Internal validity of the French version of the Family Coping Questionnaire (FCQ): A confirmatory factor analysis.

Family members of patients with schizophrenia, especially when they assume caregivers' positions, experience difficulties to adapt to the situation. To gain insight into these caregivers' coping style is a challenge to decrease the stress of family members, and in this way, improve patient related outcome. The FCQ (Family Coping Questionnaire) is an adapted clinical assessment tool that focuses on specific ways to cope with dysfunction that characterize the psychotic pathology. The goal of this study was to provide validity evidence about the French version of the FCQ. Swiss and French family members of individuals suffering from schizophrenia (n = 204) responded to the FCQ. A confirmatory factor analysis (CFA) was applied estimating two models. The seven-factor model showed adequate fit to the data while the three-factor model fit was poor. This FCQ internal validation showed an adequate model fit with a French population including various family members (parents, siblings, etc.) of persons with enduring mental illness

Active inference, sensory attenuation and illusions.

Active inference provides a simple and neurobiologically plausible account of how action and perception are coupled in producing (Bayes) optimal behaviour. This can be seen most easily as minimising prediction error: we can either change our predictions to explain sensory input through perception. Alternatively, we can actively change sensory input to fulfil our predictions. In active inference, this action is mediated by classical reflex arcs that minimise proprioceptive prediction error created by descending proprioceptive predictions. However, this creates a conflict between action and perception; in that, self-generated movements require predictions to override the sensory evidence that one is not actually moving. However, ignoring sensory evidence means that externally generated sensations will not be perceived. Conversely, attending to (proprioceptive and somatosensory) sensations enables the detection of externally generated events but precludes generation of actions. This conflict can be resolved by attenuating the precision of sensory evidence during movement or, equivalently, attending away from the consequences of self-made acts. We propose that this Bayes optimal withdrawal of precise sensory evidence during movement is the cause of psychophysical sensory attenuation. Furthermore, it explains the force-matching illusion and reproduces empirical results almost exactly. Finally, if attenuation is removed, the force-matching illusion disappears and false (delusional) inferences about agency emerge. This is important, given the negative correlation between sensory attenuation and delusional beliefs in normal subjects--and the reduction in the magnitude of the illusion in schizophrenia. Active inference therefore links the neuromodulatory optimisation of precision to sensory attenuation and illusory phenomena during the attribution of agency in normal subjects. It also provides a functional account of deficits in syndromes characterised by false inference and impaired movement--like schizophrenia and Parkinsonism--syndromes that implicate abnormal modulatory neurotransmission

Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)

Purpose Thrombocytopenia (platelet count < 150 × 109/L) is common in intensive care unit (ICU) patients and is likely associated with worse outcomes. In this study we present international contemporary data on thrombocytopenia in ICU patients. Methods We conducted a prospective cohort study in adult ICU patients in 52 ICUs across 10 countries. We assessed frequencies of thrombocytopenia, use of platelet transfusions and clinical outcomes including mortality. We evaluated pre-selected potential risk factors for the development of thrombocytopenia during ICU stay and associations between thrombocytopenia at ICU admission and 90-day mortality using pre-specified logistic regression analyses. Results We analysed 1166 ICU patients; the median age was 63 years and 39.5% were female. Overall, 43.2% (95% confidence interval (CI) 40.4–46.1) had thrombocytopenia; 23.4% (20–26) had thrombocytopenia at ICU admission, and 19.8% (17.6–22.2) developed thrombocytopenia during their ICU stay. Non-AIDS-, non-cancer-related immune deficiency, liver failure, male sex, septic shock, and bleeding at ICU admission were associated with the development of thrombocytopenia during ICU stay. Among patients with thrombocytopenia, 22.6% received platelet transfusion(s), and 64.3% of in-ICU transfusions were prophylactic. Patients with thrombocytopenia had higher occurrences of bleeding and death, fewer days alive without the use of life-support, and fewer days alive and out of hospital. Thrombocytopenia at ICU admission was associated with 90-day mortality (adjusted odds ratio 1.7; 95% CI 1.19–2.42). Conclusion Thrombocytopenia occurred in 43% of critically ill patients and was associated with worse outcomes including increased mortality. Platelet transfusions were given to 23% of patients with thrombocytopenia and most were prophylactic.publishedVersio

Coping profiles of family caregivers of people with schizophrenia: Differentiations between parent and sibling caregivers

Background: Prior research on informal caregivers of people with schizophrenia (PWS) has primarily focused on parental caregivers. However, siblings also play an important role in the recovery process of PWS. Aims: The aim of this study is to compare the coping profiles of family caregivers according to whether they are siblings or parents of the PWS.Method:Parent and sibling caregivers (N¼181) completed the Family Coping Questionnaire (FCQ), which assessed their coping strategies. Results: The results reveal that parents and siblings do not use the same coping strategies and styles.Three coping profiles were identified depending on the caregiver’s relationship with the PWS. Most parents displayed an undifferentiated profile (96.7%), while siblings were more heterogeneously distributed among the undifferentiated profile (58.3%), problem-focused profile (37.5%), and emotion and social support-focused profile (4.2%). Conclusions: These findings suggest that the coping capacities of family caregivers to deal with the illness of their sibling or child with schizophrenia are diverse and that it is important to differentiate among them. This would enable these caregivers to benefit from support that could be tailored to their specific needs

Seismic risk in Belgium for ordinary buildings: methodological aspects and study cases

peer reviewedBelgium is located in a region in which damaging earthquakes exist. Assessing the risks for the society caused by this seismic activity is complex but useful. We propose in this paper the concept of a general tool for a first level assessment of seismic risks aiming a rapid identification of problematic buildings in a given area. General methodological aspects are presented. For a building, the risk is represented by a volume in a multi-dimensional space. This space is defined by axes representing the main parameters that have an influence on the risk. We are Seismic Risk 2008 - Earthquakes in North-Western Europe especially developing the assessment of the Belgian buildings vulnerability. We also express the importance of including a parameter to consider the specific value of cultural heritage. Then we apply the proposed tool to analyze and compare methods of seismic risk assessment used in Belgium. They differ by the spatial scale of the studied area. Study cases for the whole Belgian Territory and for parts of cities in Liège and Mons (Be) aim also to give an overview of the overall risk in Belgium