Being a Child in the Midst of Terrorism

Terrorism—a planned, often politically motivated event designed to kill many innocent victims and inflict physical pain, psychological suffering, and fear on an entire community—is new to our Western culture, but not to children worldwide. Terrorism, violence, and disaster have involved children in the form of naturally occurring events; transportation accidents; exposure to war; social, ethnic and religious conflict; and as collateral damage in adult mass casualty incidents. Throughout childhood and adolescence, children are physically less capable and emotionally more vulnerable to the effects of terrorism. This fact may make children likely primary targets for terrorism in the future. Children are unique from the perspective of their anatomy, physiology, emotional development, and response to specific physical and psychological insults. These unique needs of children have rarely been considered in disaster planning. Civilian emergency physicians and Emergency Medical Services (EMS) systems have learned about mass casualty incidents through military models, focused on the needs of adult victims; consequently, they have limited personal clinical experience with pediatric disaster medicine. A terrorist attack with predominately pediatric casualties would have a tremendous and far-reaching impact on all child survivors, family members, and the community at large. All facets of the EMS system must be aware of this potential and be prepared to meet the special and divergent needs of children in the setting of a chemical, biological, radiation, or explosive event that involves large numbers of children. A paradigm shift that deals with unaddressed issues of treatment, equipment, triage, and training is a critical step in preparing to address the needs of children in the midst of terrorism

Developing normal reading skills: aspects of the visual processes underlying word recognition.

International audienceVisual word recognition performance of first graders (mean age: 6.6 years) through fifth graders (mean age: 10.8 years) was investigated using an experimental technique that is known to elicit the "viewing position effect" in skilled readers. The results showed that this effect, which consists of a systematic variation of performance as a function of fixation position within words, emerged early at the end of the 1st year of reading instruction. Visual field asymmetries in recognizing individual letters in words were also observed starting from first grade. Effects of word familiarity were obtained as early as in second grade. In contrast to skilled readers, children showed a marked word-length effect, which persisted through the first 5 years of instruction. No other qualitative differences between beginning and skilled readers were apparent. Hence, the basics of reading skills, as measured by the present technique, seem to be attained very early during acquisition. Further experience mainly reduces the time a reader needs to extract visual information from print

From "logographic" to normal reading: the case of a deaf beginning reader.

International audienceVisual word recognition of a profoundly deaf girl (AH) with developmental reading disorders was explored using an experimental technique that measures performance as a function of eye fixation within a word. AH's fixation-dependent word recognition profile revealed that she was inferring the identity of words using a "logographic" reading strategy (i. e., using salient visual features). Following this observation a special training program that enhances the understanding of grapheme-phoneme relations was applied. After few months of training, AH's reading skills improved, while her fixation-dependent performance changed to become like that of normal readers. We discuss the impact of our technique for the early diagnosis of reading impairments

The Dintilhac report and its implications for forensic neuropsychological evaluation

When preparing neuropsychological expert reports, the neuropsychologist is asked to make a precise assessment of the victims' cognitive dysfunction, generally after traumatic head injury. The expert is usually required to assess the nature of the neuropsychological deficits, their correlation with any brain lesions and their imputability to the accident or crime in question, to estimate a possible date of stabilisation and to evaluate the heads of damage. The basic principle of compensation for personal injury is to consider the circumstances in which the victim would have been if the prejudicial event (for example, the accident) had not occurred and to assess, on the basis of these various heads of damage, compensation for the injury suffered. While it is not the neuropsychologist's role to evaluate the compensation as such, he or she has however to specify which aspects of cognitive function are deficient and what impact this dysfunction has on a personal and occupational level. Until recently, compensation for personal injury, and notably for cognitive deficits, was assessed with reference to nine principal heads of damage, in particular the conventional concepts of total temporary disability (incapacite temporaire totale [ITT]), defined as the period during which the victim was temporarily unable to carry out their usual occupational and personal activities, and partial permanent disability (incapacite partielle permanente [IPP]), defined as a percentage and corresponding to the reduction, after stabilisation, in the victim's functional capacity that is, their physical and psychological potential here again from an occupational and personal viewpoint. However, concretely, the emphasis had shifted to take into account only the pecuniary aspects of injury relating to the domain of "having", that is the loss of income due to cessation of work, while the non-pecuniary aspects relating to the domain of "being" were often ignored. New classification. - The Dintilhac report has established a new classification of heads of physical damage which abandons these two ambiguous concepts of ITT and IPP. Damage now includes three categories: pecuniary and non-pecuniary; temporary and permanent and damage to direct and indirect victims. We define the new heads of damage to direct victims, illustrate them with examples from neuropsychological expert reports, compare the old and the new classifications and discuss the implications of the Dintilhac report for expert assessment. The report appears to remove the ambiguities previously mentioned, since ITT has been replaced by two new heads of damage which are clearly defined as pecuniary and non-pecuniary: "loss of present occupational income" (pertes de gains professionnels actuels [PGPA]) and "temporary functional deficiency" (deficit fonctionnel temporaire [DFT]), respectively. Similarly, IPP is replaced by two new heads of damage, which are also clearly defined as pecuniary and non-pecuniary and are the poststabilisation equivalents of PGDA and DFT: these are "loss of future earnings" (pertes de gains professionnels futurs [PGPF]) and "permanent functional deficiency" (deficit fonctionnel permanent [DFP]). Concerning the other heads of damage, the amendments introduced by the new classification do not basically modify the earlier concepts but are nevertheless more precise in certain respects. The "pretium doloris", or "price of pain", is replaced by "suffering sustained" (souffrances endurees [SE]) with little fundamental change. The same is true of "loss of amenity" (prejudice d'agrement [PA]). The term of "aesthetic impairment" (prejudice esthetique [PE]) also remains the same, but whereas it previously related only to permanent impairment, it now includes temporary impairment, before stabilisation. What was formerly termed "loss of sexual function" now consists of "loss of sexual function" (prejudice sexuel [PS]) as well as "loss of the prospect of founding a family" (prejudice d'etablissement [PE]), allowing a finer distinction to be made between the damages sustained. The former "third party" (tierce personne) is now covered under the headings of "assistance by a third party" (assistance par tierce personne [ATP]), "expenses of accommodation conversion" (frais de logement adapte [FLA]) and "expenses of vehicle conversion" (frais de vehicule adapte [FVA]), which here again provides greater precision in the heads of compensation. Lastly, what was previously known as "loss of opportunity" (perte de chance) is divided into three different categories: "loss of education, whether at school, university or in training" (prejudice scolaire, universitaire ou de formation [PSU]), "loss of future occupational earnings" (perte de gains professionnels futurs [PGPF]) and in part the "occupational impact" (incidence professionnelle [IP]). Conclusion. - In summary, these various heads of damage concerning direct victims that are proposed by the Dintilhac report result in a more detailed evaluation of compensation for personal injury. Assessment of a certain number of heads of damage is an integral part of the preparation of a neuropsychological expert report and the fact that these heads of damage are now better defined makes the expert's task easier. As the neuropsychologist, generally called upon to give an expert opinion, now has better knowledge of this new classification, he or she will be able to give clearer and fuller answers to the questions raised and so comply with the principle of civil law relating to compensation for personal injury: "compensate the injury, all the injury, but nothing except the injur

Age-related hearing loss in individuals and their caregivers: effects of coping on the quality of life among the dyads

Sébastien Lazzarotto,1,2 Karine Baumstarck,1 Anderson Loundou,1 Zeinab Hamidou,1,3 Valérie Aghababian,1 Tanguy Leroy,1,4 Pascal Auquier1 1EA 3279, Self-Perceived Health Assessment Research Unit, School of Medicine, Aix Marseille Université, 2French Regional Institute for Prevention of Aging, Marseille, 3National Clinical Research Quality of Life in Oncology Platform, Marseille, 4Social Psychology Research Group (GRePS EA 4163), Université Lumière Lyon 2, Bron, France Objectives: Age-related hearing loss (ARHL) impacts the daily living and quality of life (QoL) of affected individuals and the functioning of family caregivers. In the specific context of voluntary medical checkups, we examined sample dyads (ARHL individual and the caregiver) to determine whether QoL of patients and caregivers is influenced by coping strategies implemented either by themselves or their relatives.Methods: This was a cross-sectional study with a descriptive/correlative design performed in a French preventive health center (Regional Institute for Prevention of Aging, Marseille, France) for the beneficiaries of pension funds of private sector employees. The samples included beneficiary–caregiver dyads. The beneficiaries had bilateral (mild to moderately severe) ARHL. Self-reported data were collected as follows: QoL using the World Health Organization Quality of Life questionnaire, coping strategies using the Brief Coping Orientation to Problems Experienced Scale, and anxiety and mood using visual analog scales.Results: The final sample comprised 44 beneficiaries and 44 caregivers. The caregiver was the partner of the beneficiary in 73% of cases. The QoL scores of the social dimension were significantly lower for beneficiaries and caregivers compared with French age- and sex-matched controls. Among beneficiaries and caregivers, coping strategies based on problem solving were the most commonly used strategies. The use of positive thinking strategies was associated with higher QoL scores. The more one member of the dyad used an avoidance coping strategy, the more the other member used a positive thinking strategy.Conclusion: This study emphasizes that QoL of individuals with age-related hearing impairment and their natural caregivers is related to the coping strategies that they use. This finding suggests that targeted interventions should be offered to help individuals who experience emotional difficulties to implement more efficient coping strategies. Keywords: age-related hearing impairment, caregivers, dyads, quality of life, coping, emotional status&nbsp

Age-related hearing loss in individuals and their caregivers: Effects of coping on the quality of life among the dyads

International audienc