Special Care and School Difficulties in 8-Year-Old Very Preterm Children: The Epipage Cohort Study

OBJECTIVES: To investigate school difficulties, special care and behavioral problems in 8 year-old very preterm (VPT) children. PATIENT AND METHODS: Longitudinal population-based cohort in nine regions of France of VPT children and a reference group born at 39-40 weeks of gestation (WG). The main outcome measures were information about school, special care and behavioral problems using Strengths and Difficulties Questionnaire from a questionnaire to parents. RESULTS: Among the 1439 VPT children, 5% (75/1439) were in a specialised school or class, 18% (259/1439) had repeated a grade in a mainstream class and 77% (1105/1439) were in the appropriate grade-level in mainstream class; these figures were 1% (3/327) , 5% (16/327) and 94% (308/327) , respectively, for the reference group. Also, 15% (221/1435) of VPT children in a mainstream class received support at school versus 5% (16/326) of reference group. More VPT children between the ages of five and eight years received special care (55% (794/1436)) than children born at term (38% (124/325)); more VPT children (21% (292/1387)) had behavioral difficulties than the reference group (11% (35/319)). School difficulties, support at school, special care and behavioral difficulties in VPT children without neuromotor or sensory deficits varied with gestational age, socioeconomic status, and cognitive score at the age of five. CONCLUSIONS: Most 8-year-old VPT children are in mainstream schools. However, they have a high risk of difficulty in school, with more than half requiring additional support at school and/or special care. Referral to special services has increased between the ages of 5 and 8 years, but remained insufficient for those with borderline cognitive scores

DETECTING CYTOMEGALOVIRUS IN BREASTMILK: Towards a device for self-monitoring risks of postnatal infection

International audienceHuman cytomegalovirus (HCMV) infection is a major cause of morbidity worldwide especially in newborn infants. While congenital HCMV infection affects 2-5% of preterm newborns, the risk of postnatal infection particularly through breast milk is higher in this population (prevalence about 20%) since more than one mother on two is affected. Congenital and postnatal infection can lead to important clinical complications such as deafness, learning disabilities, and mental retardation during childhood. Neonatologists are squeezed in their clinical practice: either breastfeeding is favored without any milk treatment going on exposure of preterm infants to a potential infection, or milk is systematically treated by freezing or pasteurization but with deprivation of non-at-risk infants from the benefits of fresh milk. In this position paper, we propose a possible solution to differentiate milk with risk of HCMV contamination from milk without any risk. This would allow subsequent adaptation of the milk feeding strategy. Also, because the HCMV contamination peak appears 4 to 8 weeks after birth, the work we present here should lead to a device meant to be used both at hospital and at home in a self-testing manner

Sustainable machining approach for CAD/CAM/CNC systems based on a dynamic environmental assessment

International audienceSustainability assessment is becoming an unquestionable issue for manufacturing companies that are urged by governments and customers to provide environment-friendly products. Machining, as one of the major manufacturing operations, has high potential factors regarding the environmental impacts of production system. Nevertheless, environmental assessments are mainly done post-product design and post-machining processes design. Integrating environmental assessment in the machining processes design could lead to significant improvements in sustainable manufacturing field. Major difficulties to perform such an assessment are the availability of the machining data and the lack of calculation rules to express them in terms of environmental impacts. This article presents a new approach based on the STandard for the Exchange of Product model data—compliant Numerical Control to integrate the machining environmental assessment in the earlier design phases. It proposes to establish cognitive links between the machining data included in STandard for the Exchange of Product model data—compliant Numerical Control and environmental indicators. The approach is implemented on a demonstrator and validated by a use case

J Clin Med

Background: The announcement of Parkinson's disease (PD) diagnosis may provoke negative feelings that impact the ability to cope with the disease and all life changes related to this new condition. There are scarce data on how to improve communication about PD diagnosis and which factors may influence this outcome. Methods: We performed a national French survey, investigating the diagnosis announcement impact on a large population of people living with PD (PwPD), who recently received the diagnosis (≤1 year since PD diagnosis), and on related caregivers and health care professionals (HCPs), from tertiary and community-based hospitals. Results: A total of 397 PwPD (45% female and 82% > 50 years old), 192 caregivers and 120 HCPs (69% neurologists) completed the questionnaire. The diagnosis was not expected by about 60% of PwPD and induced negative feelings in the majority (82%) of them. Negative feelings that PwPD experience in the moment of the diagnosis announcement were related with male gender [OR = 2.034, CI 95% 1.09-3.78; p = 0.025] and older age [OR = 1.05, CI 95% 1.01-1.08; p = 0.004], while tremor as the first symptom had a threshold significance [OR = 1.78, CI 95% 0.994-3.187; p = 0.052]. Half of the PwPD and caregivers considered that they did not receive enough information and one third had a short-term appointment to rediscuss the diagnosis. A total of 82% of PwPD expressed the willingness to have a multidisciplinary follow-up (PD nurse, psychologists). Only 24% of the HCPs had been trained for PD announcement. Conclusions: The way a PD diagnosis is delivered represents a pivotal moment in the journey of PwPD and caregivers. This process requires improvement in addressing the gaps expressed by PwPD, caregivers, and HCPs through a participatory approach

A French survey on the lockdown consequences of COVID-19 pandemic in Parkinson's disease. The ERCOPARK study

International audienceBackground: In 2020 the coronavirus disease 19 (COVID-19) pandemic imposed a total and sudden lockdown. We aimed to investigate the consequences of the first COVID-19 lockdown (mid-March - mid-April 2020) on motor and non-motor symptoms (NMS) in a cohort of French people with Parkinson's disease (PwP).Methods: PwP were enrolled either by an on-line survey sent from the national France Parkinson association (FP) to reach the French community of PwP or as part of outpatients' telemedicine visits followed by an hospital-based Parkinson Expert Center (PEC). All patients were evaluated using the same standardized questionnaire assessing motor and NMS (including a list of most disabling, new or worsened symptoms and Patient's Global Impression-Improvement scales [PGI-I]) psycho-social queries and quality of life.Results: 2653 PwP were included: 441 (16.6%) in the PEC group and 2122 (83.4%) in the community-based group. Physiotherapy was interrupted among 88.6% of the patients. 40.9% referred a clinical modification of their symptoms. Based on the questionnaire, pain (9.3%), rigidity (9.1%) and tremor (8.5%) were the three most frequently new or worsened reported symptoms. Based on the PGI-I, the motor symptoms were the most affected domain, followed by pain and psychic state. PwP in community-based group tended to have more frequent worsening for motor symptoms, motor complications, pain and confusion than those of the PEC group.Conclusions: The first COVID-19 lockdown had a negative impact on motor and NMS of PwP. Efforts should be allocated to avoid interruption of care, including physiotherapy and physical activities and implement telemedicine