Étude des réponses physiologiques aiguës à l’exercice intermittent de haute intensité chez le patient insuffisant cardiaque

L’optimisation de l’exercice par intervalles de haute intensité (EIHI) chez les patients insuffisants cardiaques (IC) n’a jamais été étudiée auparavant. Nous avons comparé les réponses cardio-pulmonaires aiguës lors de 4 différents EIHI dans le but de trouver le protocole optimisé chez les patients IC. Les patients IC étaient aléatoirement alloués à 4 sessions d’EIHI. Chaque phase d’exercice était à une intensité de 100% de la puissance aérobie maximale (PAM), mais de différentes durées (30s ou 90s) et de type de récupération (passive ou active). Chaque protocole d’EIHI durait un maximum de 30 minutes ou jusqu’à épuisement. Considérant le temps total d’exercice, l’adhérence, une perception d’effort moins élevée, le confort du patient ainsi que des temps similaires passés à un haut pourcentage du VO2pic, le mode avec intervalles courts (30s) et récupération passive s’est avéré être le protocole d’EIHI optimisé chez ces patients. Suite à cette étude, nous avons voulu comparer les réponses cardio-pulmonaires aiguës d’un exercice continu d’intensité modéré (ECIM) par rapport à celles de l’EIHI optimisé de dépense énergétique équivalente chez les patients IC. L’objectif de cette étude était de comparer les réponses cardio-pulmonaires, l’adhérence, la perception de l’effort, l’inflammation et les biomarqueurs cardiaques. Comparativement à l’ECIM, l’adhérence, l’efficience et la tolérance étaient plus élevées lors de l’EIHI optimisé chez les patients IC tout en produisant un stimulus physiologique important. L’EIHI n’a causé aucune arythmie significative ou d’effets délétères sur l’inflammation (CRP), le BNP et la nécrose myocardique (C-TnT) chez les patients IC. L’EIHI semble être un mode d’exercice prometteur et devrait être considéré lors de la réadaptation cardiaque chez les patients IC.Optimization of high intensity interval exercise (HIIE) in patients with chronic heart failure (CHF) has never been studied. We have compared the acute cardiopulmonary responses to four different HIIE in order to optimized HIIE protocol in CHF patients. Patients with CHF were randomized to 4 HIIE sessions, all with exercise phases at 100% of maximal aerobic power (MAP), but which varied in interval duration (30s or 90s) and type of recovery (passive or active). Each HIIE protocol lasted until exhaustion or up to 30 minutes. When considering total exercise time, exercise adherence, lower perceived exertion ratings, patient’s comfort and similar time spent at a high percentage of VO2peak, the mode with short intervals (30s) and passive recovery appeared to be the optimal HIIE mode for these patients. We therefore sought to compare the acute cardiopulmonary responses of a moderate intensity continuous exercise (MICE) compared to an optimized HIIE of equal total energy expenditure in patients with CHF. The purpose of this study was to compare cardiopulmonary responses, exercise adherence, perceived exertion, inflammation and cardiac biomarkers measured on optimized HIIE compared to MICE in patients with CHF. Compared to MICE, HIIE showed a higher exercise adherence, was more efficient and well tolerated by CHF patients while still providing a high physiological stimulus. HIIE did not induced significant arrhythmias or deleterious effects on inflammation (CRP), BNP and myocardial necrosis (C-TnT) in patients with CHF. We conclude that HIIE is a promising training mode that should be considered for cardiac rehabilitation interventions in patient with CHF

Mentalizing techniques used by psychodynamic therapists working with children and early adolescents

The aim of this study was to identify, categorize, and develop a conceptual frame of mentalization-based interventions used by experienced child and adolescent psychodynamic therapists. Two experienced therapists selected 14 sessions that represented their work during the first year of treatment. Sessions were transcribed and segmented to identify interactional units for coding. QDA Miner software was used to facilitate data analysis. A systematic qualitative, inductive/deductive approach was followed starting from categories identified in the literature, but also including newly emerging categories and interventions. Seven sessions were double coded to stabilize the coding tree and a "member check" was completed where therapists rated their own transcripts. A total of 24 mentalization-based techniques were identified, including 17 additional techniques. A conceptual framework organizing all observed mentalization-based interventions is proposed. The findings of this study provide a framework for studying techniques that may enhance the capacity to mentalize, and that could be features of therapeutic practice across a range of modalities of psychotherapy

Mentalizing Mediates the Association Between Childhood Maltreatment and Adolescent Borderline and Narcissistic Personality Traits

Background: Childhood maltreatment is theorized to undermine the development of mentalizing and to disrupt the development of healthy narcissism and the integration of personality at the level of affect and interpersonal regulation. Consistent with this, mentalizing can be expected to mediate the relationship between childhood maltreatment and vulnerable and grandiose narcissism as well as borderline personality traits, but this has not been examined in adolescents. Objective: The aim of this study was to examine associations between childhood maltreatment and adolescent personality disorder traits and test the mediating role of mentalizing in a sample of 263 adolescents and young adults aged 12 to 21. Methods: Participants recruited from school and a tertiary institution completed the Childhood Experiences of Care and Abuse Questionnaire (CECA-Q), the Borderline Personality Features Scale for Children (BPFS-C), the Pathological Narcissism Inventory (PNI) and the Reflective Function Questionnaire for Youth (RFQ-Y). Results: Adolescents with histories of sexual and physical abuse reported significantly more borderline personality features, as well as vulnerable and grandiose narcissism. They also reported signficantly more mentalizing difficulties including confusion regarding mental states and excessive certainty regarding mental states of others. Confusion regarding mental states partially mediated the relation between emotional abuse and borderline personality traits, as well as vulnerable and grandiose narcissism. Excessive certainty regarding the mental states of others mediated the relationship between childhood experiences of role reversal and grandiose narcissism. Conclusion: The findings are consistent with a mentalization model of adolescent personality difficulties and show that the relation between childhood maltreatment and personality disorder traits in adolescents may be in part understood in terms of the impact of such experiences on different dimensions of mentalizing

Mentalization and dissociation in the context of trauma: Implications for child psychopathology

Dissociation is a common reaction subsequent to childhood sexual abuse (CSA) and has been identified as a risk factor for child psychopathology. There is also evidence that mentalization contributes to resilience in the context of abuse. However, at this stage little is known regarding the relationship between mentalization and dissociation, and their respective contributions to psychopathology. The aim of this study was to examine pathways from CSA to depressive symptoms, externalizing behaviour difficulties and sexualized behaviour, through mentalization and dissociation. These pathways were examined in a sample of 168 mother-child dyads including 74 dyads where children (aged 7–12) had histories of sexual abuse. Maternal mentalization was assessed using the Parent Development Interview-Revised and children’s mentalization was assessed using the Child Reflective Functioning Scale. Children completed the Child Depression Inventory and parents completed the Child Dissociative Checklist, the Child Behavior Checklist and the Child Sexual Behavior Inventory. Direct and indirect paths from CSA to child psychopathology via children’s mentalization and dissociation were examined using Mplus. Two distinct paths from abuse to psychopathology were identified. Child mentalization partially mediated the relationship between CSA and depressive symptoms. The effects of CSA on externalizing symptoms and sexualized behaviour difficulties were sequentially mediated through mentalisation and dissociation

Intergenerational Pathways From Reflective Functioning to Infant Attachment Through Parenting

The aim of this prospective study was to examine temporal pathways from mothers’ reflective functioning (RF) through parenting to infant attachment measured more than 16 months later. Participants were 88 mother–infant dyads from demographically diverse backgrounds and included a group of mothers with histories of childhood maltreatment. RF was assessed using the RF rating of the Adult Attachment Interview before the birth of the baby. Parenting was assessed when the infants were 6 months old using the Maternal Sensitivity scale, as well as when they were 16 months using the Disconnected and Extremely Insensitive Parenting scale. Infant attachment was assessed when the infants were 16 months old using the Strange Situation. As hypothesised, the study findings showed that mothers’ mentalization regarding their own early attachment relationships was associated with later parenting and infant attachment. Negative parenting behaviours explained the link between mothers’ RF about their own attachment relationships and infant attachment disorganization. The findings suggest that mothers’ mentalization about their early attachment relationships has important implications in the transition to becoming parents themselves. Mentalization appears to be particularly important in helping mothers screen and inhibit negative parenting behaviours that would otherwise undermine infant attachment security and organization

Measurement of the Integrated Faraday Rotations of BL Lac Objects

We present the results of multi-frequency polarization VLA observations of radio sources from the complete sample of northern, radio-bright BL Lac objects compiled by H. Kuhr and G. Schmidt. These were used to determine the integrated rotation measures of 18 objects, 15 of which had never been measured previously, which hindered analysis of the intrinsic polarization properties of objects in the complete sample. These measurements make it possible to correct the observed orientations of the linear polarizations of these sources for the effect of Faraday rotation. The most probable origin for Faraday rotation in these objects is the Galactic interstellar medium. The results presented complete measurements of the integrated rotation measures for all 34 sources in the complete sample of BL Lac objects.Comment: 9 pages, 7 figure

Post-traumatic stress disorder in sexually abused children: secure attachment as a protective factor

The aim of the present study was to examine the hypothesis that attachment and CSA interacted such that school aged CSA survivors with insecure attachment to parents would be at an elevated risk of developing PTSD and trauma symptoms. Participants (n = 111, ages 7-12) comprised two groups, child CSA survivors (n = 43) and a matched comparison group of children (n = 68) recruited from the community. Children completed the Child Attachment Interview as well as the Trauma Symptom Checklist for Children (TSCC). There was a significant interaction between sexual abuse history and attachment security, such that sexually abused children with insecure attachment representations had significantly more PTSD and trauma symptoms than sexually abused children with secure attachment to parents. The findings show that using a dual lens of attachment and CSA can facilitate identification children most at risk have important implications for understanding risk and resilience processes

Determination of complex dielectric functions of ion implanted and implanted‐annealed amorphous silicon by spectroscopic ellipsometry

Measuring with a spectroscopic ellipsometer (SE) in the 1.8–4.5 eV photon energy region we determined the complex dielectric function (ϵ = ϵ1 + iϵ2) of different kinds of amorphous silicon prepared by self‐implantation and thermal relaxation (500 °C, 3 h). These measurements show that the complex dielectric function (and thus the complex refractive index) of implanted a‐Si (i‐a‐Si) differs from that of relaxed (annealed) a‐Si (r‐a‐Si). Moreover, its ϵ differs from the ϵ of evaporated a‐Si (e‐a‐Si) found in the handbooks as ϵ for a‐Si. If we use this ϵ to evaluate SE measurements of ion implanted silicon then the fit is very poor. We deduced the optical band gap of these materials using the Davis–Mott plot based on the relation: (ϵ2E2)1/3 ∼ (E− Eg). The results are: 0.85 eV (i‐a‐Si), 1.12 eV (e‐a‐Si), 1.30 eV (r‐a‐Si). We attribute the optical change to annihilation of point defects

Parental reflective functioning as a moderator of child internalizing difficulties in the context of child sexual abuse

The objective was to examine pathways from child sexual abuse (CSA) and maternal mentalizing to child internalizing and externalizing difficulties and to test models of MRF as moderator of the relationships between CSA and child difficulties. The sample was comprised of 154 mothers and children aged 2–12 where 64 children had experienced CSA. To assess parental mentalizing the Parental Development Interview was rated with the Parental Reflective Functioning Scale. Child internalizing and externalizing difficulties were assessed with the Child Behavior Checklist (CBCL). Results indicate that there were significant inverse relationships between maternal mentalizing and child internalizing and externalizing difficulties. When maternal mentalizing was considered together with CSA, only maternal mentalizing was a significant predictor of child difficulties. Furthermore, maternal mentalizing moderated the relationship between CSA and child internalizing difficulties. These findings provide evidence of the importance of the parents’ mentalizing stance for psychiatric symptoms of children aged 2–12, as well as children’s recovery from CSA. The clinical implications of the findings are discussed

Measuring Grandiose and Vulnerable Narcissism in Adolescents

The Pathological Narcissism Inventory (PNI) has been widely used with adults. Its vulnerable and grandiose dimensions have been differentially associated with psychopathology and interpersonal difficulties. While the PNI has been used with adolescents, its structure and correlates remain to be investigated. The aim of this study was to examine the psychometric properties of the French PNI for adolescents and its association with indices of dysfunction. A total of 570 adolescents completed the PNI, the Youth Self Reportto assess internalizing and externalizing difficulties, and the Self-Perception Profile for Adolescents to assess self-esteem. Results showed that the first and second-order factor structure of the PNI for adolescents is identical to the one found in adults. Temporal stability at one month was good. Between gender differences, as well as correlations between PNI dimensions, internalizing and externalizing difficulties, and self-esteem further add to the conclusion that the French PNI-A has good psychometric properties. Key words: adolescence, narcissism, measure, french, pathological narcissism inventor