Association Francophone pour les Soins Oncologiques de Support

BackgroundVery preterm children are at greater risk of academic difficulties (AD). Some of them start school a year earlier than anticipated during pregnancy due to being born preterm. The aim of this study was to analyze the relationship between neurodevelopment, school-entry age, and AD at age seven. MethodAD were assessed at age seven in children born before 33 weeks of gestation between January 1st, 2007 and December 31, 2014 and enrolled in LIFT cohort. To analyze the relationship between school-entry age and AD, we used generalized equations with adjustment for perinatal, socio-economic factors, and neurodevelopment assessed by Age Stages Questionnaire (ASQ) at 5 years. Moreover, we used Global Scholar Adaptation (GSA) score to evaluate the school adaptation. Results2599 children were in routine schooling. Entering school a year earlier was observed in 597 (23.0%). AD was known for 1943/2599 (74.8%). Starting school a year earlier was associated with an increased rate of AD: 35.4% in the exposed group versus 20.2% in the non-exposed group, with a relative risk of 1.76 (95% CI: 1.48; 2.08). Both starting school a year earlier and ASQ at 5 years old were independently associated with the GSA score at age 7: standardized β=-0.15 (95% CI:-0.10;-0.20) and 0.40 (95% CI: 0.35; 0.45) respectively. ConclusionStarting school a year earlier than anticipated during pregnancy was associated with an increased rate of AD at age 7 in children born very preterm, independently of their neurodevelopment at age 5 assessed by ASQ. Basing school entry age on corrected age seems appropriate to mitigate this risk.

Abstract The absence of a specific tool to evaluate the impact of Supportive care in general and socioesthetics in particular as a rendered medical service is undoubtedly at the origin of the lack of published research based on scientific standards.In this context, we developed one supportive-care patient-reported outcome [PRO] using the multistep methods following COSMIN recommendations. Its construction followed all recommended steps: elaboration of the questionnaire, measurement properties of the questionnaire, internal and external validation, test-retest validation and translation, cross-cultural adaptation and cognitive debriefing. In total, our questionnaire includes11 items. It is scored by adding each VAS, making it range from 0 to 110, with a higher benefit when the score is higher. The Cronbach’s α coefficient is 0.88 for the entire questionnaire. The questionnaire thus constructed is a reflection of the patient's feelings, and it is quite natural that the name The “patient centricity questionnaire” (PCQ) was retained and validated by the Scientific Committee. The PCQ correlated negatively and moderately with the PSS, positively and moderately with the mental dimension of the and poorly with the WB12, the physical dimension of the SF-12 and the satisfaction EVA. Constructed according to the recommendations, the PCQ meets the prerequisite for this type of questionnaire. Its short format (11 questions) and simplicity of use allow it to be used by a large number of people and provides an pragmatic answer by making available to research teams a simple, reliable, easy-to-use and validated tool. It makes possible randomized studies to prove the impact on quality of life of the Supportive care in general and socioesthetics" in particular.

Au Portugal, Housing First (Logement d’abord) retient de façon croissante l’attention de prestataires de services et d’organisations pour sans-abri, ainsi que celle de responsables politiques. Le premier programme a débuté en 2009, à Lisbonne, et est géré par l’Association pour l’étude et l’intégration psychosociale et une ong , en collaboration avec des chercheurs de l’ ispa -Institut universitaire. Le projet Casas primeiro était destiné à des sans-abri de longue durée, souffrant de problèmes de santé mentale et vivant dans des conditions extrêmement rudes. Le projet offrait aux gens un accès immédiat à des appartements indépendants et dispersés, loués via le marché immobilier privé, et proposait des services de soutien personnalisés, flexibles et axés sur les usagers. Le projet-pilote de deux ans a donné des résultats très positifs. Cet article expose les origines et la diffusion des idées de Housing First au Portugal. Il examine plus particulièrement la façon dont ce projet-pilote a influencé le changement du système du sans-abrisme au niveau municipal comme au niveau national. Sont décrits dans cet article les efforts de soutenabilité et les initiatives de diffusion visant à promouvoir les programmes de Housing First dans d’autres communautés, ainsi que la formation et les activités d’assistance technique. Sans oublier les développements récents sur le changement de politique sociale qui en découle.

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We analyze two multi-chord stellar occultations by Pluto observed on July 18th, 2012 and May 4th, 2013, and monitored respectively from five and six sites. They provide a total of fifteen light-curves, twelve of them being used for a simultaneous fit that uses a unique temperature profile, assuming a clear (no-haze) and pure N_2 atmosphere, but allowing for a possible pressure variation between the two dates. We find a solution that fits satisfactorily (i.e. within the noise level) all the twelve light-curves, providing atmospheric constraints between ~1,190 km (pressure ~ 11 \mubar) and ~ 1,450 km (pressure ~0.1 \mubar) from Pluto's center. Our main results are: (1) the best-fitting temperature profile shows a stratosphere with strong positive gradient between 1,190 km (at 36 K, 11 \mubar) and r = 1,215 km (6.0 \mubar), where a temperature maximum of 110 K is reached; above it is a mesosphere with negative thermal gradient of -0.2 K/km up to ~ 1,390 km (0.25 \mubar), where, the mesosphere connects itself to a more isothermal upper branch around 81 K; (2) the pressure shows a small (6 %) but significant increase (6-\sigma level) between the two dates; (3) without troposphere, Pluto's radius is found to be R_P = 1,190 +/- 5km. Allowing for a troposphere, R_P is constrained to lie between 1,168 and 1,195 km; (4) the currently measured CO abundance is too small to explain the mesospheric negative thermal gradient. Cooling by HCN is possible, but only if this species is largely saturated; Alternative explanations like zonal winds or vertical compositional variations of the atmosphere are unable to explain the observed mesospheric trend.

BackgroundNivestim™ (filgrastim) is a follow-on biologic agent licensed in the EU for the treatment of neutropenia and febrile neutropenia induced by myelosuppressive chemotherapy. Nivestim™ has been studied in phase 2 and 3 clinical trials where its efficacy and safety was found to be similar to its reference product, Neupogen®. Follow-on biologics continue to be scrutinised for safety. We present a design for two observational phase IV studies that are evaluating the safety profile of Nivestim™ for the prevention and treatment of febrile neutropenia (FN) in patients treated with cytotoxic chemotherapy in general clinical practice.Methods/DesignThe NEXT (Tolérance de Nivestim chez les patiEnts traités par une chimiothérapie anticancéreuse cytotoXique en praTique courante) and VENICE (VErträglichkeit von NIvestim unter zytotoxischer Chemotherapie in der Behandlung malinger Erkrankungen) trials are multicentre, prospective, longitudinal, observational studies evaluating the safety profile of Nivestim™ in 'real-world’ clinical practice. Inclusion criteria include patients undergoing cytotoxic chemotherapy for malignancy and receiving Nivestim as primary or secondary prophylaxis (NEXT and VENICE), or as treatment for ongoing FN (NEXT only). In accordance with European Union pharmacovigilance guidelines, the primary objective is to evaluate the safety of Nivestim™ by gathering data on adverse events in all system organ classes. Secondary objectives include obtaining information on patient characteristics, efficacy of Nivestim™ therapy (including chemotherapy dose intensity), patterns of use of Nivestim™, and physician knowledge regarding filgrastim prescription and the reasons for choosing Nivestim™. Data will be gathered at three visits: 1. At the initial inclusion visit, 2. At a 1-month follow-up visit, and 3. At the end of chemotherapy.Recruitment for VENICE commenced in July 2011 and in November 2011 for NEXT. VENICE completed recruitment in July 2013 with 407 patients, and NEXT in September 2013 with 2123 patients. Last patient, last visit for each study will be December 2013 and March 2014 respectively.DiscussionThe NEXT and VENICE studies will provide long-term safety, efficacy and practice pattern data in patients receiving Nivestim™ to support myelosuppressive chemotherapy in real world clinical practice. These data will improve our understanding of the performance of Nivestim™ in patients encountered in the general patient population.Trial registrationNEXT NCT01574235, VENICE NCT01627990