Mettre en œuvre pour la première fois la démarche d'investigation avec des élèves de CE2 : une séquence sur les conditions de germination d'une graine

Au cours d'un stage en pratique accompagnée, nous avons mis en œuvre la démarche d'investigation avec une classe de CE2, lors d'une séquence sur les conditions de germination d'une graine. Il s'agissait d'une découverte, tant pour les élèves que pour nous. Notre objectif était, au-delà de l'acquisition de connaissances, de permettre aux élèves de comprendre cette démarche scientifique et de se l'approprier. Nous pensions que par sa seule mise en œuvre nous atteindrions ce but. Il ressort de l'analyse des résultats et de notre pratique qu'il n'est pas suffisant de faire vivre la démarche d'investigation aux élèves pour qu'ils la comprennent et se l'approprient, et a fortiori la première fois. Un fort étayage est nécessaire, afin de baliser chacune des étapes et les rendre porteuses de sens pour les élèves

Incontinence and psychological symptoms in Phelan-McDermid syndrome

Aims Phelan-McDermid syndrome (PMD) is a congenital syndrome caused by a deletion on chromosome 22q13.3. About 600 cases have been identified worldwide. PMD is characterized by neonatal hypotonia, moderate/severe intellectual impairment, impaired expressive language, and typical dysmorphic features. Psychological symptoms as hyperactivity, attention problems, restlessness, and stereotyped-repetitive behavior were reported. The aim of the study was to assess incontinence and associated psychological problems in PMD. Methods Forty-one individuals with PMD were recruited through a German support group (48.8% male; mean age 13.4 years; range, 4-55 years). Parents or caregivers completed the developmental behavior checklist (DBC), as well as the parental questionnaire: enuresis/urinary incontinence, including six questions on adaptive toileting skills. Results Rates of nocturnal enuresis (NE), daytime urinary incontinence, and fecal incontinence were 86%, 73%, and 79%. Rates were similar in all age groups (children, teens, adults). Constipation was present in 19%. Forty-two percent of the sample had a clinically relevant DBC score, with adults more affected than teens. Persons with NE had significantly higher “anxiety/depression” subscale scores. Toileting skills were more developed in adults than in children. Sixty-eight percent had further physical disabilities. Conclusions Incontinence rates in PMD are high in all age groups. However, persons with PMD can improve their toilet skills. Therefore, the assessment and treatment of incontinence in persons with PMD is recommended. Constipation does not seem to be a major problem in PMD. Due to the high prevalence rates of somatic conditions, an assessment for organic and functional incontinence is recommended

Anxiety disorders, depression and incontinence in preschool children : A population-based study

Objective The aim was to examine associations of specific anxiety disorders, depressive symptoms, and incontinence in a representative, population-based sample of preschool children. Methods All preschool children of a defined geographical area examined before school-entry were included. Parents completed a questionnaire including the Preschool Feelings Checklist (PFC), eight questions referring to nocturnal enuresis (NE), daytime urinary incontinence (DUI), fecal incontinence (FI) and constipation, and 30 items regarding Diagnostic and Statistical Manual of Mental Disorders—Fifth Edition (DSM-5) diagnostic criteria of separation anxiety disorder (SAD), social phobia (SOC), specific phobia (PHOB), and generalized anxiety disorder (GAD). Data of 1206 children (mean age = 5.7 years; 53.5% boys) are presented. Results 34.6% of incontinent children had an anxiety disorder based on DSM-5 criteria and 13.3% had clinically relevant depressive symptoms (measured by the PFC). Rates of incontinence overall were 14.1% (11.9% NE, 3.1% DUI, and 1.8% FI) and 6.3% for constipation. Rates of SOC and PHOB were increased in NE (20.8% and 25.4%), DUI (39.3% and 34.5%) and FI (35.3% and 50.0%) compared to continent children (13.5% and 17.2%). Children with constipation had higher rates of SOC, PHOB, and GAD than those without. Compared to continent children (9.7%), depressive symptoms were more frequent in children with NE (26.8%), DUI (50.0%), and FI (61.9%). Conclusion Anxiety disorders and depressive symptoms are common in children with incontinence. The most specific DSM-5 disorders associated with incontinence are SOC and PHOB, which can be incapacitating and may require treatment. Due to the high rates of anxiety disorders, it is important to screen all children with incontinence, for example, with specific questionnaires

Incontinence in persons with tuberous sclerosis complex

Aims Tuberous sclerosis complex (TSC) is a multisystem genetic disorder caused by a mutation in the TSC1 or TSC2 gene with a broad spectrum of physical and psychological manifestations. The aim of the study was to examine incontinence, psychological problems, and adaptive behavior skills in patients with TSC. Methods Through a worldwide TSC support group, 26 children (4‐17 years) and 15 adults (18‐50 years) with TSC were recruited (38.1% male, mean age 16.4 years). Parents or care‐givers completed the Developmental Behavior Checklist (DBC), the Parental Questionnaire: Enuresis/urinary Incontinence, and the Vineland Adaptive Behavior Scales (3rd edition). Results A total of 60.0% of the participants had nocturnal enuresis (NE), 51.3% daytime urinary incontinence (DUI) and 52.4% fecal incontinence (FI). 65.4% of children and 50.0% of adults had a clinically relevant DBC score. Psychological symptoms were associated with at least one subtype of incontinence. The mean adaptive behavior composite (ABC) score of the patients was 57.2 (SD = 26.1), with 38.1% in the average or below‐average range (IQ >70), 26.2% with a mild, 11.9% with a moderate and 23.8% with a severe/profound intellectual disability. The incontinence rate was significantly higher in the groups with a lower ABC score. Conclusion A substantial proportion of patients with TSC are affected by incontinence and psychological symptoms. Incontinence was higher in persons with lower adaptive skills and those with at least one type of incontinence showed a significantly higher DBC score. As incontinence and psychological problems affect daily functioning and well‐being, assessment, and treatment are recommended

Psychopathologie und elterlicher Stress bei 3- bis 6-jährigen Kindern mit Ausscheidungsstörungen

Objective: Incontinence and functional gastrointestinal disorders are common in young children and are associated with higher rates of psychological symptoms and mental disorders. This article focuses on the mutual association between incontinence and related toilet refusal syndrome, parental stress, and children’s psychopathology especially in young children. Methods: Children’s psychological symptoms, mental disorders, and parental stress levels were assessed in 38 parent-child dyads involving children with incontinence and 42 dyads of typically developing (TD) children. Results: Compared to TD children, patients had higher internalizing and externalizing CBCL scores and higher rates of clinically relevant externalizing problems. However, the rates of clinically relevant internalizing problems and mental disorders did not differ. The parents of children with incontinence reported signifi cantly higher stress levels regarding child-related stress factors (PSI-CD) than did parents of TD children. However, there were no clinically relevant parental stress scores on a group level, which remained below the clinical range (T-value < 60). When simultaneously analyzed, children’s (comorbid) mental disorders but not incontinence had a major impact on parental stress. Conclusions: Despite moderate stress levels, incontinence symptoms, urinary and fecal incontinence are highly prevalent in young children. However, stress among parents of young children was mainly elicited by any (comorbid) mental disorder.Fragestellung: Ausscheidungsstörungen (AS) wie funktionelle Harn- und Stuhlinkontinenz sind sehr häufi ge Störungen im Vorschulalter und sind mit einer erhöhten Prävalenz von psychopathologischen Symptomen und psychischen Störungen bei den betroffenen Kindern assoziiert. Innerhalb der vorliegenden Arbeit wird der wechselseitige Zusammenhang von funktioneller Harn- und Stuhlinkontinenz sowie dem damit in Verbindung stehenden Toilettenverweigerungssyndrom auf die kindliche Psychopathologie und das elterliche Stresserleben speziell bei jungen Kindern untersucht. Methode: Psychopathologische Symptome, psychische Störungen und elterliche Stressbelastung wurden in 38 Eltern-Kind-Dyaden bei Kindern mit vorhandener AS und in 42 Dyaden bei Kindern ohne AS untersucht. Ergebnisse: Kinder mit AS wiesen höhere Werte von internalisierendem und externalisierendem Problemverhalten auf und waren häufi ger von klinisch relevanter externalisierender Symptomatik betroffen. Nichtsdestotrotz war die Prävalenz psychischer Störungen vergleichbar. Eltern von Kindern mit AS berichteten signifi kant höhere kindbezogene Stresslevel. Dennoch zeigte sich auf Gruppenebene kein klinisch bedeutsamer elterlicher Stress und die mittleren Stresslevel lagen unterhalb des Bereichs der klinischen Auffälligkeit (T-Wert < 60). Bei gleichzeitiger Betrachtung des Einfl usses von AS und psychischen Störungen zeigten sich letztere als ausschlaggebend für den elterlichen Stress. Schlussfolgerungen: Trotz moderater Stresslevel konnte eine generell hohe Prävalenz von AS Symptomen bei 3–6-Jährigen aufgezeigt werden. Elterlicher Stress war jedoch bedeutsamer mit einer (komorbiden) psychischen Erkrankung assoziiert

Incontinence in autism spectrum disorder: a systematic review

Autism spectrum disorders (ASD) are defined by persistent deficits in reciprocal social interaction, communication, and language, as well as stereotyped and repetitive behavior. Functional incontinence, as well as ASD are common disorders in childhood. The aim of this systematic review was to give an overview of the co-occurrence of nocturnal enuresis (NE), daytime urinary incontinence (DUI), and fecal incontinence (FI) in ASD, and vice versa, of ASD in children with incontinence. A systematic literature search of the terms “incontinence”, “enuresis”, and “encopresis” in combination with “autism” or “Asperger” in four databases (Scopus, PubMed, PsycInfo and Web of science) was conducted. All studies that examined incontinence frequencies in samples with ASD, and studies that measured frequencies of ASD diagnoses or symptoms in samples with incontinence were included. Risk of bias and limitations of each study were described. After eligibility assessment, 33 publications were included in the review. The published literature implies a higher prevalence of incontinence in children with ASD compared to typically developing children. Limitations and biases as inappropriate diagnostic criteria for ASD and incontinence, selected samples, or lack of control groups are reported. Associations of incontinence in ASD with psychopathological symptoms were found. Vice versa, ASD symptoms are found in incontinent children, but no study included a non-ASD control sample. Incontinence symptoms are also reported as an adverse effect of medication in ASD. Due to methodological problems and definitional discrepancies in some publications, results have to be interpreted cautiously. Research in ASD and incontinence is scarce. More systematic research including state-of-the-art assessments is needed

Incontinence and psychological symptoms in Phelan-McDermid syndrome

Aims Phelan-McDermid syndrome (PMD) is a congenital syndrome caused by a deletion on chromosome 22q13.3. About 600 cases have been identified worldwide. PMD is characterized by neonatal hypotonia, moderate/severe intellectual impairment, impaired expressive language, and typical dysmorphic features. Psychological symptoms as hyperactivity, attention problems, restlessness, and stereotyped-repetitive behavior were reported. The aim of the study was to assess incontinence and associated psychological problems in PMD. Methods Forty-one individuals with PMD were recruited through a German support group (48.8% male; mean age 13.4 years; range, 4-55 years). Parents or caregivers completed the developmental behavior checklist (DBC), as well as the parental questionnaire: enuresis/urinary incontinence, including six questions on adaptive toileting skills. Results Rates of nocturnal enuresis (NE), daytime urinary incontinence, and fecal incontinence were 86%, 73%, and 79%. Rates were similar in all age groups (children, teens, adults). Constipation was present in 19%. Forty-two percent of the sample had a clinically relevant DBC score, with adults more affected than teens. Persons with NE had significantly higher "anxiety/depression" subscale scores. Toileting skills were more developed in adults than in children. Sixty-eight percent had further physical disabilities. Conclusions Incontinence rates in PMD are high in all age groups. However, persons with PMD can improve their toilet skills. Therefore, the assessment and treatment of incontinence in persons with PMD is recommended. Constipation does not seem to be a major problem in PMD. Due to the high prevalence rates of somatic conditions, an assessment for organic and functional incontinence is recommended

Effects of Heat Treatment and Pectin Addition on β -Lactoglobulin Allergenicity

International audienceThe specific effects of heat treatment and/or addition of low/high-methylated pectin (LMP/HMP) on the allergenicity of β-lactoglobulin (β-Lg) and its hydrolysis products were investigated through a two-step in vitro digestion approach. β-Lg was first hydrolyzed by pepsin and then by a trypsin/chymotrypsin (T/C) mixture done in a dialysis bag with a molecular weight cutoff of 1000. The protein digestion was followed by SDS-PAGE electrophoresis performed on each digestion product, and their in vitro allergenicity was analyzed by immunoblotting. Such procedure was applied on β-Lg samples mixed with the two kinds of pectin before or after heating (80 °C, 25 min) to determine the respective impact of heat treatment and pectin addition. Heat denaturation improved significantly the susceptibility of β-Lg against the pepsin and the T/C. This effect, which was coupled to a reduction in immunoreactivity of the digested β-Lg, appeared to be distinctively modulated by LMP and HMP. Through nonspecific interaction with the β-Lg, pectin could reduce the accessibility of cleavage sites and/or epitope sequences. This mechanism of action is discussed in relation to the intra- and intermolecular interactions between β-Lg and pectin initiated under the experimental conditions