[Management of communication in patients after severe traumatic brain injury. Pilot study]. / Programme de prise en charge de la communication à distance d'un traumatisme crânien grave. Etude pilote.

OBJECTIVE: In the long term, people with traumatic brain injury (TBI) present with communication disorders impairing their professional and social integration. The aim of this study was to evaluate the feasibility of group therapy on communication disorders of people with TBI in the post-hospital period. MATERIALS AND METHOD: Four patients were followed in the medico-social department "Auprès-TC" and took part in various day programs. Two speech therapists participated for a 7-month period using group therapy to take into account communication disorders. The patients and families were evaluated at the beginning and end of care, by use of the Lille Communication Test, the Bordeaux Scale of Verbal Communication, the Revised Neurobehavioural Rating Scale, and part of the European document EBIS. RESULTS: Despite the delay since TBI, patients showed quantitative and qualitative evolution of communicative abilities. DISCUSSION-CONCLUSION: The influence of group therapy on the improvement of communication in patients with TBI should be reconsidered, because in this study, familial and institutional environment influenced the communication. Group therapy allows for communication care from an ecological point of view, by enhancing interactions.

Composition-controlled nanocomposites of apatite and collagen incorporating silicon as an osseopromotive agent.

The development of a novel biocomposite of apatite (Ap) and collagen incorporating low-level additions of silicon (Si) as an osseopromotive agent is detailed. Designed to mimic the structural and compositional characteristics of developing bone, this composite is produced via a coprecipitation method, through which the weight percentage of Ap (i.e., the Ap/collagen ratio) can be varied. Coprecipitates produced at Ap contents of 80 wt % (Ap/collagen=4:1), 60 wt % (Ap/collagen=3:2), and 40 wt % (Ap/collagen=2:3) Ap showed markedly different morphologies, ranging from ceramic-like particulates to rope-like macro-fibrils; at all three Ap contents, however, the nanostructural features of the composites remained qualitatively indistinguishable, with equiaxed Ap nanocrystals distributed randomly throughout a matrix of amorphous collagen. Si incorporation was observed to occur preferentially in the collagenous phase-a result with potential impact on local controlled release of Si.

Maternal representation of the self as parent: connections with maternal sensitivity and maternal structuring.

Maternal representations of the self as parent were assessed via the Parent Attachment and Peer Relationship Interviews (Bretherton, Biringen, Ridgeway, Maslin-Cole, & Sherman, 1989; Biringen & Bretherton, 1988) when children were 39 months of age. Maternal sensitivity and maternal structuring during mother-child interactions were assessed at 18, 24 and 39 months. The central question of this study was whether maternal representations were related to aspects of observed maternal sensitivity and maternal structuring. We found that maternal sensitivity at 18 months predicted later maternal representations of the self as parent. But beginning at 24 months and continuing to 39 months maternal structuring proved to be a more important predictor of maternal representations of the self, in particular maternal self-esteem, even after controlling for maternal sensitivity.

Relationship of depressive, conduct, and comorbid disorders and social functioning in childhood.

OBJECTIVE: To examine the relationship of depressive, conduct, and comorbid disorders and social functioning in psychiatrically referred youths. METHOD: Subjects were 94 boys and 67 girls (mean age at initial assessment = 11.5 years) who were repeatedly evaluated with standardized instruments during a mean interval of 4.4 years. On the basis of their diagnoses during the follow-up, children were designated as having had depressive, conduct, or both (comorbid) disorders or other conditions. Two domains of social functioning were assessed: social competence and self-esteem. RESULTS: Longitudinal analyses revealed that at any given point in time, depressive, conduct, and comorbid disorders were associated with low social competence and depressive disorder also was associated with low self-esteem. At the approximate age of 15 years, on average, children with a history of conduct or comorbid disorders had lower social competence than did children with a history of depressive disorder, but these groups endorsed similar levels of self-esteem. CONCLUSION: Some areas of social dysfunction associated with comorbid depressive and conduct disorders appear to reflect mostly the effects of conduct disorder. The latter condition has a more severe and longer-term impact on children's social competence than does depression. In addition, whereas depression has an adverse effect on self-esteem, this effect appears to be temporary.

Concordance between mothers' reports and children's self-reports of depressive symptoms: a longitudinal study.

OBJECTIVE: Developmental factors and maternal depression were examined for their impact on mother-child and clinician-child agreement concerning children's internal depressive symptoms. METHOD: Data were derived from a clinically referred, racially mixed sample of school-age boys and girls (n = 113), with a study entry diagnosis of depression. Measures of agreement were based on parallel items from the self-rated Children's Depression Inventory, mother-rated Child Behavior Checklist, and clinician-rated, semistructured psychiatric interview with both the child and mother. Repeated measures of agreement were modeled longitudinally over a maximum of 7 years as a function of age, social-cognitive development, and maternal depression. Additional covariates were maternal psychopathology (excluding depression), socioeconomic status, and child's gender and verbal ability. RESULTS: Mother-child and clinician-child agreement increased as a function of the child's age during the follow-up and was consistently attenuated by maternal depression. Depressed mothers overrated their children's symptomatology as compared with the children's self-reports. CONCLUSIONS: Clinicians should consider the young patient's age and level of maternal depression when weighing the relative merits of self-report and parental report of the child's depressive symptoms. Additional research is necessary to understand the mechanisms of change in parent-child agreement.