Gravité de la consommation de psychotropes des adolescents ayant un trouble des conduites

Bien que le trouble des conduites soit reconnu pour être le trouble le plus associé à une consommation problématique de psychotropes, relativement peu de recherches ont examiné les caractéristiques de cette consommation chez des jeunes ayant spécifiquement un diagnostic de trouble des conduites. À partir de plusieurs indicateurs de gravité de la consommation de psychotropes, l’étude propose de tracer un portrait de cette consommation chez des garçons et des filles présentant un trouble des conduites (N = 181) et de déterminer si ce portrait se distingue de celui d’autres jeunes dont les comportements antisociaux ne respectent pas les critères diagnostiques de ce trouble (N = 204). L’étude montre que les jeunes qui ont un trouble des conduites se distinguent des autres jeunes sur la presque totalité des indicateurs de gravité mesurés. L’usage de drogues dures, la fréquence élevée de la consommation et la présence de conséquences négatives liées à la prise des psychotropes sont les indicateurs les plus étroitement associés à la présence de ce trouble. Si ces résultats illustrent la gravité du portrait de consommation de ces jeunes, ils suggèrent aussi que la présence de conséquences négatives peut constituer un important levier pour l’intervention.Although conduct disorder is among disorders mostly associated with substance misuse at the adolescence, relatively few studies examined the characteristics of this consumption of teenagers who have a diagnosis of conduct disorder. Based on many indicators of the severity of the substance consumption, the purposes of this study were to describe substance consumption pattern of boys and girls with conduct disorder (N = 181) and to determine if their consumption is different from that of teenagers who also have antisocial behaviour, but no diagnosis of conduct disorder (N = 204). The results showed that youths with conduct disorder are significantly different from youths without conduct disorder on almost all indicators of severity. The use of hard drugs, regular consumption and presence of negative consequences associated with substance use were the indicators mostly related to the presence of a conduct disorder. These findings are examined in the perspective of treatment programs for youths with conduct disorder

Profils de consommation d’adolescents, garçons et filles, desservis par des centres jeunesse

Les décideurs et les intervenants des centres jeunesse (CJ) du Québec ont souvent attiré l’attention sur le défi d’intervention que représente la consommation de psychotropes des adolescents qu’ils desservent. Afin de déterminer jusqu’à quel point la consommation pour cette clientèle de jeunes constitue un problème et de mieux cibler les jeunes auprès desquels il est prioritaire d’intervenir, cette étude propose d’établir le profil de consommation de psychotropes et d’identifier des caractéristiques personnelles, familiales et sociales associées. L’échantillon est composé de 408 jeunes (dont 127 filles) de 12 à 17 ans pris en charge par des CJ du Québec (Montréal, Québec, Estrie, Côte-Nord). La consommation de psychotropes est évaluée à l’aide de l’Indice de gravité d’une toxicomanie pour adolescents (Germain et coll. 1998). L’étude fait ressortir trois profils de consommateurs dont la consommation est soit faible (28,9 %), modérée (37,3 %) ou élevée (33,8 %). Ces profils se retrouvent dans des proportions comparables chez les garçons et les filles. Les jeunes ayant une consommation élevée sont plus âgés et fréquentent un plus grand nombre d’amis consommateurs que les jeunes des autres profils de consommateurs. Ces résultats sont discutés dans une perspective d’intervention.Policymakers and educators from youth centres in Quebec have often emphasized the challenge represented by substance users in their treatment programs. In order to determine the extent to which their consumption represents a problem and to better identify those in need of urgent intervention, this study established consumption profiles and examined the associated personal, family and social correlates. The sample was composed of 408 adolescents (127 girls), aged 12 to 17 years old, who received services from Quebec’s youth centres (Montreal, Quebec City, the Eastern Townships, and the North Shore). Three groups of substance users were identified using the Addiction Severity Index for Youth (Germain et al., 1998): 1) light consumption (28.9%), 2) moderate consumption (37.3%), and 3) severe consumption (33.8%). A similar proportion of boys and girls were found within each group. Youth who had a severe consumption profile were older and had more substance users as friends than youth in the other profiles. Implications for substance use treatment in youth centres are discussed.Los responsables de la toma de decisiones y las personas de apoyo de los centros para la juventud de Quebec han llamado la atención, a menudo, sobre el desafío que representa el consumo de psicotrópicos de los adolescentes a los que proveen servicios. A fin de determinar hasta qué punto el consumo de esta clientela constituye un problema y de determinar mejor cuáles son los jóvenes con quienes es prioritario intervenir, este estudio propone establecer el perfil de consumo de los psicotrópicos e identificar las características personales, familiares y sociales relacionadas con el mismo. La muestra se compone de 408 jóvenes (de los cuales 127 son mujeres) de 12 a 17 años, que los centros para la juventud de Quebec (Montreal, Quebec, Estrie y Côte-Nord) han tomado a su cargo. El consumo de psicotrópicos se evalúa mediante el índice de gravedad de una toxicomanía para adolescentes (Germain y col. 1998). El estudio destaca tres perfiles de consumidores cuyo consumo es ya sea escaso (28,9%), moderado (37,3%) o elevado (33,8%). Estos perfiles se encuentran en proporciones comparables entre los varones y las mujeres. Los jóvenes que tienen un consumo más elevado son de más edad y frecuentan una cantidad más grande de amigos consumidores que los jóvenes de otros perfiles de consumidores. Estos resultados se analizan en el marco de una perspectiva de intervención

The appeal of the Functional Fitness MOT to older adults and health professionals in an outpatient setting: a mixed-method feasibility study

Purpose: To understand the views and perceptions regarding the Functional Fitness MOT (FFMOT), a battery of functional tests followed by a brief motivational interview, of both the older people undergoing it and the health professionals delivering it. Patients and methods: Physically inactive older adults (n=29) underwent the FFMOT and subsequently attended focus groups to share their perceptions of it and to discuss the barriers, motivators, health behavior change, and scope to improve physical activity (PA) levels. PA levels were recorded at baseline and again at 12 weeks together with a post-intervention questionnaire concerning behavior change. Participating physiotherapists and technical instructors were interviewed. Results: Most participants felt they had learned about their abilities and comparisons with their peers, had a change in perception about the importance of good balance and strength, and felt the FFMOT helped raise their awareness of local and self-directed physical activity opportunities. Most felt their awareness of the need for PA had not changed, but 25% of participants started a new organized PA opportunity. The health professionals perceived the FFMOT as being easy to administer, educating, and motivating for participants to increase their PA. Space, time, finances, and insecurity about having the necessary skills to conduct the FFMOTs were seen as barriers in implementing the FFMOT in daily practice. Conclusion: Over half of those offered the FFMOT accepted it, suggesting it is appealing. However, most participants felt they were already active enough and that their awareness of the need for PA had not changed. There were positive perceptions of the FFMOT from both professionals and older people, but both felt the FFMOT could be held in a community venue. The overall findings suggest that the FFMOT is feasible in the clinical setting, but its effectiveness has yet to be determined

Feasibility trial evaluation of a peer volunteering active aging intervention: ACE (Active, Connected, Engaged)

© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. BACKGROUND: ACE (Active, Connected, Engaged) is a theory-informed, pragmatic intervention using peer volunteering support to promote active ageing in socially disengaged, inactive older adults. This study aimed to establish ACE's feasibility and acceptability. METHODS: Fifty-four older adults were recruited as either peer volunteers (activators; n = 15) or participants (ACEs; n = 39). Participants were randomized to one-to-one support from an activator (ACEs-Intervention [ACEs-I]) or a waiting-list control group (ACEs-Control [ACEs-C]). Activators supported ACEs-I to get out more and engage with local activities. Objectively measured physical activity (PA), lower limb function, and number of out of house activities were assessed at baseline and post-intervention. A mixed-methods process evaluation assessed changes in confidence to get out and about, social support, autonomy, competence, and relatedness. RESULTS: Eighty-two percent of ACEs (mean age = 73.7 years [SD 7.3]) and all activators completed assessments at both baseline and post-intervention (6 months). ACEs-I reported more out of house activities (M [SD] = 6.34 [4.15]). ACEs-I increased physical function post-intervention (M [SD] = 9.8 [2.3]). ACEs-I reported improved well-being and vitality and increased confidence to get out and about, confidence in the face of specific barriers, knowledge of local initiatives, and perceived social support post-intervention. Activators, although sufficiently active at baseline, increased their PA further. ACE was well-accepted and easy to deliver. CONCLUSIONS: ACE is an acceptable and feasible intervention for helping socially disengaged older people to get out and about more, improve their confidence, and engage more with their community

A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial.

BACKGROUND: Published evaluations of successful interventions to prevent falls in people with sight impairment (SI) are limited. The aim of this feasibility study is to optimise the design and investigation of home safety (HS) and home exercise (HE) programmes to prevent falls in older people with SI. METHODS: A community-based feasibility study in north-west England comprising a three-arm randomised controlled trial (RCT) allocated participants to (1) a control group receiving usual care and social visits, (2) an experimental group receiving the HS programme and (3) an experimental group receiving the HS + HE programme. Participants were community-dwelling, aged 65 years and older and sight impaired. Primary outcome data on falls were collected continuously over 6 months. Secondary outcomes on physical activity (self-report and instrumented) and adherence were collected at baseline and 3 and 6 months for HE and at 6 months for the HS programme. Costs for the HS and HS + HE groups were calculated from logs of time spent on home visits, telephone calls and travel. The research assistant and statistician were blinded to group allocation. RESULTS: Altogether, 49 people were recruited over a 9-month period (randomised: 16 to control, 16 to HS, 17 to HS + HE). The interventions were implemented over 6 months by an occupational therapist at a cost per person (pounds sterling, 2011) of £249 (HS) and £674 (HS + HE). Eighty-eight percent (43/49) completed the trial and 6-month follow-up. At 6-month follow-up, 100 % reported partially or completely adhering to HS recommendations but evidence for adherence to HE was equivocal. Although self-reported physical activity increased, instrumented monitoring showed a decrease in walking activity. There were no statistically significant differences in falls between the groups; however, the study was not powered to detect a difference. CONCLUSION: It is feasible and acceptable for an occupational therapist to deliver HS and HE falls prevention programmes to people with SI living independently in the community. Future studies could access Local Authority Registers of people with SI to improve recruitment rates. Further research is required to identify how to improve adherence to HE and to measure changes in physical activity before conducting a definitive RCT. TRIAL REGISTRATION: ISRCTN53433311 , registered on 8 May 2014

Geographical and environmental approaches to urban malaria in Antananarivo (Madagascar)

<p>Abstract</p> <p>Background</p> <p>Previous studies, conducted in the urban of Antananarivo, showed low rate of confirmed malaria cases. We used a geographical and environmental approach to investigate the contribution of environmental factors to urban malaria in Antananarivo.</p> <p>Methods</p> <p>Remote sensing data were used to locate rice fields, which were considered to be the principal mosquito breeding sites. We carried out supervised classification by the maximum likelihood method. Entomological study allowed vector species determination from collected larval and adult mosquitoes. Mosquito infectivity was studied, to assess the risk of transmission, and the type of mosquito breeding site was determined. Epidemiological data were collected from November 2006 to December 2007, from public health centres, to determine malaria incidence. Polymerase chain reaction was carried out on dried blood spots from patients, to detect cases of malaria. Rapid diagnostic tests were used to confirm malaria cases among febrile school children in a school survey.</p> <p>A geographical information system was constructed for data integration. Altitude, temperature, rainfall, population density and rice field surface area were analysed and the effects of these factors on the occurrence of confirmed malaria cases were studied.</p> <p>Results</p> <p>Polymerase chain reaction confirmed malaria in 5.1% of the presumed cases. Entomological studies showed <it>An. arabiensis </it>as potential vector. Rice fields remained to be the principal breeding sites. Travel report was considered as related to the occurrence of <it>P. falciparum </it>malaria cases.</p> <p>Conclusion</p> <p>Geographical and environmental factors did not show direct relationship with malaria incidence but they seem ensuring suitability of vector development. Absence of relationship may be due to a lack of statistical power. Despite the presence of <it>An. arabiensis</it>, scarce parasitic reservoir and rapid access to health care do not constitute optimal conditions to a threatening malaria transmission. However, imported malaria case is suggestive to sustain the pocket transmission in Antananarivo.</p

Seroprevalence of malaria in inhabitants of the urban zone of Antananarivo, Madagascar

BACKGROUND: Antananarivo, the capital of Madagascar, is located at an altitude of over 1,200 m. The environment at this altitude is not particularly favourable to malaria transmission, but malaria nonetheless remains a major public health problem. The aim of this study was to evaluate exposure to malaria in the urban population of Antananarivo, by measuring the specific seroprevalence of Plasmodium falciparum. METHODS: Serological studies specific for P. falciparum were carried out with an indirect fluorescent antibody test (IFAT). In a representative population of Antananarivo, 1,059 healthy volunteers were interviewed and serum samples were taken. RESULTS: The seroprevalence of IgG+IgA+IgM was 56.1% and that of IgM was 5.9%. The major risk factor associated with a positive IgG+IgA+IgM IFAT was travel outside Antananarivo, whether in the central highlands or on the coast. The abundance of rice fields in certain urban districts was not associated with a higher seroprevalence. CONCLUSION: Malaria transmission levels are low in Antananarivo, but seroprevalence is high. Humans come into contact with the parasite primarily when travelling outside the city. Further studies are required to identify indigenous risk factors and intra-city variations more clearly

The dominant Anopheles vectors of human malaria in Africa, Europe and the Middle East: occurrence data, distribution maps and bionomic précis

<p>Abstract</p> <p>Background</p> <p>This is the second in a series of three articles documenting the geographical distribution of 41 dominant vector species (DVS) of human malaria. The first paper addressed the DVS of the Americas and the third will consider those of the Asian Pacific Region. Here, the DVS of Africa, Europe and the Middle East are discussed. The continent of Africa experiences the bulk of the global malaria burden due in part to the presence of the <it>An. gambiae </it>complex. <it>Anopheles gambiae </it>is one of four DVS within the <it>An. gambiae </it>complex, the others being <it>An. arabiensis </it>and the coastal <it>An. merus </it>and <it>An. melas</it>. There are a further three, highly anthropophilic DVS in Africa, <it>An. funestus</it>, <it>An. moucheti </it>and <it>An. nili</it>. Conversely, across Europe and the Middle East, malaria transmission is low and frequently absent, despite the presence of six DVS. To help control malaria in Africa and the Middle East, or to identify the risk of its re-emergence in Europe, the contemporary distribution and bionomics of the relevant DVS are needed.</p> <p>Results</p> <p>A contemporary database of occurrence data, compiled from the formal literature and other relevant resources, resulted in the collation of information for seven DVS from 44 countries in Africa containing 4234 geo-referenced, independent sites. In Europe and the Middle East, six DVS were identified from 2784 geo-referenced sites across 49 countries. These occurrence data were combined with expert opinion ranges and a suite of environmental and climatic variables of relevance to anopheline ecology to produce predictive distribution maps using the Boosted Regression Tree (BRT) method.</p> <p>Conclusions</p> <p>The predicted geographic extent for the following DVS (or species/suspected species complex*) is provided for Africa: <it>Anopheles </it>(<it>Cellia</it>) <it>arabiensis</it>, <it>An. </it>(<it>Cel.</it>) <it>funestus*</it>, <it>An. </it>(<it>Cel.</it>) <it>gambiae</it>, <it>An. </it>(<it>Cel.</it>) <it>melas</it>, <it>An. </it>(<it>Cel.</it>) <it>merus</it>, <it>An. </it>(<it>Cel.</it>) <it>moucheti </it>and <it>An. </it>(<it>Cel.</it>) <it>nili*</it>, and in the European and Middle Eastern Region: <it>An. </it>(<it>Anopheles</it>) <it>atroparvus</it>, <it>An. </it>(<it>Ano.</it>) <it>labranchiae</it>, <it>An. </it>(<it>Ano.</it>) <it>messeae</it>, <it>An. </it>(<it>Ano.</it>) <it>sacharovi</it>, <it>An. </it>(<it>Cel.</it>) <it>sergentii </it>and <it>An. </it>(<it>Cel.</it>) <it>superpictus*</it>. These maps are presented alongside a bionomics summary for each species relevant to its control.</p

Roadmap on energy harvesting materials

Ambient energy harvesting has great potential to contribute to sustainable development and address growing environmental challenges. Converting waste energy from energy-intensive processes and systems (e.g. combustion engines and furnaces) is crucial to reducing their environmental impact and achieving net-zero emissions. Compact energy harvesters will also be key to powering the exponentially growing smart devices ecosystem that is part of the Internet of Things, thus enabling futuristic applications that can improve our quality of life (e.g. smart homes, smart cities, smart manufacturing, and smart healthcare). To achieve these goals, innovative materials are needed to efficiently convert ambient energy into electricity through various physical mechanisms, such as the photovoltaic effect, thermoelectricity, piezoelectricity, triboelectricity, and radiofrequency wireless power transfer. By bringing together the perspectives of experts in various types of energy harvesting materials, this Roadmap provides extensive insights into recent advances and present challenges in the field. Additionally, the Roadmap analyses the key performance metrics of these technologies in relation to their ultimate energy conversion limits. Building on these insights, the Roadmap outlines promising directions for future research to fully harness the potential of energy harvesting materials for green energy anytime, anywhere