Testing the Feasibility of a Passive and Active Case Ascertainment System for Multiple Rare Conditions Simultaneously: The Experience in Three US States

Background: Owing to their low prevalence, single rare conditions are difficult to monitor through current state passive and active case ascertainment systems. However, such monitoring is important because, as a group, rare conditions have great impact on the health of affected individuals and the well-being of their caregivers. A viable approach could be to conduct passive and active case ascertainment of several rare conditions simultaneously. This is a report about the feasibility of such an approach. Objective: To test the feasibility of a case ascertainment system with passive and active components aimed at monitoring 3 rare conditions simultaneously in 3 states of the United States (Colorado, Kansas, and South Carolina). The 3 conditions are spina bifida, muscular dystrophy, and fragile X syndrome. Methods: Teams from each state evaluated the possibility of using current or modified versions of their local passive and active case ascertainment systems and datasets to monitor the 3 conditions. Together, these teams established the case definitions and selected the variables and the abstraction tools for the active case ascertainment approach. After testing the ability of their local passive and active case ascertainment system to capture all 3 conditions, the next steps were to report the number of cases detected actively and passively for each condition, to list the local barriers against the combined passive and active case ascertainment system, and to describe the experiences in trying to overcome these barriers. Results: During the test period, the team from South Carolina was able to collect data on all 3 conditions simultaneously for all ages. The Colorado team was also able to collect data on all 3 conditions but, because of age restrictions in its passive and active case ascertainment system, it was able to report few cases of fragile X syndrome. The team from Kansas was able to collect data only on spina bifida. For all states, the implementation of an active component of the ascertainment system was problematic. The passive component appears viable with minor modifications. Conclusions: Despite evident barriers, the joint passive and active case ascertainment of rare disorders using modified existing surveillance systems and datasets seems feasible, especially for systems that rely on passive case ascertainment

Long-term autonomous hydrophones for large-scale hydroacoustic monitoring of the oceans

International audienceWe have developed a set of long-term autonomous hydrophones dedicated to long-term monitoring of low-frequency sounds in the ocean (<120Hz). Deploying arrays of such hydrophones (at least 4 instruments) proves a very efficient approach to monitor acoustic events of geological origin (earthquakes, icequakes), sea state or large baleen whales, over large and remote areas of the world ocean (up to 1000 km between instruments or more). Such approach takes advantage of the high sensitivity of hydrophones and of the long-range acoustic properties of the water column. Our instrument have been designed to be deployed for more than one year, continuously recording the ocean sounds at 240Hz with high dynamic 24-bit resolution

"Sur la montagne nue" (texte de création) : suivi de L’écriture de l’autofiction à la troisième personne chez Gabrielle Roy, Marguerite Duras et Annie Ernaux et ses échos dans "Sur la montagne nue" (essai réflexif)

Sur la montagne nue est un recueil de huit nouvelles à la forme particulière: les textes sont divisés en paragraphes qui présentent, en alternance, deux voix, deux femmes distinctes. Ces femmes parlent d’elles-mêmes à la troisième personne du singulier. Il n’y a pas de dialogues, seulement des voix qui se donnent l’une après l’autre et qui se rejoignent par le biais de la mémoire. Il s’agit de nouvelles certes, mais elles ont été écrites pour la scène, pour des comédiennes, pour être entendues. De surcroît, les propos de ces textes sont généralement autofictionnels. Dans la partie théorique, je questionne le choix d’une narration à la troisième personne pour l’écriture de l’autofiction. Pour ce faire, je compare mon travail avec la pratique de Gabrielle Roy, Marguerite Duras et Annie Ernaux qui ont elles aussi, dans certains moments de leurs oeuvres, choisi ce type de narration pour l’écriture de soi

L’ajustement situationnel et personnel des jeunes adultes émergents ayant présenté des problèmes de comportement extériorisés au secondaire

Dans cette étude, nous examinons les situations scolaires et sociales ainsi que l’ajustement des jeunes ayant présenté des problèmes extériorisés au secondaire, au moment de la transition à la vie adulte. Les résultats obtenus auprès d’un échantillon de 93 jeunes ayant présenté des problèmes extériorisés et de 93 jeunes du groupe témoin montrent que, de façon générale, les premiers ont des situations et un ajustement comparables aux jeunes du groupe témoin, à l’exception des mesures relatives aux comportements délinquants. Les comparaisons en fonction du genre, à l’intérieur du groupe ayant présenté des problèmes extériorisés, révèlent un ajustement plus difficile chez les filles.This article describes both school and social situations as well as the adjustment during transition to adulthood of youths who had displayed externalized problem behaviours in their high school years. Results show that when compared to a control group of youths (N = 93) those with problem behaviours (N = 93) have similar situations with regards to employment, schooling and residential arrangements. However, they still show more delinquent behaviours than their counterparts. Significant differences arise when gender is compared within the behaviour problem group. Girls demonstrate more difficult adjustment problems both internalized and externalized than boys.En este estudio, examinamos las situaciones escolares y sociales así como el ajuste de los jóvenes que presentaron problemas exteriorizados en la secundaria, al momento de la transición a la vida adulta. Los resultados conseguidos con una muestra de 93 jóvenes que presentaron problemas exteriorizados y de 93 jóvenes del grupo muestra indican que, de manera general, los primeros viven unas situaciones y un ajuste comparables a los jóvenes del grupo muestra, a la excepción de las medidas relacionadas con los comportamientos delincuentes. Las comparaciones hechas según el género, dentro del grupo que presentó problemas exteriorizados, revelan un ajuste más difícil por parte de las niñas

Children's body mass index, participation in school meals, and observed energy intake at school meals

<p>Abstract</p> <p>Background</p> <p>Data from a dietary-reporting validation study with fourth-grade children were analyzed to investigate a possible relationship of body mass index (BMI) with daily participation in school meals and observed energy intake at school meals, and whether the relationships differed by breakfast location (classroom; cafeteria).</p> <p>Methods</p> <p>Data were collected in 17, 17, and 8 schools during three school years. For the three years, six, six, and seven of the schools had breakfast in the classroom; all other schools had breakfast in the cafeteria. Information about 180 days of school breakfast and school lunch participation during fourth grade for each of 1,571 children (90% Black; 53% girls) was available in electronic administrative records from the school district. Children were weighed and measured, and BMI was calculated. Each of a subset of 465 children (95% Black; 49% girls) was observed eating school breakfast and school lunch on the same day. Mixed-effects regression was conducted with BMI as the dependent variable and school as the random effect; independent variables were breakfast participation, lunch participation, combined participation (breakfast and lunch on the same day), average observed energy intake for breakfast, average observed energy intake for lunch, sex, age, breakfast location, and school year. Analyses were repeated for BMI category (underweight/healthy weight; overweight; obese; severely obese) using pooled ordered logistic regression models that excluded sex and age.</p> <p>Results</p> <p>Breakfast participation, lunch participation, and combined participation were not significantly associated with BMI or BMI category irrespective of whether the model included observed energy intake at school meals. Observed energy intake at school meals was significantly and positively associated with BMI and BMI category. For the total sample and subset, breakfast location was significantly associated with BMI; average BMI was larger for children with breakfast in the classroom than in the cafeteria. Significantly more kilocalories were observed eaten at breakfast in the classroom than in the cafeteria.</p> <p>Conclusions</p> <p>For fourth-grade children, results provide evidence of a positive relationship between BMI and observed energy intake at school meals, and between BMI and school breakfast in the classroom; however, BMI and participation in school meals were not significantly associated.</p

How accurate are parental responses concerning their fourth-grade children's school-meal participation, and what is the relationship between children's body mass index and school-meal participation based on parental responses?

<p>Abstract</p> <p>Background</p> <p>This article investigated (1) parental response accuracy of fourth-grade children's school-meal participation and whether accuracy differed by children's body mass index (BMI), sex, and race, and (2) the relationship between BMI and school-meal participation (based on parental responses).</p> <p>Methods</p> <p>Data were from four cross-sectional studies conducted from fall 1999 to spring 2003 with fourth-grade children from 13 schools total. Consent forms asked parents to report children's usual school-meal participation. As two studies' consent forms did not ask about lunch participation, complete data were available for breakfast on 1,496 children (51% Black; 49% boys) and for lunch on 785 children (46% Black; 48% boys). Researchers compiled nametag records (during meal observations) of meal participation on randomly selected days during children's fourth-grade school year for breakfast (average nametag days across studies: 7-35) and for lunch (average nametag days across studies: 4-10) and categorized participation as "usually" (≥ 50% of days) or "not usually" (< 50% of days). Weight and height were measured. Concerning parental response accuracy, marginal regression was used with agreement between parental responses and nametag records as the dependent variable; independent variables were BMI, age, sex, race, and study. Concerning a relationship between BMI and school-meal participation, marginal regression was used with BMI as the dependent variable; independent variables were breakfast participation, lunch participation, age, sex, race, and study.</p> <p>Results</p> <p>Concerning breakfast participation and lunch participation, 74% and 92% of parents provided accurate responses, respectively. Parental response accuracy was better for older children for breakfast and lunch participation, and for Black than White children for lunch participation. Usual school-meal participation was significantly related to children's BMI but in opposite directions -- positively for breakfast and inversely for lunch.</p> <p>Conclusions</p> <p>Parental response accuracy of children's school-meal participation was moderately high; however, disparate effects for children's age and race warrant caution when relying on parental responses. The BMI results, which showed a relationship between school-meal participation (based on parental responses) and childhood obesity, conflict with results from a recent article that used data from the same four studies and found no significant relationship when participation was based on nametag records compiled for meal observations.</p