Validation transculturelle d'une échelle en contexte humanitaire : dépistage des difficultés psychologiques du jeune enfant haoussa au Niger (Maradi)

Psychological difficulties are sometimes difficult to assess during a medical consultation by a non-specialist (psychologist, psychiatrist). This is especially the case when it comes to young children, in humanitarian intervention contexts, entailing an insufficient answer to the needs of mental health care. The lack of cross culturally validated tools that meet the requirement of such intervention, fast and simple to identify the needs combined with a lack of professional involve difficulties even impossibility of implementing appropriate care. In this study, we implemented a cross cultural validation of a screening tool for psychological difficulties in humanitarian context for children aged 3 to 6 years old, the PSYCa 3-6 (Psychological Screening tool for Young Children aged 3 to 6 years old). This tool was originally created and developed during a humanitarian intervention; its content has been refined and modified along its use. The main validation took place in Niger, and two additional validations have been implemented in Colombia and Kenya. In total, 888 children aged 3 to 6 years were recruited between October 2009 and February 2012. Qualitative research has been also implemented to collect information regarding the local perception of psychological difficulties, prior to the validation. Quantitative research has focused on the psychometric and clinical properties of the tool. The three versions, Hausa, Spanish and Swahili showed adequate psychometric and clinical qualities including a good concurrent validity, scores being correlated with the gold standard. Qualitative research was used to refine and to strengthen the results. To our knowledge, this is the first validation of a screening tool for preschool children including a cross cultural component for use in several humanitarian contexts. Such tools, cross culturally validated in several contexts, are a key component to promote access to mental health care for children, often not on the list of priorities during the interventions.Les difficultés psychologiques sont parfois difficiles à évaluer au cours d'une consultation médicale par un non professionnel (psychologue, psychiatre). Ceci est d'autant plus vrai dans le cas particulier des jeunes enfants lors d'interventions humanitaires, ce qui conduit souvent à une réponse insuffisante aux besoins de soins psychiques. Le manque d'outils validés de manière transculturelle qui répondent aux exigences d'intervention, rapide et simple pour identifier les besoins combinés à un manque de professionnels impliquent des difficultés voire l'impossibilité de mettre en place les prises charges adéquates. Dans ce travail, nous avons réalisé la validation transculturelle d'un outil de dépistage des difficultés psychologiques en contexte humanitaire destiné aux enfants âgés de 3 à 6 ans, le PSYCa 3-6 (Psychological Screening tool for Young Children aged 3 to 6). Cet outil a été initialement créé et développé en 1999 lors d'une intervention humanitaire, son contenu a été affiné et modifié au fur et à mesure de son utilisation. La validation principale a eu lieu au Niger, et deux validations complémentaires ont été mises en place en Colombie et au Kenya. Au total, 888 enfants âgés de 3 à 6 ans ont été inclus entre Octobre 2009 et Février 2012. Une recherche qualitative a été mise en place en amont de la validation pour collecter des informations concernant la perception des difficultés psychologiques localement au Niger. La recherche quantitative s'est intéressée aux qualités psychométriques et cliniques de l'outil.Les trois versions haoussa, espagnole et swahili ont montré des qualités psychométriques et cliniques adéquates incluant une bonne validité concurrente, les scores obtenus à l'outil étant corrélés au gold standard. La recherche qualitative a permis d'affiner et de renforcer les résultats.A notre connaissance, il s'agit de la première validation d'un outil de dépistage pour des enfants d'âge préscolaire incluant un volet transculturel pour usage dans des contextes humanitaires variés. De tels outils validés pour des contextes différents sont indispensables pour promouvoir l'accès aux soins psychiques pour les enfants, souvent non prioritaires dans ces interventions

Development of a patient rated scale for mental health global state for use during humanitarian interventions

Funding: Médecins Sans FrontièresWe present the results of a cross-cultural validation of the Mental Health Global State (MHGS) scale for adults and adolescents (<14 years old). We performed two independent studies using mixed methods among 103 patients in Hebron, Occupied Palestinian Territories and 106 in Cauca, Colombia. The MHGS was analyzed psychometrically, sensitivity and specificity, ability to detect clinically meaningful change, compared to the Clinical Global Impression-Severity scale (CGI-S). Principal component analysis was used to reduce the number of questions after data collection. The scale demonstrated good internal consistency, with a Cronbach alpha score of 0.80 in both settings. Test retest reliability was high, ICC 0.70 (95% CI [0.41-0.85]) in Hebron and 0.87 (95% CI [0.76-0.93]) in Cauca; inter-rater reliability was 0.70 (95% CI [0.42-0.85]) in Hebron and 0.76 (95% CI [0.57-0.88]) in Cauca. Psychometric properties were also good, and the tool demonstrated a sensitivity of 85% in Hebron and 100% in Cauca, with corresponding specificity of 80% and 79%, when compared to CGI-S. The MHGS showed promising results to assess global mental health thereby providing an additional easy to use tool in humanitarian interventions. Additional work should focus on validation in at least one more context, to adhere to best practices in transcultural validation

Intra-household use and acceptability of Ready-to-Use-Supplementary-Foods distributed in Niger between July and December 2010.

Few studies have looked at consumption of Ready-to-Use-Supplementary-Foods (RUSFs) during a nutritional emergency. Here, we describe the use and acceptability of RUSF within households in four districts of the region of Maradi, Niger during large scale preventive distributions with RUSF in 2010 targeted at children 6-35months of age. Our study comprised both quantitative and qualitative components to collect detailed information and to allow in-depth interviews. We performed a cross-sectional survey in 16 villages between two monthly distributions of RUSF (October-November 2010). All households with at least one child who received RUSF were included and a total of 1842 caregivers were interviewed using a structured questionnaire. Focus groups and individual interviews of 128 caregivers were conducted in eight of the selected villages. On average, 24.7% of households reported any sharing of RUSF within the household. Sharing practices outside the household remained rare. Most of the sharing reported occurred among children under 5years of age living in the household. On average, 91% of caregivers in all districts rated the child's appreciation of the products as good or very good. Program planning may need to explicitly accounting for the sharing of products among children under 5 within household

Impact regimes and post-formation sequestration processes: implications for the origin of heavy noble gases in terrestrial planets

The difference between the measured atmospheric abundances of neon, argon, krypton, and xenon for Venus, Earth, and Mars is striking. Because these abundances drop by at least 2 orders of magnitude as one moves outward from Venus to Mars, the study of the origin of this discrepancy is a key issue that must be explained if we are to fully understand the different delivery mechanisms of the volatiles accreted by the terrestrial planets. In this work, we aim to investigate whether it is possible to quantitatively explain the variation of the heavy noble gas abundances measured on Venus, Earth, and Mars, assuming that cometary bombardment was the main delivery mechanism of these noble gases to the terrestrial planets. To do so, we use recent dynamical simulations that allow the study of the impact fluxes of comets upon the terrestrial planets during the course of their formation and evolution. Assuming that the mass of noble gases delivered by comets is proportional to the rate at which they collide with the terrestrial planets, we show that the krypton and xenon abundances in Venus and Earth can be explained in a manner consistent with the hypothesis of cometary bombardment. In order to explain the krypton and xenon abundance differences between Earth and Mars, we need to invoke the presence of large amounts of CO2-dominated clathrates in the Martian soil that would have efficiently sequestered these noble gases. Two different scenarios based on our model can also be used to explain the differences between the neon and argon abundances of the terrestrial planets. In the first scenario, cometary bombardment of these planets would have occurred at epochs contemporary with the existence of their primary atmospheres. Comets would have been the carriers of argon, krypton, and xenon, while neon would have been gravitationally captured by the terrestrial planets. In the second scenario, we consider impacting comets that contained significantly smaller amounts of argon, an idea supported by predictions of noble gas abundances in these bodies, provided that they formed from clathrates in the solar nebula. In this scenario, neon and argon would have been supplied to the terrestrial planets via the gravitational capture of their primary atmospheres whereas the bulk of their krypton and xenon would have been delivered by comets

Perceptions, attitudes, and willingness of healthcare and frontline workers to participate in an Ebola vaccine trial in Uganda.

BACKGROUND: Understanding the knowledge, perception and attitudes towards Ebola vaccines is an important factor in ensuring future use of these vaccines. A qualitative methods study embedded in an Ebola vaccine immunogenicity and safety trial (NCT04028349) was conducted to explore the knowledge and perceptions of healthcare (HCWs) and frontline workers (FLWs), about Ebola vaccines and their willingness to participate or recommend participation in Uganda. METHOD: We carried out focus group discussions and semi-structured interviews before and after vaccination, with 70 HCWs and FLWs who consented to participate in the trial, and in the qualitative component, from August to September 2019. Data were analysed using thematic content analysis. RESULTS: Respondents showed good knowledge about Ebola and the vaccines in general, and had wide access to information through several channels, including the study team. On prevention, particular attention was given to effective communication within health facilities. Misconceptions were mainly around route of transmission, animal origin and types of vaccines. Previous fears were based on rumours circulating in the community, mainly about the presence of the virus in the vaccine, side effects and intention to harm (e.g. by "the whites"), ultimately insisting on transparency, trust and involvement of local leaders. Acceptability of participation was motivated by the need to protect self and others, and the willingness to advance research. Majority were willing to recommend participation to their community. CONCLUSIONS: Overall, information sharing leads to a better understanding and acceptance of vaccine trials and a positive vaccination experience can be a deciding factor in the acceptance of others. Particular attention should be paid to involving the community in addressing misconceptions and fears, while ensuring that participants have access to vaccination sites in terms of transport, and that they are properly accommodated at the study site including staying for a reasonable period of time

Savants et écrivains : portraits croisés dans la France du XIXe siècle

Cette anthologie regroupe 78 textes qui sont autant de portraits révélateurs de la manière dont peut s’incarner, au XIXe siècle, le positionnement sur la carte des savoirs : le caractère, au sens où l’entendait La Bruyère, y joue toujours un rôle définitoire, permettant en sous-main de penser la spécificité des compétences, le « profil » des disciplines en formation. C’est cette personnification de la « différence » entre homme de lettres et homme de sciences qu’explore cette anthologie, en essayant d’exposer ses rouages et ses enjeux, mais aussi ses principales figures. La stratégie de reconnaissance qui gouverne ce type de textes n’a cependant pas pour but unique la source réelle du portrait. Elle cherche également à affirmer la pertinence d’un regard et d’un discours qui entendent maintenir leur spécificité, voire leurs prérogatives : la manière de présenter l’Autre en dit long sur la conception de sa propre pratique, mais aussi sur sa conception du savoir. Le point de vue sur l’une trahit toujours l’optique (idéologique ou esthétique) de l’autre. Qu’ils aient pour point commun de se concentrer sur la pratique du modèle (section « Portraits in situ »), de rechercher le contre-pied (« Anti-portraits ») ou de mettre en œuvre un art « scientifique » de la description (« Physiognomonies ») ; qu’ils reposent sur la devinette (« Portraits-mystère »), ou sur l’exemplarité (« Allégories », « Images d’Épinal »), les portraits réunis dans cette anthologie croisent non seulement les regards et les modèles, mais également les représentations des disciplines. En mesurant une différence, ils témoignent quoi qu’il en soit d’une obsession – voire d’une fascination – réciproque, perceptible dans l’usage de procédés communs. Ce sont eux qui fournissent son architecture à cette anthologie, dont le but est de faire apparaître un art et une stratégie du portrait partagés

Intrahousehold management and use of nutritional supplements during the hunger gap in Maradi region, Niger: A qualitative study

Background: Nutritional supplements are used for preventing and treating childhood malnutrition. While there is a growing body of evidence on product efficacy, less emphasis has been placed on how they are perceived and used at the household level. Here, we report on the intrahousehold management of three different supplements (Ready to Use Supplementary food (RUSF), medium quantity lipid-based nutrient supplements (LNS-MQ) and Super Cereal Plus (SC+)) in the region of Maradi (Niger). The main objective of this study was to describe the use, consumption and perception of the three different nutritional products at the household level. Methods: The study was conducted in the Madarounfa district in the region of Maradi (February - March 2012). Female caregivers were purposely selected from eligible households and invited to participate. Data were collected through focus group discussion and interviews and were analyzed using thematic content analysis. Results: In total, 114 caregivers participated. Three major themes were initially identified and included preparation and conservation; consumption and sharing practices as well as perception of impact. The data showed good acceptance at the household level including perceived benefits for the target children, health improvement, prevention of illness and malnutrition. Sharing and gifting at both household and community level were also reported. Conclusions: Caregivers displayed positive perceptions toward the investigated supplements. Patterns of actual management should be considered in the design, implementation, monitoring and evaluation of future programs

Indicative evaluation of psychological disturbance amongst young children affected by the January 2010 Haiti earthquake, in Port-au-Prince

International audienceThe article presents a research for the indicative evaluation of psychological disturbance amongst young children following the 2010 earthquake in Haiti. We used a new psychological evaluation questionnaire for young children, the PSYCa 3–6. It is a hetero-evaluation tool and is completed on site by the interviewer. The questionnaire was conducted in Port-au-Prince. The average age of the 166 children taking part in the study was 58 months. Psychological disturbance score appears to be high amongst our child population in Port-au-Prince. This corroborates other research into the psychological condition of natural disaster victims. A higher score of psychological disturbance was observed amongst boys and in the youngest group of children. This first application of the PSYCa 3–6, in a natural disaster area, highlights its capacity to identify children in great difficulties, the acceptability of the questionnaire and its appropriateness for use in humanitarian crisis areas