Les hommes et la fonction paternelle dans la famille antillaise

Le modèle matrifocal d'organisation familiale reste toujours prépondérant dans les Petites Antilles malgré une confrontation ancienne au modèle nucléaire occidental. Il doit ses particularités aux conditions de son développement initial dans le contexte de l'esclavage et son maintien est favorisé par certaines dispositions sociales dans les Antilles françaises. Dans ce modèle les pères semblent graviter à la périphérie de la famille sans toutefois être invisibles, ni absents ou en conflit. Leur présence au domicile peut même être intermittente, mais de manière prévisible et régulière, rassurante pour l'enfant auquel ils accordent toute leur attention à ces moments-là. Le rôle dit paternel est assuré de manière plus complexe, non seulement par le père mais aussi par d'autres personnages masculins ou même féminins et même par l'ensemble du réseau social lorsque celui-ci garde une bonne cohésion. Lorsqu'il est fonctionnel, ce modèle est tout aussi à même qu'un autre de répondre aux besoins affectifs, éducatifs et de socialisation d'un enfant. Après un rappel des conditions historiques et économiques ayant donné naissance à ce type très particulier d'organisation familiale, cet article présente à travers l'étude de trois cas cliniques comment les deux modèles (nucléaire et matrifocal) se côtoient dans les Antilles françaises, et comment les professionnels de santé mentale procèdent aux raccommodages en cas d'accrocs.Men and the paternal function in Caribbean families It has previously been noted that one of the essential features of Caribbean families is the dominant position of women. Compared with the Western model of the nuclear family, these "matrifocal" families can give the impression that men and fathers are only marginally present or completely absent from the family scene, thus encouraging clinicians to view these families as deficient or pathological and their children as being "single-parented". Following a review of historical and economic factors contributing to this particular organization of the Afro-Caribbean family, this article uses three clinical cases studies to highlight the following points : 1) extended matrifocal families can resourcefully respond to the child's fundamental socialization needs ; 2) the paternal role can be and is often fulfilled in these families in a variety of ways (by fathers as well as others persons or social groups) which appropriately meet the developmental needs of the child ; and 3) when Caribbean families' ability to "father" the child is disrupted (through social isolation, emigration, developmental problems), mental health professionals should try to promote the (re)construction of an extended family network which applies more flexible concepts of "fatherhood" than those dictated by the nuclear family model.Los hombres y la función paternal en la familia antillana El modelo matrifocal de la organisación familial queda siempre preponderante en las Antillas Menores a pesar de una confrontación anciana al modelo nuclear occidental. Debe sus particularidades a las condiciones de su desarrollo inicial en el contexto de la esclavitud y su conservación esta favorisada por ciertas disposiciones sociales en las Antillas francesas. En este modelo los padres parecen gravitar a la periferia de la familia pero sin embargo estar invisibles, ausentes o en conflicto. Su presencia en el domicilio puede ser intermitente, pero de manera previsible y regular, tranquilizadora para el niño a quien acuerdan toda su atención durante estos momentos. El papel dicho paternal esta asegurado de manera más compleja, no solamente por el padre pero tambien por otros personajes masculinos o aun femeninos y hasta por el conjunto del red social cuando este mantiene una buena cohesión. Cuando es funcional, este modelo puede a pesar de todo responder como otro a las necesidades afectivas, educativas y de socialización de un niño. Después de una evocación de las condiciones historicas y economicas que dieron nacimiento a este tipo particular de organisación familial, a través el estudio de tres casos clinicos, este artículo presenta como los dos modelos (nuclear y matrifocal) se relacionan en las Antillas francesas y como los profesionales de la salud proceden en el arreglo en casos de desgarrones

Training Symbol-Based Equalization for Quadrature Duobinary PDM-FTN Systems

A training symbol-based equalization algorithm is proposed for polarization de-multiplexing in quadrature duobinary (QDB) modulated polarization division multiplexedfaster-than-Nyquist (FTN) coherent optical systems. The proposed algorithm is based on the least mean square algorithm, and multiple location candidates of a symbol are considered in order to make use of the training symbols with QDB modulation.Results show that an excellent convergence performance is obtained using the proposed algorithm under different polarization alignment scenarios. The optical signal-to-noise ratio required to attain a bit error rate of 2*10-2 is reduced by 1.7 and 1.8 dB using the proposed algorithm, compared to systems using the constant modulus algorithm with differential coding for 4-ary quadrature amplitude modulation(4-QAM) and 16-QAM systems with symbol-by-symbol detection, respectively.Furthermore, comparisons with the Tomlinson-Harashima precoding-based FTN systems illustrate that QDB is preferable when 4-QAM is utilized

Completeness of Reporting in Diet- and Nutrition-Related Randomized Controlled Trials and Systematic Reviews With Meta-Analysis:Protocol for 2 Independent Meta-Research Studies

Background: Journal articles describing randomized controlled trials (RCTs) and systematic reviews with meta-analysis of RCTs are not optimally reported and often miss crucial details. This poor reporting makes assessing these studies’ risk of bias or reproducing their results difficult. However, the reporting quality of diet- and nutrition-related RCTs and meta-analyses has not been explored. Objective: We aimed to assess the reporting completeness and identify the main reporting limitations of diet- and nutrition-related RCTs and meta-analyses of RCTs, estimate the frequency of reproducible research practices among these RCTs, and estimate the frequency of distorted presentation or spin among these meta-analyses. Methods: Two independent meta-research studies will be conducted using articles published in PubMed-indexed journals. The first will include a sample of diet- and nutrition-related RCTs; the second will include a sample of systematic reviews with meta-analysis of diet- and nutrition-related RCTs. A validated search strategy will be used to identify RCTs of nutritional interventions and an adapted strategy to identify meta-analyses in PubMed. We will search for RCTs and meta-analyses indexed in 1 calendar year and randomly select 100 RCTs (June 2021 to June 2022) and 100 meta-analyses (July 2021 to July 2022). Two reviewers will independently screen the titles and abstracts of records yielded by the searches, then read the full texts to confirm their eligibility. The general features of these published RCTs and meta-analyses will be extracted into a research electronic data capture database (REDCap; Vanderbilt University). The completeness of reporting of each RCT will be assessed using the items in the CONSORT (Consolidated Standards of Reporting Trials), its extensions, and the TIDieR (Template for Intervention Description and Replication) statements. Information about practices that promote research transparency and reproducibility, such as the publication of protocols and statistical analysis plans will be collected. There will be an assessment of the completeness of reporting of each meta-analysis using the items in the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and collection of information about spin in the abstracts and full-texts. The results will be presented as descriptive statistics in diagrams or tables. These 2 meta-research studies are registered in the Open Science Framework. Results: The literature search for the first meta-research retrieved 20,030 records and 2182 were potentially eligible. The literature search for the second meta-research retrieved 10,918 records and 850 were potentially eligible. Among them, random samples of 100 RCTs and 100 meta-analyses were selected for data extraction. Data extraction is currently in progress, and completion is expected by the beginning of 2023. Conclusions: Our meta-research studies will summarize the main limitation on reporting completeness of nutrition- or diet-related RCTs and meta-analyses and provide comprehensive information regarding the particularities in the reporting of intervention studies in the nutrition field

Completeness of reporting in diet- and nutrition-related randomized controlled trials and systematic reviews with meta-analysis: protocol for 2 independent meta-research studies

Background: Journal articles describing randomized controlled trials (RCTs) and systematic reviews with meta-analysis of RCTs are not optimally reported and often miss crucial details. This poor reporting makes assessing these studies’ risk of bias or reproducing their results difficult. However, the reporting quality of diet- and nutrition-related RCTs and meta-analyses has not been explored. Objective: We aimed to assess the reporting completeness and identify the main reporting limitations of diet- and nutrition-related RCTs and meta-analyses of RCTs, estimate the frequency of reproducible research practices among these RCTs, and estimate the frequency of distorted presentation or spin among these meta-analyses. Methods: Two independent meta-research studies will be conducted using articles published in PubMed-indexed journals. The first will include a sample of diet- and nutrition-related RCTs; the second will include a sample of systematic reviews with meta-analysis of diet- and nutrition-related RCTs. A validated search strategy will be used to identify RCTs of nutritional interventions and an adapted strategy to identify meta-analyses in PubMed. We will search for RCTs and meta-analyses indexed in 1 calendar year and randomly select 100 RCTs (June 2021 to June 2022) and 100 meta-analyses (July 2021 to July 2022). Two reviewers will independently screen the titles and abstracts of records yielded by the searches, then read the full texts to confirm their eligibility. The general features of these published RCTs and meta-analyses will be extracted into a research electronic data capture database (REDCap; Vanderbilt University). The completeness of reporting of each RCT will be assessed using the items in the CONSORT (Consolidated Standards of Reporting Trials), its extensions, and the TIDieR (Template for Intervention Description and Replication) statements. Information about practices that promote research transparency and reproducibility, such as the publication of protocols and statistical analysis plans will be collected. There will be an assessment of the completeness of reporting of each meta-analysis using the items in the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement and collection of information about spin in the abstracts and full-texts. The results will be presented as descriptive statistics in diagrams or tables. These 2 meta-research studies are registered in the Open Science Framework. Results: The literature search for the first meta-research retrieved 20,030 records and 2182 were potentially eligible. The literature search for the second meta-research retrieved 10,918 records and 850 were potentially eligible. Among them, random samples of 100 RCTs and 100 meta-analyses were selected for data extraction. Data extraction is currently in progress, and completion is expected by the beginning of 2023. Conclusions: Our meta-research studies will summarize the main limitation on reporting completeness of nutrition- or diet-related RCTs and meta-analyses and provide comprehensive information regarding the particularities in the reporting of intervention studies in the nutrition field. International Registered Report Identifier (IRRID): DERR1-10.2196/4353

Protocol for a meta-research study of protocols for diet or nutrition-related trials published in indexed journals:general aspects of study design, rationale and reporting limitations

INTRODUCTION: The Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) reporting guideline establishes a minimum set of items to be reported in any randomised controlled trial (RCT) protocol. The Template for Intervention Description and Replication (TIDieR) reporting guideline was developed to improve the reporting of interventions in RCT protocols and results papers. Reporting completeness in protocols of diet or nutrition-related RCTs has not been systematically investigated. We aim to identify published protocols of diet or nutrition-related RCTs, assess their reporting completeness and identify the main reporting limitations remaining in this field. METHODS AND ANALYSIS: We will conduct a meta-research study of RCT protocols published in journals indexed in at least one of six selected databases between 2012 and 2022. We have run a search in PubMed, Embase, CINAHL, Web of Science, PsycINFO and Global Health using a search strategy designed to identify protocols of diet or nutrition-related RCTs. Two reviewers will independently screen the titles and abstracts of records yielded by the search in Rayyan. The full texts will then be read to confirm protocol eligibility. We will collect general study features (publication information, types of participants, interventions, comparators, outcomes and study design) of all eligible published protocols in this contemporary sample. We will assess reporting completeness in a randomly selected sample of them and identify their main reporting limitations. We will compare this subsample with the items in the SPIRIT and TIDieR statements. For all data collection, we will use data extraction forms in REDCap. This protocol is registered on the Open Science Framework (DOI: 10.17605/OSF.IO/YWEVS). ETHICS AND DISSEMINATION: This study will undertake a secondary analysis of published data and does not require ethical approval. The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research

Scoring system for renal pathology in Fabry disease: report of the International Study Group of Fabry Nephropathy (ISGFN)

Background. In Fabry nephropathy, alpha-galactosidase deficiency leads to accumulation of glycosphingolipids in all kidney cell types, proteinuria and progressive loss of kidney function. Methods. An international working group of nephrologists from 11 Fabry centres identified adult Fabry patients, and pathologists scored histologic changes on renal biopsies. A standardized scoring system was developed with a modified Delphi technique assessing 59 Fabry nephropathy cases. Each case was scored independently of clinical information by at least three pathologists with an average final score reported. Results. We assessed 35 males (mean age 36.4 years) and 24 females (43.9 years) who mostly had clinically mild Fabry nephropathy. The average serum creatinine was 1.3mg/dl (114.9 μmol/l); estimated glomerular filtration rate was 81.7 ml/min/1.73 m2 and urine protein to creatinine ratio was 1.08 g/g (122.0 mg/mmol). Males had greater podocyte vacuolization on light microscopy (mean score) and glycosphingolipid inclusions on semi-thin sections than females. Males also had significantly more proximal tubule, peritubular capillary and vascular intimal inclusions. Arteriolar hyalinosis was similar, but females had significantly more arterial hyalinosis. Chronic kidney disease stage correlated with arterial and glomerular sclerosis scores. Significant changes, including segmental and global sclerosis, and interstitial fibrosis were seen even in patients with stage 1-2 chronic kidney disease with minimal proteinuria. Conclusions. The development of a standardized scoring system of both disease-specific lesions, i.e. lipid deposition related, and general lesions of progression, i.e. fibrosis and sclerosis, showed a spectrum of histologic appearances even in early clinical stage of Fabry nephropathy. These findings support the role of kidney biopsy in the baseline evaluation of Fabry nephropathy, even with mild clinical disease. The scoring system will be useful for longitudinal assessment of prognosis and responses to therapy for Fabry nephropath

Validation de la version française de la Binge Eating Scale : étude de sa structure factorielle, de sa consistance interne et de sa validité de construit en population clinique et non clinique: Validation française de la Binge Eating Scale

International audienceObjective: The Binge Eating Scale is a widely used scale to assess binge eating disorder in obese patients. Until now this scale has not been validated on a French population, and no psychometrically sound tool assesses binge eating disorder in the French. This study aimed to test the psychometric properties of a French version of the Binge Eating Scale by establishing its factor structure, internal consistency, and construct validity in both a non-clinical population and a clinical population (obese patients who are candidates for bariatric surgery). Methods: 553 non clinical subjects and 63 morbidly obese patients who were candidates for bariatric surgery were assessed with the BES and the Bulimic Investigatory Test, Edinburgh or BITE (which assesses both binge eating behaviours and use of inappropriate compensatory behaviours). We tested the factor structure of the instrument, its internal consistency, its construct validity with measures of binge eating, and its construct validity with measures of inappropriate compensatory behaviours to avoid weight gain. In 47 out of the 63 obese patients, we assessed binge eating disorder (SCID). Results: In the non clinical population, the BES had a one factor structure (which accounted for 61 % of the variance), excellent internal consistency (= 0.93), and high construct validity with measures of binge eating. In this population, construct validity with measures of inappropriate compensatory behaviours was confirmed in overweight and obese subjects (p = 0.42), but not in underweight and optimal weight subjects (p < 0.001). In obese patients candidates for bariatric surgery, we demonstrated that the BES had a one factor structure (which accounted for 46 % of the variance), had high internal consistency (= 0.88) and high construct validity with measures of binge eating and good construct validity with measures of inappropriate compensatory behaviours to avoid weight gain. In the subpopulation of 47 obese patients, sensitivity, specificity, positive predictive value and negative predictive value were respectively 75 %, 88.4 %, 37.5 % and 97.4 % (BES threshold=18). Discussion: In this study, we validated a psychometrically sound French version of the Binge Eating Scale, both in a non clinical and a clinical sample. The psychometric properties of the French version of the BES are comparable to its original version with a one factor structure. The BES is a useful tool to assess binge eating disorder in obese patients (e.g., bariatric surgery candidates), but might not differentiate between binge eating disorder and bulimia nervosa in underweight and optimal weight subjects.Objectif : la Binge Eating Scale (BES) est un outil utile pour évaluer et dépister l’hyperphagie boulimique chez les sujets obèses, mais n’a jusqu’à présent pas été validé en français. L’objectif de ce travail était de tester les propriétés psychométriques de la version française de la Binge Eating Scale (BES), en établissant sa structure factorielle, sa consistance interne et sa validité de construit en population non clinique et clinique. Matériel et méthode : la BES a été testée auprès d’une population non clinique (n=553) et de patients obèses morbides candidats à la chirurgie bariatrique (n=63), avec administration concomitante de la Bulimic Investigatory Test, Edinburgh (BITE) pour tester la validité de construit. Résultats : la BES possède une structure mono-factorielle (expliquant 61 % de la variance en population non clinique et 46 % en population clinique), une très bonne consistance interne (respectivement de =0,93 et =0,88) et une très bonne validité de construit vis-à-vis des comportements boulimiques. La validité de construit vis-à-vis du recours à des comportements compensatoires était confirmée en population clinique et chez les sujets obèses ou en surpoids de la population non clinique (p=0,42), mais pas chez les patients normo-pondéraux ou maigres de la population non clinique (p<0,001). Conclusion : la version française de la BES possède des propriétés psychométriques proches de la version originale. La BES est un outil utile pour évaluer et dépister l’hyperphagie boulimique chez les sujets obèses, pouvant notamment être utilisé chez les patients candidats à la chirurgie bariatrique