Kidney transplantation in childhood: mental health and quality of life of children and caregivers

Our objective was to assess the mental health and health-related quality of life (HRQOL) in children and their parents after renal transplantation (TX) compared to healthy controls and children with acute lymphoblastic leukemia (ALL) and to identify possible health status variables associated with impaired mental health and HRQOL. Thirty-eight TX children with a median age of 13 (range 3–19) years were investigated. Mental health was assessed by the Pediatric Quality of Life Inventory (PedsQL) 4.0 Generic Core Scales and the Strength and Difficulties Questionnaire (SDQ-20). Each mother’s own mental health and QOL were assessed by the General Health Questionnaire (GHQ-30) and the Quality of Life Scale (QOLS). Forty children with ALL [median age 11 (8.5–15.4) years] and 42 healthy children [median age 11 (8.9– 15) years] served as controls. Treadmill exercise results from 22 of the 38 patients were included in the analysis. TX children showed significantly higher levels of mental health problems and lower HRQOL at 2 to 16 years after transplantation compared to both control groups. Body mass index and maximal oxygen uptake (n = 22/38) were significant predictors of child mental health (SDQ) and child QOL (PedsQL), respectively. Based on these results, we suggest that rehabilitation after TX should include a focus on physical activity and QOL to reduce interconnected physical and psychological morbidity in kidney TX children

Outcome after renal transplantation. Part II: Quality of life and psychosocial adjustment

Knowledge of health-related quality of life (QOL) and psychosocial adjustment (PA) in children after renal transplantation (RTPL) is limited. QOL and PA were evaluated by standardized tests in patients after RTPL. Thirty-seven children of median age 14.5 years (range 6.5-17 years) were investigated a mean 4.5 years (range 0.5-12.8 years) after RTPL. Child- and parent-rated QOL was evaluated with the Child Quality of life Questionnaire of The Netherlands Organization for Applied Scientific Research Academical Medical Centre (TNO-AZL). PA was assessed by the Child Behaviour Checklist (CBCL) providing parental reports of a child's behaviour. In patients' self-ratings, the QOL dimension physical complaints (P < 0.0005) scored significantly better than that of healthy controls, whereas the dimension positive emotional functioning was impaired (P = 0.02). Parents rated motor functioning (P = 0.002), autonomy (P = 0.01), cognition (P = 0.04) and positive emotions (P < 0.0005) as significantly impaired. Parents also assessed PA significantly (P = 0.02) impaired with regard to internalizing behaviour. Dialysis duration, young age at RTPL, living-related donation, steroid treatment, adverse family relationships and maternal distress had a significantly negative impact on QOL and PA (P < 0.05). Patients rated QOL higher than did healthy controls. Parents evaluated their children's QOL and PA more pessimistically than did the patients themselves. Both illness-related variables and family environment played an important role

Diagnostic des troubles du spectre autistique, un enjeu pour un meilleur accompagnement des personnes [Autism spectrum disorder : a diagnosis for a better support]

Autism spectrum disorders (ASD) are neurodevelopmental disorders at the origin of severe handicap. The clinical expression of these disorders is strongly variable according to the presence of an intellectual deficiency or an associated organic and\or psychiatric disorder. Getting a correct diagnosis of ASD as a child or an adult can help a person and the professionals understand past difficulties, identify his or her strengths, and adapt the right kind of help. A complete diagnosis, realized by a trained multidisciplinary team, allows to define the necessary strategies of global support, in partnership with families. Treatments and services can improve a person's symptoms and ability to function. These characteristics must be regularly assessed in time

Simulation de performance d'un système multi-sources d'énergie en utilisant le plancher chauffant pour chauffer un bâtiment

National audienc

Decision threshold associated with multiple measurements. Application to the synthesis of the environment monitoring results

When the sample activity is measured for various reasons several times, then with each measurement can be associated an individual decision threshold and limit of detection. Each measurement can be analyzed through its own decision threshold. The whole measurements can sometimes present contradictory results, some measurements being lower than the decision threshold and other higher. The problem then arises to build a decision threshold and a detection limit taking into account all the individual results, and to decide if the radioactivity is finally detected or not. It is interesting to note that it is possible sometimes that the decision threshold taking account all results makes it possible to decide that the radioactivity is present whereas the totality of the individual results are negative in terms of individual decision threshold. The purpose of this article is to show how these thresholds and these coherent limits cumulated can be determined in way according to the experimental conditions. In a general way a rigorous method of cumulating makes it possible to systematically decrease the decision threshold and limit of detection in terms of activity. This approach has interesting applications in gamma spectrometry with multi-emitters, discharge or periodical environmental measurements. On the basis of measurements realized by the IRSN within the framework of the national monitoring of the environment, we will see the potential impact of these methods on the final assessments

Blanc périveinulaire isolé révélant une intolérance à l’hypoxie : à propos d’un cas

International audienc