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Search Results: 1 - 10 of 6185 matches for " Sarah Hustache "
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The Colombian conflict: a description of a mental health program in the Department of Tolima
Elisabeth Sanchez-Padilla, German Casas, Rebecca F Grais, Sarah Hustache, Marie-Rose Moro
Conflict and Health , 2009, DOI: 10.1186/1752-1505-3-13
Abstract: We observed differences between the urban and rural settings in the traumatic events reported, the clinical expression of the disorders, the disorders diagnosed, and their severity. Although the duration of the treatment was limited due to security reasons and access difficulties, patient condition at last visit improved in most of the patients. These descriptive results suggest that further studies should be conducted to examine the role of short-term psychotherapy, adapted specifically to the context, can be a useful tool to provide psychological care to population affected by an armed conflict.Colombia has been seriously affected by an internal armed conflict for more than 40 years. The "guerrillas," the Revolutionary Armed Forces of Colombia (FARC) and the National Liberation Army (ELN), paramilitary groups and the governmental military, control different aspects of the social and political landscape. Civilian populations are the main victims of this conflict, forced to displace, suffering kidnapping, extortion, threats or assassinations.Due to the security problems, very few medical actors are present and even less mental health professionals are able to work in the region. Médecins Sans Frontières-France (MSFF) has been working in mental health support programs in the department of Tolima, Colombia, since 2002. Tolima, which groups 47 municipalities, is considered a strategic corridor in the armed conflict in Colombia, and has been occupied for more than 30 years.The MSFF mental health program in Tolima was based on a short-term multi-faceted treatment developed according to the psychological and psychosomatic needs of the population. Here, we describe the population attending during 2005-2008, as well as the psychological treatment provided during this period and its outcomes.Between 2005 and 2008, MSFF provided psychological care and treatment in Ibague, the capital of the department of Tolima, and in various rural villages. Three mental health teams provide
Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey
Anne-Laure Page, Sarah Hustache, Francisco J Luquero, Ali Djibo, Mahamane Manzo, Rebecca F Grais
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-389
Abstract: A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted.In total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0) and 3.4% (95% CI: 2.2-4.6), respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1) reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household.The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of severe diarrheal diseases would capture only a fraction of severe diarrhea. Lower levels of health structures should be considered to obtain informative data to ensure appropriate care and burden estimates.Although better sanitation, hygiene and access to care have successfully alleviated the burden of diarrheal diseases in developed countries [1,2], diarrhea remains the second leading cause of death in children under 5 years of age in the world, representing nearly one in five child deaths - about 1.5 million each year [3,4]. In sub-Saharan Africa, the etiology of diarrhea is se
Mortality Risk among Children Admitted in a Large-Scale Nutritional Program in Niger, 2006
Nael Lapidus, Andrea Minetti, Ali Djibo, Philippe J. Guerin, Sarah Hustache, Valérie Gaboulaud, Rebecca F. Grais
PLOS ONE , 2009, DOI: 10.1371/journal.pone.0004313
Abstract: Background In 2006, the Médecins sans Frontières nutritional program in the region of Maradi (Niger) included 68,001 children 6–59 months of age with either moderate or severe malnutrition, according to the NCHS reference (weight-for-height<80% of the NCHS median, and/or mid-upper arm circumference<110 mm for children taller than 65 cm and/or presence of bipedal edema). Our objective was to identify baseline risk factors for death among children diagnosed with severe malnutrition using the newly introduced WHO growth standards. As the release of WHO growth standards changed the definition of severe malnutrition, which now includes many children formerly identified as moderately malnourished with the NCHS reference, studying this new category of children is crucial. Methodology Program monitoring data were collected from the medical records of all children admitted in the program. Data included age, sex, height, weight, MUAC, clinical signs on admission including edema, and type of discharge (recovery, death, and default/loss to follow up). Additional data included results of a malaria rapid diagnostic test due to Plasmodium falciparum (Paracheck?) and whether the child was a resident of the region of Maradi or came from bordering Nigeria to seek treatment. Multivariate logistic regression was performed on a subset of 27,687 children meeting the new WHO growth standards criteria for severe malnutrition (weight-for-height<?3 Z score, mid-upper arm circumference<110 mm for children taller than 65 cm or presence of bipedal edema). We explored two different models: one with only basic anthropometric data and a second model that included perfunctory clinical signs. Principal Findings In the first model including only weight, height, sex and presence of edema, the risk factors retained were the weight/height1.84 ratio (OR: 5,774; 95% CI: [2,284; 14,594]) and presence of edema (7.51 [5.12; 11.0]). A second model, taking into account supplementary data from perfunctory clinical examination, identified other risk factors for death: apathy (9.71 [6.92; 13.6]), pallor (2.25 [1.25; 4.05]), anorexia (1.89 [1.35; 2.66]), fever>38.5°C (1.83 [1.25; 2.69]), and age below 1 year (1.42 [1.01; 1.99]). Conclusions Although clinicians will continue to perform screening using clinical signs and anthropometry, these risk indicators may provide additional criteria for the assessment of absolute and relative risk of death. Better appraisal of the child's risk of death may help orientate the child towards either hospitalization or ambulatory care. As the transition from the NCHS
Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo
Sarah Hustache, Marie-Rose Moro, Jacky Roptin, Renato Souza, Grégoire Gansou, Alain Mbemba, Thomas Roederer, Rebecca F Grais, Valérie Gaboulaud, Thierry Baubet
International Journal of Mental Health Systems , 2009, DOI: 10.1186/1752-4458-3-7
Abstract: 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.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).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.Sexual violence is not simply a consequence or side effect of war and displacement, but rather can be used as a deliberate tool of war [1]. Aside from medical consequences, such as sexually transmitted diseases or unwanted pregnancies, sexual violence, and rape in particular, may lead to long-lasting trauma and s
A rapid screening tool for psychological distress in children 3–6years old: results of a validation study
Caroline Marquer, Caroline Barry, Yoram Mouchenik, Sarah Hustache, Douma M Djibo, Mahamane L Manzo, Bruno Falissard, Anne Révah-Lévy, Rebecca F Grais, Marie-Rose Moro
BMC Psychiatry , 2012, DOI: 10.1186/1471-244x-12-170
Abstract: 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.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.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.The mental health needs of young children in humanitarian contexts often remain unaddressed [1-4]. During the acute phase of a humanitarian emergency, and in humanitarian contexts in general, psychological care of children may come far down on the list of priorities. The limited number of both local and international medical professionals combined with the relative lack of mental health professionals in these settings also hinders the implementation of mental health activities [5]. Further, even when mental health professionals are present, they are rarely specialists in yo
Using Metaphors to Aid Student Meta-Learning: When You’re Learning at Your Best Your Like What?  [PDF]
Sarah Nixon
Creative Education (CE) , 2013, DOI: 10.4236/ce.2013.47A2006

Metaphors are widely discussed within educational research and this paper adds to the body of knowledge in relation to students using these as a tool to support meta-learning. Metaphors free up space for creative thinking by moving the mind from one place to another and have been found to be an effective cognitive device for learning. This project focuses on what students are like when they are “learning at their best” and discusses what knowing this information does for both individual self-awareness and working with others. Six final year students spent half a day exploring, developing and pictorially representing their “learning at best” metaphors. All six metaphors were different and showed the internal representations of the individuals when they were learning at their best. However out of the discourse common themes arose from the group in relation to what was needed to support learning these included time of day, mood, pace and environment. All six students were positive that the development of personal learning metaphors was beneficial and thought that it was important that these were developed systematically over time. The benefits were highlighted to be both for the individual working on their own and for understanding others in group work situations.

A Day in the Life of an Early Childhood Teacher: Identifying the Confronting Issues and Challenges That Arise  [PDF]
Sarah Ohi
Creative Education (CE) , 2014, DOI: 10.4236/ce.2014.511115

Recent emphasis upon Early Childhood as an educational priority for the Australian Government has resulted in increases in funding, government initiatives, course providers and the introduction of new policies to the sector in order to improve the quality of early childhood education. The study reported here investigated the “reality” of what it means to be an Early Childhood Teacher within this changing context and identified the roles and responsibilities and the associated challenges. A case study involving observation and interviews with five Bachelor qualified Teachers from varied early childhood settings was undertaken in order to gain knowledge about their experiences and perspectives on their work. The data were analyzed using a grounded theory approach involving the identification of key themes and issues about the nature of teachers’ work. The findings revealed that in their everyday practice teachers played a complex array of roles that required them to contribute far more than just their teaching skills and knowledge. They were expected to concurrently enact the roles of educator, leader, advocate, communicator, counsellor and administrator whilst juggling everyday challenges including a “lack of time”, the need for “further support and more resources” and “building successful partnerships with parents”.

Neisseria sicca Endocarditis Complicated by Intracranial and Popliteal Aneurysms in a Patient with a Bicuspid Aortic Valve
Guillaume Debellemanière,Catherine Chirouze,Laurent Hustache-Mathieu,Damien Fournier
Case Reports in Infectious Diseases , 2013, DOI: 10.1155/2013/895138
Neisseria sicca Endocarditis Complicated by Intracranial and Popliteal Aneurysms in a Patient with a Bicuspid Aortic Valve
Guillaume Debellemanière,Catherine Chirouze,Laurent Hustache-Mathieu,Damien Fournier,Alessandra Biondi,Bruno Hoen
Case Reports in Infectious Diseases , 2013, DOI: 10.1155/2013/895138
Abstract: We report a case of infective endocarditis due to Neisseria sicca complicated by intracranial and popliteal aneurysms and hepatic and splenic infarcts in a patient with a bicuspid aortic valve. No predisposing factor other than poor dental condition was found. The patient fully recovered after antibiotic therapy, aortic and mitral valve replacement, endovascular occlusion of the middle-cerebral artery aneurysm, and surgical treatment of the popliteal artery aneurysm. 1. Background The Neisseria genus includes a wide range of species, N. meningitidis and N. gonorrhoeae being the two most frequently involved in infections in humans. Other species, which are part of normal oropharyngeal flora, are often referred to as “nonpathogenic Neisseria” although they may be responsible for serious conditions such as endocarditis, meningitis, osteomyelitis, vertebral osteomyelitis, and pneumonia. We report the case of a patient with Neisseria sicca endocarditis, complicated with mycotic aneurysms of the middle cerebral and popliteal arteries. 2. Case Presentation A 41-year-old male patient with a known history of bicuspid aortic valve was admitted to hospital for persisting fever and flu-like syndrome. He had smoked 40 cigarettes a day for 10 years and denied any illicit drug use. Twenty days prior to admission, he had developed myalgia, anorexia, intermittent fever and fatigue. He had been evaluated by his general practitioner whose findings were unremarkable. One week later, laboratory test results were as follows: whole white blood cell count 16.7?G/L and C-reactive protein 336?mg/L. Urine culture was positive for E. coli (103?CFU/ml) and the patient was given amoxicillin/clavulanate. Because his symptoms did not abate he was admitted to hospital. On admission, temperature was 38.5°C, heart rate was 98?bpm, and blood pressure was 100/80?mmHg. Cardiac examination revealed a systolic murmur, maximal at the aortic area. Breath sounds were normal. The liver was moderately enlarged. There was no pedal edema. Neurological examination was unremarkable. Dental condition was poor. The WBC count was 19.4?G/L. Serum ALT and AST levels were 184?U/L and 216?U/L, respectively;??γ-GT was 146?U/L; alkaline phosphatase was 133?U/L and C-reactive protein was 278?mg/L. Brain natriuretic peptide level was 217?pg/mL (0–100?pg/mL). Chest X-ray was normal. Electrocardiogram showed a sinus rhythm and a heart rate of 100?bpm. Transesophageal echocardiography showed a bicuspid aortic valve with a ?mm vegetation attached on the ventricular leaflet, associated with a grade 2 aortic
Behavioural Sleep Disorders across the Developmental Age Span: An Overview of Causes, Consequences and Treatment Modalities  [PDF]
Sarah Lee Blunden
Psychology (PSYCH) , 2012, DOI: 10.4236/psych.2012.33035
Abstract: Behavioural sleep problems, that is, sleep problems that do not have a physiological aetiology, but rather a behavioural or psychological aetiology, are reported in between 20% - 40% of children and adolescents. These sleep disorders are categorised as Behavioural Insomnia of Childhood (BIC) in the International Classification of Sleep Disorders. BIC can result in short sleep duration and poor quality sleep and can have wide ranging effects on mental and physical health, cognitive and social functioning and development in infants, pre-schoolers, school aged children and adolescents. Each age group have a particular set of behaviourally based sleep disorders. This paper presents a broad overview of BIC and covers essential information about these sleep disorders, their aetiologies, effects on development and non medical treatment modalities.
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