Unexpected behavioural consequences of preterm newborns' clothing.

International audienceRestrictions of preterm newborns' movements could have consequences ranging from stress enhancement to impairment of their motor development. Therefore, ability to freely express motor activities appears crucial for their behavioural and physiological development. Our aim was to evaluate behavioural issues of two types of clothing used in NICU. We observed 18 healthy 34-37 post-conception week-old preterm newborns, during resting periods, when they were undisturbed by any interventions. Newborns wore either light clothing (bodysuit and a light wrapping) or heavy clothing (pyjamas, cardigan and sleep-sack). The percentages of time each subject spent in different postures were compared between clothing situations. Arm and hand postures differed in relation to clothing: babies bent their arms more and held their hands nearer their heads when in bodysuits than when in sleepwear. Consequently, babies in bodysuits spent more time touching their body or their environment whereas the others generally were touching nothing. Self-touch is an important way to comfort one's self. Heavy clothing may impair self-soothing behaviours of preterm newborn babies that already lack other forms of contact. Results suggest that more attention should be paid to apparently routine and marginal decisions such as choice of clothes

Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening.

In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries

Treatment of Hepatitis C as Prevention: A Modeling Case Study in Vietnam

Background: Treatment of hepatitis C (HCV) is very effective, achieving a cure in 50–90 % of patients. Besides its own good for individuals, this most likely translates in reduced transmission, but this phenomenon has yet to be fully explored. Methods and Findings: In this mathematical modeling study done in the context of Vietnam, we estimated the public health benefit that HCV therapy for injecting drug users (IDUs) may achieve. Treatment coverage of 25, 50 and 75 % of chronically HCV-infected IDUs (4 years into infection) is predicted to reduce the chronic HCV viremia prevalence respectively by 21, 37 and 50%, 11 years after full scale up to the intended coverage. At a constant 50 % coverage level, earlier treatment, 3, 2, and 1 year into infection is predicted to reduce the chronic HCV viremia prevalence by 46, 60 and 85%. In these later 3 scenarios, for every 100 treatment courses provided, a total of respectively 50, 61 and 94 new infections could be averted. These benefits were projected in the context of current low coverage of methadone maintenance therapy and needles/ syringes exchange programs, and these services expansion showed complementary preventive benefits to HCV therapy. The program treatment commitment associated with the various scenarios is deemed reasonable. Our model projections are robust under adjustment for uncertainty in the model parameter values. Conclusions: In this case study in Vietnam, we project that treatment of HCV for injecting drug users will have a preventative herd effect in addition to curing patients in need for therapy, achieving a substantial reduction in HCV transmission an

Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices

Background The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge. Methods We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study. Results Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children. Conclusions Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected childre

DIVERGENCES IMMUNO-VIROLOGIQUES, SELENIUMEMIE ET CROISSANCE PONDERALE CHEZ 82 ENFANTS INFECTES PAR LE VIH (EVALUATION DE LEURS CORRELATIONS PRONOSTIQUES)

LILLE2-BU Santé-Recherche (593502101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Family socio-economic status (SES) influences early perception of turn-taking violation by 6-month-old infants

International audienc

Conversation et non-respect du tour de parole : comment les bébés de 6 mois réagissent-ils ?

National audienc

Six-month-old infants are sensible to turn-taking violation

International audienceTurn-taking is an important characteristic of conversational skills, where speakers and listeners alternate smoothly their roles, avoiding overlaps and extensive gaps between turns. A child needs more than 3 years to handle turn-taking skills although alternated vocalizations with his/her parents become predominant around the age of 9 months. Our experiment aimed to assess the ability of 6-month-old infants to perceive a breach of turn-taking characteristics: namely overlap. The infants watched videos of three sketches in which two women spoke to them. Three different situations were presented to each infant: 1) the first speaker turned towards the second person to allow her to speak; 2) the second speaker started speaking right as soon as the first speaker has finished; 3) the second speaker started to speak before the first speaker has finished (=overlap). The pictures of both speakers were presented side by side before and after each sketch. We measured the looking time at each speaker before and after each sketch. The infants looked longer at the second speaker after she overlapped the first one in the conversation. Overlap perception by infants seems to occur around 6 months, even before they are able to alternate smoothly their vocalizations with their parents.

Conversational skills: Detection of turn-taking violation in 6-month-old infants

International audienceTurn-taking is an important characteristic of everyday life communication. During a conversation, speakers and listeners alternate smoothly their roles and participants avoid overlaps and extensive gaps between conversational turns (Sacks et al, 1974). A child needs more than 3 years to handle turn-taking skills although alternated vocalizations between a child and his/her parents become predominant before a child is 9 months old (Casillas et al, 2015; Jasnow, 1986). Our experiment aimed to assess the ability of 6-month-old infants to perceive a breach of turn-taking characteristics, namely an overlap. To do so, the infants (N=40) watched videos of three sketches in which two women spoke to them. Three different situations were presented to each infant: 1) the first speaker turned toward the second to allow her to speak; 2) the second speaker started speaking right at the end of the first speaker's sentence; 3) the second speaker started speaking before the end of the first speaker's sentence (=overlap). The pictures of both speakers were presented side by side before and after each sketch. Sketches were shown in a random order and speakers differed between sketches. We measured the time infants looked at each speaker before and after each sketch. Six-month-old infants looked longer to the second speaker after she realized an overlap in the conversation. However, this behavioral response was only observed when the infants had previously seen two sketches with a respected turn-taking. Thus, their reaction to an overlap depended on their short-term experience. Six-month-old infants need to be exposed to correctly alternated turns to detect subsequently a breach in an interaction. Nevertheless, this suggests that the precursor of overlap perception by infants occurs around 6 months, even before they are able to alternate smoothly their vocalizations with their parents