Human q fever

Q fever is a ubiquitous zoonosis due to Coxiella burnetii, a strict intracellular bacterium. Transmission to man occurs mainly through the inhalation of infected aerosols, arising mostly from livestock deliveries. The main characteristic of Q fever is its clinical variability, acute forms being associated with primary infection (flu-like syndrome, pneumopathy, hepatitis). The clinical expression also varies with age and sex. Chronic Q fever (mainly associated with endocarditis) may develop in people at risk (patients with valvular disease or immunosuppression or pregnant women), hence the importance of serological screening for Q fever in people at risk, and of the detection of valvular anomalies in patients with acute Q fever.La fièvre Q est une zoonose ubiquitaire due à Coxiella burnetii, bactérie intracellulaire stricte. La transmission à l'Homme se fait principalement par inhalation d'aérosols infectés, en particulier lors de la mise bas des mammifères. La principale caractéristique de la fièvre Q est la variabilité de son expression clinique, avec des formes aiguës lors de la primo-infection (syndrome pseudo-grippal, pneumopathie, hépatite). L'expression clinique varie également selon et le sexe. Chez les sujets à risque (patients atteints d'une valvulopathie ou immunodéprimés, femmes enceintes), la fièvre Q peut évoluer vers une forme chronique (provoquant généralement une endocardite), d'où l'importance du dépistage sérologique de la fièvre Q chez les sujets à risque et de la recherche de toute anomalie valvulaire devant un cas de fièvre Q aiguë

The Family Alliance Assessment Scales: Steps Toward Validity and Reliability of an Observational Assessment Tool for Early Family Interactions

We present the first steps in the validation of an observational tool for father-mother-infant interactions: the FAAS (Family Alliance Assessment Scales). Family-level variables are acknowledged as unique contributors to the understanding of the socio-affective development of the child, yet producing reliable assessments of family-level interactions poses a methodological challenge. There is, therefore, a clear need for a validated and clinically relevant tool. This validation study has been carried out on three samples: one non-referred sample, of families taking part in a study on the transition to parenthood (normative sample; n=30), one referred for medically assisted procreation (infertility sample; n=30) and one referred for a psychiatric condition in one parent (clinical sample; n=15). Results show that the FAAS scales have (1) good inter-rater reliability and (2) good validity, as assessed through known-group validity by comparing the three samples and through concurrent validity by checking family interactions against parents' self-reported marital satisfactio

Validation of the French Version of the Experiences in Close Relationships– Revised (ECR-R) Adult Romantic Attachment Questionnaire

This study aimed to validate the French version of the Experiences in Close Relationships-Revised (ECR-R) adult attachment questionnaire by investigating its internal structure and construct validity. The sample (N = 600) consisted of an equal number of male and female participants aged 25-45 years. Variables linked to adult romantic attachment (marital satisfaction, sexual satisfaction and fears associated with sexual activities, and self-esteem) were assessed using a set of questionnaires. The reliability of the two attachment dimensions (viz., avoidance and anxiety) was satisfactory. Confirmatory factor analyses revealed that the original two-factor model explained the data collected with the French ECR-R most satisfactorily. The assessment of measurement invariance showed that the structure is the same across the original U. S. sample and our sample, across men and women, and across single individuals and those in a couple relationship. Our evaluation of construct validity showed that the higher avoidance and anxiety, the lower self-esteem and sexual satisfaction and the higher the fears associated with sexuality. These results are theoretically coherent and consistent with those of previous studies of the English version of the scale. We conclude that the French version is valid

The Diaper Change Play: Validation of a New Observational Assessment Tool for Early Triadic Family Interactions in the First Month Postpartum

The quality of family relations, observed during mother-father-infant triadic interactions, has been shown to be an important contributor to child social and affective development, beyond the quality of dyadic mother-child, father-child, and marital relationships. Triadic interactions have been well described in families with 3 month olds and older children using the Lausanne Trilogue Play (LTP). Little is known about the development of mother-father-baby interactions in the very 1st weeks postpartum, mostly because no specific observational setting or particular instrument had been designed to cover this age yet. To fill this gap, we adapted the LTP to create a new observational setting, namely the Diaper Change Play (DCP). Interactions are assessed using the Family Alliance Assessment Scales for DCP (FAAS-DCP). We present the validation of the DCP and its coding system, the FAAS-DCP. The three validation studies presented here (44 mother-father-child-triads) involve a sample of parents with 3-week-old infants recruited in two maternity wards (n = 32 and n = 12) in Switzerland. Infants from both sites were all healthy according to their APGAR scores, weight at birth, and scores on the NICU Network Neurobehavioral Scale (NNNS), which was additionally conducted on the twelve infants recruited in one of the maternity ward. Results showed that the "FAAS -DCP" coding system has good psychometric properties, with a good internal consistency and a satisfying reliability among the three independent raters. Finally, the "FAAS-DCP" scores on the interactive dimensions are comparable to the similar dimensions in the FAAS-LTP. The results showed that there is no statistically significant difference on scores between the "FAAS-DCP" and the "FAAS," which is consistent with previous studies underlying stability in triadic interaction patterns from pregnancy to 18 months. These first results indicated that the DCP is a promising observational setting, able to assess the development of the early family triadic functioning. The DCP and the FAAS-DCP offer to both clinicians and researchers a way to improve the understanding of the establishment of early family functioning as well as to study the young infant's triangular capacity. Perspectives for future research will be discussed

Interactive synchrony and infants’ vagal tone as an index of emotion regulation: associations within each mother- and father-infant dyad and across dyads

IntroductionStudies have shown that infants’ emotion regulation capacities are closely linked to the quality of parent-infant interactions. However, these links have been mostly studied in mother-infant dyads and less is known about how the quality of father-infant interactions contributes to the development of emotion regulation during infancy. In this study, we aimed to investigate the links between interactive synchrony (i.e., an index of the quality of parent-infant coordination of interactive behaviors) and infants’ vagal tone (i.e., a physiological index of emotion regulation). To understand the respective contributions of both parents, as well as the interrelations between the functioning of both dyads within a family, we observed mothers and fathers from 84 families interacting with their infants.MethodsSynchrony was assessed by using the CARE-Index; infants’ vagal tone was derived from the analysis of infants’ electrocardiograms recorded during the interactions. Moreover, to take the play’s order into account, we counterbalanced the procedure, so that approximately half of the mothers played first. We specified a first structural equation modeling (SEM) model to investigate the associations between interactive synchrony and the infants’ root mean square of successive differences (RMSSD), an index of vagal regulation, in the two successive parts of the play. We conducted a multigroup analysis in a second SEM model to investigate the associations of the first SEM model in two groups based on the order of interaction.ResultsThe results of the SEM models showed that greater synchrony was related to greater infant RMSSD within mother-infant dyads and across one dyad to the other dyad in the full sample and in the group of fathers who interacted first with the infants. The associations between synchrony and infant vagal tone within father-infant dyads never appeared to be significant, nor did any associations within each dyad and across dyads when mothers interacted first.DiscussionThis study highlights that the links between interactions and infants’ vagal tone are sensitive to family members’ interdependencies and some conditions (the order of interaction)

Parental sensitivity, family alliance and infants' vagal tone: Influences of early family interactions on physiological emotion regulation

In this study, we investigated the influence of parental sensitivity and family alliance on infants’ vagal tone, considered as a physiological indicator of emotion regulation. Studies on mother–infant interactions have shown that vagal tone can be influenced by the quality of the interaction, such as interacting with a sensitive mother. To date, no study has investigated the influence of paternal sensitivity or family alliance on infants’ vagal tone. We hypothesized that maternal sensitivity, paternal sensitivity, and family alliance would be associated with infants’ vagal tone during dyadic and triadic interactions. We also explored if family alliance would act as a moderator on the association between parental sensitivity and vagal tone and if the sensitivity of both parents would act as a moderator on the association between family alliance and vagal tone. This study took place in Switzerland and included 82 families with their 3–4-month-old infants. Results showed that maternal sensitivity and family alliance were associated with infants’ vagal tone, but paternal sensitivity was not. We found no significant moderation effect. However, result tendencies suggested that the contribution of paternal sensitivity to infants’ emotion regulation could be influenced by family alliance, whereas maternal sensitivity and family alliance have a unique contribution

Q Fever in France, 1985–2009

To assess Q fever in France, we analyzed data for 1985–2009 from the French National Reference Center. A total of 179,794 serum samples were analyzed; 3,723 patients (one third female patients) had acute Q fever. Yearly distribution of acute Q fever showed a continuous increase. Periodic variations were observed in monthly distribution during January 2000–December 2009; cases peaked during April–September. Q fever was diagnosed more often in patients in southeastern France, where our laboratory is situated, than in other areas. Reevaluation of the current positive predictive value of serologic analysis for endocarditis was performed. We propose a change in the phase I (virulent bacteria) immunoglobulin G cutoff titer to >1,600. Annual incidences of acute Q fever and endocarditis were 2.5/100,000 persons and 0.1/100,000 persons, respectively. Cases and outbreaks of Q fever have increased in France

The Family Alliance Model: A Way to Study and Characterize Early Family Interactions

The aim of this paper is to present the family alliance (FA) model, which is designed to conceptualize the relational dynamics in the early family. FA is defined as the coordination a family can reach when fulfilling a task, such as playing a game or having a meal. According to the model, being coordinated as a family depends on four interactive functions: participation (all members are included), organization (members assume differentiated roles), focalization (family shares a common theme of activity), affect sharing (there is empathy between members). The functions are operationalized through the spatiotemporal characteristics of non-verbal interactions: for example, distance between the partners, orientation of their bodies, congruence within body segments, signals of readiness to interact, joint attention, facial expressions. Several standardized observational situations have been designed to assess FA: The Lausanne Trilogue Play (with its different versions), in which mother, father, and baby interact in all possible configurations of a triad, and the PicNic Game for families with several children. Studies in samples of non-referred and referred families (for infant or parental psychopathology) have highlighted different types of FA: disorganized, conflicted, and cooperative. The type of FA in a given family is stable through the first years and is predictive of developmental outcomes in children, such as psychofunctional symptoms, understanding of complex emotions, and Theory of Mind development

Wind in November, Q Fever in December

An investigation in southern France confirms the role of wind in Coxiella burnetii transmissio