Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

ABSTRACT: BACKGROUND: Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo. METHODS: Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville. RESULTS: The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment). CONCLUSION: We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings

Virtual coupling potential for elastic scattering of 10,11^{10,11}Be on proton and carbon targets

International audienceThe 10;11Be(p,p) and (12C, 12C) reactions were analyzed to determine the in uence of the weak binding energies of exotic nuclei on their interaction potential. The elastic cross sections were measured at GANIL in inverse kinematics using radioactive 10;11Be beams produced at energies of 39:1 A and 38:4A MeV. The elastic proton scattering data were analyzed within the framework of the microscopic Jeukenne-Lejeune-Mahaux (JLM) nucleon-nucleus potential. The angular distributions are found to be best reproduced by reducing the real part of the microscopic optical potential, as a consequence of the coupling to the continuum. These effects modify deeply the elastic potential. Including the Virtual Coupling Potential (VCP), we show the ability of the general optical potentials to reproduce the data for scattering of unstable nuclei, using realistic densities. Finally, the concepts needed to develop a more general and microscopic approach of the VCP are discussed

Coupling effects in the elastic scattering of 6^{6}He on 12^{12}C

To study the effect of the weak binding energy on the interaction potential between a light exotic nucleus and a target, elastic scattering of 6He at 38.3 MeV/nucleon on a 12C target was measured at Grand Accélérateur National d'Ions Lourds (GANIL). The 6He beam was produced by fragmentation. The detection of the scattered particles was performed by the GANIL spectrometer. The energy resolution was good enough to separate elastic from inelastic scattering contributions. The measured elastic data have been analyzed within the optical model, with the real part of the optical potential calculated in the double-folding model using a realistic density-dependent nucleon-nucleon interaction and the imaginary part taken in the conventional Woods-Saxon (WS) form. A failure of the "bare" real folded potential to reproduce the measured angular distribution over the whole angular range suggests quite a strong coupling of the higher-order breakup channels to the elastic channel. To estimate the strength of the breakup effects, a complex surface potential with a repulsive real part (designed to simulate the polarization effects caused by the projectile breakup) was added to the real folded and imaginary WS potentials. A realistic estimate of the polarization potential caused by the breakup of the weakly bound 6He was made based on a parallel study of 6He+12C and 6Li+12C optical potentials at about the same energies

A rapid screening tool for psychological distress in children 3--6years old: results of a validation study.

International audienceABSTRACT: BACKGROUND: The mental health needs of young children in humanitarian contexts often remain unaddressed. The lack of a validated, rapid and simple tool for screening combined with few mental health professionals able to accurately diagnose and provide appropriate care mean that young children remain without care. Here, we present the results of the principle cross-cultural validation of the "Psychological Screening for Young Children aged 3 to 6" (PSYCAa3-6). The PSYCa 3--6 is a simple scale for children 3 to 6 years old administered by non-specialists, to screen young children in crises and thereby refer them to care if needed. METHODS: This study was conducted in Maradi, Niger. The scale was translated into Hausa, using corroboration of independent translations. A cross-cultural validation was implemented using quantitative and qualitative methods. A random sample of 580 mothers or caregivers of children 3 to 6 years old were included. The tool was psychometrically examined and diagnostic properties were assessed comparing the PSYCa 3--6 against a clinical interview as the gold standard. RESULTS: The PSYCa 3--6 Hausa version demonstrated good concurrent validity, as scores correlated with the gold standard and the Clinical Global Impression Severity Scale (CGI-S) [rho = 0.41, p-value = 0.00]. A reduction procedure was used to reduce the scale from 40 to 22 items. The test-retest reliability of the PSYCa 3--6 was found to be high (ICC 0.81, CI95% [0.68; 0.89]). In our sample, although not the purpose of this study, approximately 54 of 580 children required subsequent follow-up with a psychologist. CONCLUSIONS: To our knowledge, this is the first validation of a screening scale for children 3 to 6 years old with a cross-cultural validation component, for use in humanitarian contexts. The Hausa version of the PSYCa 3--6 is a reliable and a valuable screening tool for psychological distress. Further studies to replicate our findings and additional validations of the PSYCa 3--6 in other populations may help improve the delivery of mental health care to children

De maladie négligée à maladie prioritaire (150 ans d'histoire de la trypanosomiase humaine africaine)

La trypanosomiase humaine africaine est une parasitose d'évolution aiguë pour la forme rhodésiense en Afrique de l'Est, plus chronique pour la forme gambiense dans le reste de l'Afrique sub-saharienne. Après transmission du parasite par piqûre d'une glossine la maladie évolue en deux phases, hémolymphatique puis neurologique, avant d'aboutir au décès inéluctable. Avec 300 000 à 500 000 malades estimés actuellement par l'OMS elle fait peser un lourd fardeau sur l'Afrique. L'OMS tente depuis de nombreuses années d'alerter la communauté médicale et politique de la réémergence de la maladie sur le continent africain. Cette prise de conscience semble aujourd'hui se faire. L'histoire de la maladie du sommeil s'est répétée de façon presque identique durant ces 150 dernières années : les premières épidémies débutèrent vers 1895 faisant en trente ans plus d'un million de morts. Les autorités ne s'en préoccupèrent que dans les années 20. Son accès au statut de maladie prioritaire permit alors son contrôle grâce à des hommes tels que le docteur Eugène Jamot, pour ne laisser persister que de très rares cas au début des années 60. Mais suite à l'indépendance des pays africains elle se propagea progressivement, pour arriver aujourd'hui, au bout de près de quarante ans d'indifférence, à la même situation que celle du début du siècle. Certains facteurs de cette réémergence sont liés à la maladie elle-même : c'est une infection complexe et difficilement contrôlable. Par ailleurs d'autres déterminants politiques, économiques et scientifiques, en condamnant la maladie du sommeil à l'indifférence depuis les années 60, ont contribué a sa réémergence. L'analyse de la période coloniale et de la fin du XXème siècle permet de mettre en évidence des déterminants communs qui ont entraîné la prise en charge de la trypanosomiase. On peut constater que l'accès au statut de maladie prioritaire est influencé par des déterminants politiques, sociologiques et économiques, qui convergent pour aboutir à la prise de conscience de la menace que représente cette maladie. Alors que l'espoir d'endiguer la progression de la maladie du sommeil était faible à la fin du XXème siècle, un nouvel optimisme renaît actuellement, autorisé par ce nouveau statut. Mais tout reste encore à faire.GRENOBLE1-BU Médecine pharm. (385162101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Short-course treatment with ceftriaxone for leptospirosis: A retrospective study in a single center in Eastern France.

International audienceShort-course (less than 7 days) antibiotic treatments have been rarely assessed in the management of leptospirosis. We analyzed the charts of patients hospitalized with confirmed and probable leptospirosis in a teaching hospital between 1994 and 2012. Of 89 patients with confirmed or probable leptospirosis, 21 patients (11 confirmed, 10 probable - 14 uncomplicated and 7 severe forms) admitted between 2001 and 2012 received ceftriaxone (1-2 g daily) for less than 7 days. Apyrexia was obtained within 2 days of treatment in all patients and no relapse was observed. These data support the hypothesis that short-course treatments of 3-6 days with ceftriaxone (1-2 g per day) may be an option in the treatment of uncomplicated and severe forms of leptospirosis responding quickly to therapy. This hypothesis deserves being confirmed in further clinical studies

Acquisition rapide de figures polaires à l'aide de détecteurs de zone sur la ligne DiffAbs - Synchrotron SOLEIL

International audienceL'anisotropie structurelle, par exemple la texture, peut régir d'importantes propriétés physiques d'un film mince, telles que les propriétés électriques, magnétiques et/ou mécaniques. La texture (information d'orientation) est typiquement observée et quantifiée par la mesure de ce que l'on appelle les figures polaires. Une approche expérimentale optimisée mise en œuvre sur la ligne DiffAbs (Synchrotron SOLEIL) est présentée ici. À l'aide d'un détecteur de zone de pixels à rayons X et de sources de rayonnement synchrotron, une figure de pôle complète (avec des résolutions adaptées aux films minces texturés métalliques, généralement de l'ordre de quelques degrés) peut être mesurée à des intervalles de temps aussi courts qu'une minute. Les corrections nécessaires permettant la récupération complète de la figure de pôle à partir des données expérimentales en utilisant cette approche optimisée sont fournies et discutées. On constate un gain de temps de mesure jusqu'à deux ordres de grandeur par rapport à l'utilisation d'un détecteur ponctuel (approche classique) dans les mêmes conditions expérimentales. Les données mesurées à l'aide de ces deux approches sont présentées, comparées et discutées

Fast pole figure acquisition using area detectors at the DiffAbs beamline – Synchrotron SOLEIL

Structural anisotropy, for example texture, may govern important physical properties of thin film, such as electrical, magnetic and/or mechanical ones. Texture (orientation information) is typically observed and quantified by the measurement of so-called pole figures. An optimized experimental approach implemented at the DiffAbs beamline (Synchrotron SOLEIL) is presented here. Using an X-ray pixel area detector and synchrotron radiation sources, a complete pole figure (with resolutions adapted for metallic textured thin films, typically of the order of a few degrees) can be measured in time intervals as short as one minute. The necessary corrections enabling complete pole figure retrieval from the experimental data using this optimized approach are provided and discussed. A gain in measuring time by up to two orders of magnitude is found with respect to the use of a point detector (classical approach) under the same experimental conditions. Data measured using these two approaches are shown, compared and discussed

Treatment as prevention enrolling at least 75% of individuals on ART will be needed to significantly reduce HIV prevalence in a HIV cohort

International audienc