence des services spécialisés reçus par l'enfant ne spécifie rien des mécanismes par lesquels le consensus entre informateurs influe positivement l'évolution des élèves 24 mois plus tard. Ce travail se termine par un questionnement sur les différences dans l'évaluation des troubles de comportement des élèves entre la France et le Québec et apporte plusieurs contributions pour la pratique, spécifiquement l'évaluation et l'intervention.

Engagement parental dans le cheminement scolaire des enfants : perceptions de parents immigrants d'origine portugaise

L'engagement des parents dans le cheminement scolaire des enfants est souvent bénéfique à la réussite de ceux-ci. Les études démontrent que les parents immigrants ont de la difficulté à s'engager auprès de l'école de la société d'accueil. La présente recherche de maîtrise avait pour but de mettre en lumière les perceptions des parents portugais quant à leur engagement dans le cheminement scolaire de leurs enfants. Pour le cadre de référence, nous avons décidé de nous baser sur la typologie des pratiques parentales selon Epstein (1992). On a choisi cette typologie afm de répertorier et classer les pratiques parentales de nos participants. Les résultats ont permis de voir que les parents de notre étude mettent en place plusieurs pratiques d'engagement et sont très engagés dans le parcours scolaire de leurs enfants. Ces résultats soulèvent quelques contradictions avec les quelques études qui portaient déjà sur les parents portugais et l' éducation.

Les caractéristiques des jeunes et des parents associées à l'évolution de l'alliance thérapeutique en contexte d'intervention brève et intensive de crise familiale

La présente étude visait à identifier les caractéristiques des jeunes et des parents (telles que la présence de troubles internalisés chez le jeune, la présence de troubles externalisés chez le jeune, l'estime de soi du jeune, la détresse psychologique des parents, les ressources interpersonnelles du parent, la qualité de la communication dans la famille, la cohésion familiale, l'intensité et la fréquence des conflits conjugaux) associées à l'évolution de l'alliance thérapeutique en contexte d'intervention brève et intensive de crise familiale. Pour atteindre cet objectif, nous avons effectué une étude corrélationnelle et descriptive avec deux temps de mesure de l'alliance thérapeutique. Notre échantillon est composé de 96 familles participantes au programme d'intervention Crise-Ado-Famille-Enfance. Selon les résultats obtenus, la perception de l'évolution de l'alliance thérapeutique des jeunes participant au programme CAFE ne semble pas être influencée significativement par aucune des caractéristiques recensées pour la présente étude. Au niveau de la perception de l'évolution de l'alliance thérapeutique des parents, les résultats révèlent qu'une seule des caractéristiques des jeunes et des familles y est associée de façon significative, soit la présence de troubles internalisés chez le jeune.

Régulation physiologique et perception de stress chez des parents d'enfants diagnostiqués d'un trouble du spectre de l'autisme : la contribution de la présence d'un chien d'assistance et des représentations associées à l'attachement

Les troubles du spectre de l'autisme (TSAR se caractérisent par des altérations au niveau de la réciprocité des interactions sociales, des habiletés de communication verbale et non verbale, ainsi que la présence de comportements et champs d'intérêts stéréotypés. Compte tenu des conclusions décrivant leurs parents comme vivant plus de stress comparativement aux parents d'enfants non diagnostiqués sur le spectre de l'autisme, il devient nécessaire d'offrir un soutien susceptible d'alléger leur quotidien et celui de leur enfant. Le recueil de données sur l'application d'une intervention novatrice qu'est l'intégration permanente d'un chien d'assistance au sein du milieu familial offrirait une contribution considérable basée sur les conclusions des études précédentes. Le modèle conceptuel de la présente étude réfère aux transactions entre la régulation diurne du cortisol, la perception de stress parental, la sévérité des atteintes comportementales de l'enfant ainsi que les représentations d'attachement de la mère. L'approche analytique s'oriente ainsi sur le caractère multidimensionnel des variables et s'intéresse particulièrement aux différences intra-individuelles dans l'adaptation parentale illustrée par l'activité totale de cortisol sur une période de 15 semaines. L'ensemble des données soulève la présence d'une sous-activation de l'axe 1-IPA ainsi qu'une perception de niveaux élevés de stress parental. Suivant une approche centrée sur la personne, les analyses ont permis de dégager deux profils distincts de régulation basés sur l'activité totale de cortisol salivaire. La présence du chien d'assistance au sein de la famille apporte des changements notables décrits par une diminution de la réponse du cortisol au réveil spécifique au sous-groupe de mères ayant un profil de sécrétion supérieur. L'étude apporte une démonstration empirique d'une hétérogénéité des patrons de régulation hormonale issus d'un même échantillon caractérisé par le vécu d'un stress chronique. L'efficacité d'une nouvelle forme d'intervention pouvant soulager les difficultés rencontrées par les parents est discutée selon un point de vue transdisciplinaire.

Increasing the use of group interventions in a pediatric rehabilitation program: perceptions of administrators, therapists, and parents

Objectives. To explore perceptions related to increased utilization of group interventions as a part of the service reorganization within a pediatric rehabilitation program. Methods. Individual interviews with program administrators (n=13) and focus groups with therapists (n=19) and parents of children with disabilities (n=5) were conducted. Data were analyzed using a coding grid inspired by the organized action systems theory. Results. Administrators and therapists identified several issues including the need to improve the referral process for groups and the coordination across services. Groups considerably modified practice and required substantial efforts from therapists. Administrators felt groups contributed to increased service accessibility. Although therapists had some doubts about service quality in groups, especially in regard to the reduced attention to individual needs, they reported positive benefits on children’s social participation. Generally, parents were satisfied with group interventions. Conclusion. Groups appear to be a promising method of service delivery, but organizational-related issues should be considered.

La demande d’aide chez les parents vivant des difficultés avec leur adolescent - exploration de trajectoires à travers les réseaux d’aide formelle et informelle

Cette recherche, de nature exploratoire et descriptive, s’intéresse à la trajectoire de recherche d’aide chez les parents vivant des difficultés avec leur adolescent. Cette recherche utilise une méthodologie qualitative et vise à améliorer la compréhension actuelle des processus de recherche d’aide des parents et à identifier l’influence des dynamiques relationnelles et de la réponse sociale obtenue. Notre échantillon est composé de dix parents ayant eu recours à une aide professionnelle concernant des difficultés avec leur adolescent. Notre cueillette de données s’est faite à l’aide d’une entrevue semi-structurée à questions ouvertes et nous avons procédé à une analyse thématique de celles-ci. Les résultats révèlent la complexité derrière les comportements de recherches d’aide et les différentes difficultés rencontrées. Dans leurs trajectoires, trois principaux moments-clés sont distinguables : la reconnaissance du problème, la recherche de solutions et la réponse à la demande d’aide. Les différentes influences et interactions des membres du réseau d’aide informelle, du milieu scolaire et du système de services sont également détaillées. Les résultats mettent en lumière l’importance des dynamiques de négociation au sein du couple parental et l’impact des listes d’attente et des interruptions dans les services d’aide. Les résultats exposent que cette expérience est assez éprouvante pour les parents. Bien qu’elle ne permette pas de résoudre tous les problèmes rencontrés, elle se révèle avec le recul être salutaire, pour la plupart des parents.

Development of a Parent Version of the Manchester-Minneapolis Quality of Life Survey for use by Parents and Crers of UK Children: MMQL-UK (PF).

Background Although it is now widely endorsed that children should as far as possible rate their own health related quality of life (HRQL), there are situations where proxy information on child HRQL may be useful, especially where a child is too ill or young to provide their own HRQL assessment. There is limited availability of generic HRQL scales that have a parallel child and parent version and that are reliable, valid, brief, comprehensible and suitable for use in UK populations. The aims of this study were therefore to develop and validate a parent version of the anglicised Manchester-Minneapolis Quality of Life child form (MMQL-UK (CF)) and to determine the level of association between the child and parent versions of this form. Methods This study was undertaken concurrently with the anglicisation and validation of the MMQL, a measure of HRQL developed for use with children in North America. At that time, no parent version existed, so the MMQL form for children (MMQL-UK (CF)) was used as the basis for the development of the MMQL-UK parent form (PF). The sample included a control group of healthy children and their parents and five exemplar groups; children diagnosed with asthma, diabetes or inflammatory bowel disease and their parents, children in remission from cancer and their parents and children in public care and their carers. Consistency of the MMQL-UK (PF) components were assessed by calculating Cronbach's alpha. Validation of the parent questionnaire was undertaken by comparing MMQL-UK (PF) component scores with comparable components on the proxy PedsQL™ quality of life scales, comparing MMQL-UK (PF) component scores between parents of healthy and chronic disease children and by comparison of component scores from children and their parents or carers. Reproducibility and responsiveness were assessed by retesting parents by follow-up questionnaires. Results A total of 874 children (completing MMQL-UK (CF)) and 572 parents or carers (completing MMQL-UK (PF)) took part in the study. The internal consistency of all the MMQL-UK (PF) components exceeding the accepted criterion of 0.70 and the construct validity was good with moderate correlations being evident between comparable components of the MMQL-UK (PF) and the proxy PedsQL™. Discriminant validity was demonstrated with significant differences being identified between parents of healthy children and those with chronic conditions. Intra-class correlations exceeded 0.65 for all MMQL-UK (PF) components demonstrating good reproducibility. Weak to moderate levels of responsiveness were demonstrated for all but social functioning. The MMQL-UK (PF) showed moderate parent-child correlation with the MMQL-UK (CF) for all components. The best correlations were seen for those components measuring the same construct (Pearson's r ranged from 0.31 to 0.61, p < 0.01 for equivalent components). Conclusion The MMQL-UK (PF) showed moderate to good correlations with the MMQL-UK (CF) component scores. The MMQL-UK (PF) will be of use when comparing child and parent/carer perception of the impact of a child's condition on their HRQL or where the child is too ill or young to provide their own report.

Demographic, Physical, and Behavioral Characteristics Associated with TV Parenting Practices Among Latino Parents of Preschool Children

Thesis (Master's)--University of Washington, 2015

Cellular polarity in aging: role of redox regulation and nutrition

Cellular polarity concerns the spatial asymmetric organization of cellular components and structures. Such organization is important not only for biological behavior at the individual cell level, but also for the 3D organization of tissues and organs in living organisms. Processes like cell migration and motility, asymmetric inheritance, and spatial organization of daughter cells in tissues are all dependent of cell polarity. Many of these processes are compromised during aging and cellular senescence. For example, permeability epithelium barriers are leakier during aging; elderly people have impaired vascular function and increased frequency of cancer, and asymmetrical inheritance is compromised in senescent cells, including stem cells. Here, we review the cellular regulation of polarity, as well as the signaling mechanisms and respective redox regulation of the pathways involved in defining cellular polarity. Emphasis will be put on the role of cytoskeleton and the AMP-activated protein kinase pathway. We also discuss how nutrients can affect polarity-dependent processes, both by direct exposure of the gastrointestinal epithelium to nutrients and by indirect effects elicited by the metabolism of nutrients, such as activation of antioxidant response and phase-II detoxification enzymes through the transcription factor nuclear factor (erythroid-derived 2)-like 2 (Nrf2). In summary, cellular polarity emerges as a key process whose redox deregulation is hypothesized to have a central role in aging and cellular senescence.

eHealth e a adoção da inovação em assisted living technologies : o caso das demências

RESUMO - Assistimos hoje a um contexto marcado (i) pelo progressivo envelhecimento das sociedades ocidentais, (ii) pelo aumento da prevalência das doenças crónicas, de que as demências são um exemplo, (iii) pelo significativo aumento dos custos associados a estas patologias, (iv) por orçamentos públicos fortemente pressionadas pelo controlo da despesa, (v) por uma vida moderna que dificulta o apoio intergeracional, tornando o suporte proporcionado pelos filhos particularmente difícil, (vi) por fortes expectativas relativamente à prestação de cuidados de saúde com qualidade. Teremos assim de ser capazes de conseguir melhorar os serviços de saúde, ao mesmo tempo que recorremos a menos recursos financeiros e humanos, pelo que a inovação parece ser crítica para a sustentabilidade do sistema. Contudo a difusão das Assistive Living Technologies, apesar do seu potencial, tem sido bastante baixa, nomeadamente em Portugal. Porquê? Hamer, Plochg e Moreira (2012), no editorial do International Journal of Healthcare Management, enquadram a Inovação como “podendo ser imprevisível e mesmo dolorosa, pelo que talvez possamos não ficar surpreendidos se surgirem resistências e que, inovações bastante necessárias, capazes de melhorar os indicadores de saúde, tenham sido de adoção lenta ou que tenham mesmo sido insustentáveis”. Em Portugal não há bibliografia que procure caracterizar o modelo de difusão da inovação em eHealth ou das tecnologias de vivência assistida. A bibliografia internacional é igualmente escassa. O presente projeto de investigação, de natureza exploratória, tem como objetivo principal, identificar barreiras e oportunidades para a implementação de tecnologias eHealth, aplicadas ao campo das demências. Como objetivos secundários pretendemse identificar as oportunidades e limitações em Portugal: mapa de competências nacionais, e propor medidas que possa acelerar a inovação em ALT, no contexto nacional. O projeto seguirá o modelo de um estudo qualitativo. Para o efeito foram conduzidas entrevistas em profundidade junto de experts em ALT, procurando obter a visão daqueles que participam do lado da Oferta- a Indústria; do lado da Procura- doentes, cuidadores e profissionais de saúde; bem como dos Reguladores. O instrumento utilizado para a recolha da informação pretendida foi o questionário não estruturado. A análise e interpretação da informação recolhida foram feitas através da técnica de Análise de Conteúdo. Os resultados da Análise de Conteúdo efetuada permitiram expressar a dicotomia barreira/oportunidade, nas seguintes categorias aqui descritas como contextos (i) Contexto Tecnológico, nas subcategorias de Acesso às Infraestruturas; Custo da Tecnologia; Interoperabilidade, (ii) Contexto do Valor Percecionado, nas subcategorias de Utilidade; Eficiência; Divulgação, (iii) Contexto Político, compreendendo a Liderança; Organização; Regulação; Recursos, (iv) Contexto Sociocultural, incluindo nomeadamente Idade; Literacia; Capacidade Económica, (v) Contexto Individual, incluindo como subcategorias, Capacidade de Adaptação a Novas tecnologias; Motivação; Acesso a equipamentos (vi) Contexto Específico da Doença, nomeadamente o Impacto Cognitivo; Tipologia Heterogénea e a Importância do Cuidador. Foi proposto um modelo exploratório, designado de Modelo de Contextos e Forças, que estudos subsequentes poderão validar. Neste modelo o Contexto Tecnológico é um Força Básica ou Fundamental; o Contexto do Valor Percecionado, constitui-se numa Força Crítica para a adoção de inovação, que assenta na sua capacidade para oferecer valor aos diversos stakeholders da cadeia de cuidados. Temos também o Contexto Político, com capacidade de modelar a adoção da inovação e nomeadamente com capacidade para o acelerar, se dele emitir um sinal de urgência para a mudança. O Contexto Sociocultural e Individual expressam uma Força Intrínseca, dado que elas são características internas, próprias e imutáveis no curto-prazo, das sociedade e das pessoas. Por fim há que considerar o Contexto Específico da Doença, nesta caso o das demências. Das conclusões do estudo parece evidente que as condições tecnológicas estão medianamente satisfeitas em Portugal, com evidentes progressos nos últimos anos (exceção para a interoperabilidade aonde há necessidade de maiores progressos), não constituindo portanto barreira à introdução de ALT. Aonde há necessidade de investir é nas áreas do valor percebido. Da análise feita, esta é uma área que constitui uma barreira à introdução e adoção das ALT em Portugal. A falta de perceção do valor que estas tecnologias trazem, por parte dos profissionais de saúde, doentes, cuidadores e decisores políticos, parece ser o principal entrave à sua adoção. São recomendadas estratégias de modelos colaborativos de Investigação e Desenvolvimento e de abordagens de cocriação com a contribuição de todos os intervenientes na cadeia de cuidados. Há também um papel que cabe ao estado no âmbito das prioridades e da mobilização de recursos, sendo-lhe requerida a expressão do sentido de urgência para que esta mudança aconteça. Foram também identificadas oportunidades em diversas áreas, como na prevenção, no diagnóstico, na compliance medicamentosa, na terapêutica, na monitorização, no apoio à vida diária e na integração social. O que é necessário é que as soluções encontradas constituam respostas àquilo que são as verdadeiras necessidades dos intervenientes e não uma imposição tecnológica que só por si nada resolve. Do estudo resultou também a perceção de que há que (i) continuar a trabalhar no sentido de aproximar a comunidade científica, da clínica e do doente, (ii) fomentar a colaboração entre centros, com vista à criação de escala a nível global. Essa colaboração já parece acontecer a nível empresarial, tendo sido identificadas empresas Portuguesas com vocação global. A qualidade individual das instituições de ensino, dos centros de investigação, das empresas, permite criar as condições para que Portugal possa ser país um piloto e um case-study internacional em ALT, desde que para tal pudéssemos contar com um trabalho colaborativo entre instituições e com decisões políticas arrojadas.

The effect of energy and traffic light labeling on parents purchasing decisions of cereals for their children

Objective: Nutritional labeling systems are considered a tool to fight obesity since they aim to contribute for more informed food choices as well as assist consumers to make healthier nutrition options and in this manner, contribute to a decrease in the obesity rate. This study intends to analyze the effect of different types of labeling systems on parents’ purchasing decisions for their children on a specific product: breakfast cereals. More precisely, how labels affect parents’ perception of healthiness regarding cereals and if the nutritional information has an effect on intended purchases for their children. Participants and methods: We conducted a study with 135 Portuguese parents of children aged 4 to12 years. Parents answered a questionnaire with one of three hypothetical cereals menus. Menus only differed in their nutritional labeling technique: no labels (control group), reference intake labels or traffic light labels. In addition, we conducted 20 face-to-face interviews to a different group of parents in order to perform a recall task. Findings: This paper provides no evidence to suggest that energy labeling or traffic light labeling systems alone were successful in helping parents making healthy purchases of cereals for their children. Therefore, there is the need to promote supplementary policies to encourage the consumption of healthier food and help fight obesity.

Morbidity and aging in HIV-infected persons: the Swiss HIV cohort study.

BACKGROUND: Patterns of morbidity and mortality among human immunodeficiency virus (HIV)-infected individuals taking antiretroviral therapy are changing as a result of immune reconstitution and improved survival. We studied the influence of aging on the epidemiology of non-AIDS diseases in the Swiss HIV Cohort Study. METHODS: The Swiss HIV Cohort Study is a prospective observational cohort established in 1988 with continuous enrollment. We determined the incidence of clinical events (per 1000 person-years) from January 2008 (when a new questionnaire on non-AIDS-related morbidity was introduced) through December 2010. Differences across age groups were analyzed using Cox regression, adjusted for CD4 cell count, viral load, sex, injection drug use, smoking, and years of HIV infection. RESULTS: Overall, 8444 (96%) of 8848 participants contributed data from 40,720 semiannual visits; 2233 individuals (26.4%) were aged 50-64 years, and 450 (5.3%) were aged ≥65 years. The median duration of HIV infection was 15.4 years (95% confidence interval [CI], 9.59-22.0 years); 23.2% had prior clinical AIDS. We observed 994 incident non-AIDS events in the reference period: 201 cases of bacterial pneumonia, 55 myocardial infarctions, 39 strokes, 70 cases of diabetes mellitus, 123 trauma-associated fractures, 37 fractures without adequate trauma, and 115 non-AIDS malignancies. Multivariable hazard ratios for stroke (17.7; CI, 7.06-44.5), myocardial infarction (5.89; 95% CI, 2.17-16.0), diabetes mellitus (3.75; 95% CI, 1.80-7.85), bone fractures without adequate trauma (10.5; 95% CI, 3.58-30.5), osteoporosis (9.13; 95% CI, 4.10-20.3), and non-AIDS-defining malignancies (6.88; 95% CI, 3.89-12.2) were elevated for persons aged ≥65 years. CONCLUSIONS: Comorbidity and multimorbidity because of non-AIDS diseases, particularly diabetes mellitus, cardiovascular disease, non-AIDS-defining malignancies, and osteoporosis, become more important in care of HIV-infected persons and increase with older age.

Genetics: biased transmission of genomes according to parents of origin.

A new study shows that wood ant queens selectively pass the maternally-inherited half of their genome to their daughters and the paternally-inherited half to their sons. This system, which most likely evolved from ancestral hybridization, creates distinct genetic lineages.

Serum Leptin Concentration, Body Mass Index and Incident Heart Failure: The Health, Aging, and Body Composition Study

Background: Leptin is produced primarily by adipocytes. Although originally associated with the central regulation of satiety and energy metabolism, increasing evidence indicates that leptin may be an important factor for congestive heart faire (CHF). In the study, we aimed to test the hypothesis that leptin may influence CHF pathophysiology via a pathway of increasing body mass index (BMI). Methods: We studied 2,389 elderly participants aged 70 and older (M; 1161, F: 1228) without CHF and with serum leptin measures at the Health Aging, and Body Composition study. We analyzed the association between serum leptin level and risk of incident CHF using Cox hazard proportional regression models. Elevated leptin level was defined as more than the highest quartile (Q4) of leptin distribution in the total sample for each gender. Adjusted-covariates included demographic, behavior, lipid and inflammation variables (partially-adjusted models), and further included BMI (fully-adjusted models). Results: In a mean 9-year follow-up, 316 participants (13.2%) developed CHF. The partially-adjusted models indicated that men and women with elevated serum leptin levels (>=9.89 ng/ml in men and >=25 ng/ml in women) had significantly higher risks of developing CHF than those with leptin level of less than Q4. The adjusted hazard ratios (95%CI) for incident CHF was 1.49 (1.04 -2.13) in men and 1.71 (1.12 -2.58) in women. However, these associations became non-significant after adjustment for including BMI for each gender. The fully-adjusted hazard ratios (95%CI) were 1.43 (0.94 -2.18) in men and 1.24 (0.77-1.99) in women. Conclusion: Subjects with elevated leptin levels have a higher risk of CHF. The study supports the hypothesis that the influence of leptin level on risk of CHF may be through a pathway related to increasing BMI.