IMPACT de la déprivation sociale sur les difficultés psychosociales au décours d’un cancer pédiatrique:uneétude prospective IMPACT of the Social Deprivation on Psychosocial Difficulties of Pediatric Cancer Survivors:A Prospective Study

The posttreatment period is a key part of the management of pediatric cancer.During this time,school and psychological difficulties have been described in childhood cancer survivors(CCS)and can be prognostic for the success of social reintegration.This study estimated the influence of the household’s socioeconomic status(SES)on these psychosocial difficulties.This study is based on a prospective multicentric database and focused on children who received a psychosocial evaluation during their follow-up from 2013 to 2020.We retrieved data on school and psychological difficulties.Household SES was estimated by a social deprivation score.Data from1003 patients were analyzed.School difficulties were noted in 22%of CCS.A greater social deprivation was significantly associated with school difficulty.Tumor relapse,treatment with hematopoietic stem cell transplantation,and central nervous system(CNS)tumors remained significant risk factors.In the subgroup of CNS tumors,school difficulties were increased and associated with greater social deprivation.Psychological difficulties were not associated with the deprivation score.There is a link between SES and school difficulties in CCS.Further investigations should be carried out for children with CNS tumors,which is the population of the greatest concern.

Linking 24-h Movement Behavior Guidelines to Cognitive Difficulties,Internalizing and Externalizing Problems in Preterm Youth

Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.

Ableism and (Neo)Racism in School Placement Processes in Quebec: School Personnel Interpretations of Immigrant Student Difficulties - A Secondary Publication

The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.

Teachers’ Perceptions of the Challenges and Strategies in Supporting Students with Reading Difficulties

The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive approach as its research design,in addition to a set of structured interview questions administered through Google Forms to gather data from elementary teachers of Taal Central School,located at Taal Batangas.These structured interview questions were carefully designed to cover various dimensions of the study,including the types of challenges perceived by teachers,strategies employed,and possible solutions for addressing the problems encountered in the process of supporting students with reading difficulties.The results revealed that teachers faced several challenges when teaching students with reading difficulties such as emotional and motivational issues/factors,lack of resources or teaching aids,deficits in knowledge and skills,and problems with student engagement and participation.This study also showed common approaches utilized by the teachers in supporting students with reading difficulties,which were fostering a positive and supportive environment,adopting individualized and multifaceted approaches,and utilizing effective teaching tools and strategies.Lastly,teachers also concluded varied solutions in addressing the challenges perceived in teaching students with reading difficulties towards fostering reading proficiency.These include developing peer support,use of positive reinforcement,and parental involvement.Moreover,specialized resources,professional development for teachers,and specific teaching strategies are also highlighted as crucial components.By integrating these approaches,teachers concluded that it can create a supportive and effective learning environment tailored to the needs of students with reading difficulties.

Teaching Legal Englishfor Law Studentsin China:Difficultiesand Solutions

Teaching legal English for law students in China is difficult.For one thing,many Chinese law students have trouble moreor less in learning English,because the English language is not their mother tongue.For another,legal English differs a great dealfrom everyday English in many respects,including terminology,phrasing,linguistic structure,and linguistic conventions,whichmakes legal English teaching for law students in China by far harder.To solve difficulties undermining teaching legal English forlaw students in China,the author of this paper holds that in his or her actual legal English teaching,the teacher should boost lawstudents basic English teaching,expose them to cases study of specialized legal English terminology and linguistic structures andconventions.

The Difficulties and Mechanism Innovation of Constructing China's Rural Multiplex Financial System

This paper expounds the necessity of constructing China's rural multiplex financial system as follows.First,overcome the bottleneck effect arising from the shortage of capital in the process of development of rural small and medium-sized enterprise,and increase farmers' income;second,provide capital support for rural modern industrial development,and promote rural economic development;third,rationally allocate capital,master the money flow and coordinate urban-rural development.The paper also profoundly analyzes the difficulties of constructing China's rural multiplex financial system as follows.First,the existing rural financial system structure is irrational and the function is unsound;second,non-governmental financial market is disorderly and the organization is unsound;third,the rural financial system is simple and the overhaul of rural credit cooperatives system has not yet been done;fourth,the construction of rural system of financial laws and regulations is laggard,and the construction of rural multiplex financial system lacks good social environment.The specific thoughts,measures and countermeasures of constructing mechanism innovation of China's rural multiplex financial system are put forward as follows.First,increasingly perfect legal system and provide legal support for constructing China's rural multiplex financial system;second,quicken the overhaul of rural credit cooperatives system and perfect its function in China's rural multiplex financial system;third,strengthen the degree of support and development,and change the situation of simple structure of rural financial system;fourth,reinforce administrative supervision and perfect public services,and standardize the rural financial market order.

Difficulties Experienced in Trauma Nursing Practice by Expert Emergency Nurses in Japan

The objective of this study was to determine the difficulties experienced in trauma nursing practice by expert emergency nurses in Japan. Ten nurses who worked at emergency and critical care centers in Japan were directly involved in nursing patients were selected by purposive sampling and underwent semi-structured interviews regarding the difficulties they experienced in trauma nursing. The nurses were specialists in critical care nursing or were certified emergency nurses. The interview responses were analyzed by the qualitative descriptive method. The following six categories of difficulties associated with the direct care of trauma patients and their family members encountered in trauma nursing practice were identified: [Initial handling of highly urgent trauma patients], [Understanding and observing the condition of patients who are in the treatment stage], [Judging when to transition to end-stage care for patients difficult to save], [Mitigating suffering and expanding safe activities of daily living for trauma patients], [Transitional care with a long-term perspective for trauma patients], and [Relationships with the family members of patients who died]. Three categories of difficulties related to the role of the expert nurse in trauma nursing practice were identified: [Person-to-person coordination and cooperation for a trauma patient], [Playing an educational role for the nursing staff], and [Pursuing expertise in trauma nursing and gaining empirical knowledge]. The findings suggested a need to establish systems for training and consultative support and opportunities to create meaning by reflecting on fulfillment and nursing practice.

An Analysis on Mental Health Education of College Students with Financial Difficulties

With the enrollment expansion of college and continuous reform of college education system and college charging system,the number of college students with financial difficulties is increasing. The college students with family financial difficulties not only bear the huge economic burden,but also bear the huge pressure of learning and mental stress,and they have many kinds of psychological problems including psychological distress of tension and anxiety,psychological conflict of self-respect and self-abasement,conflict of desire for interpersonal interaction and self-containment and strong vanity and dependence mentality. This paper puts forward the corresponding recommendations to solve these problems.

Problem-Solving Based Intervention for Informal Caregivers: A Scoping Review

Background: Caregiving for someone is a huge task for informal caregivers. The caregiving role is often challenging and overwhelming for them. Stress, burden, and depression have been frequently identified as the negative caregiving experiences. This systematic review synthesized the available evidence for the problem-based intervention provided for caregivers as there is little insight about the effects of problem-based intervention on caregivers. Objectives: To describe: 1) the design of problem-solving intervention;2) the effects of problem-solving intervention for caregiver outcomes. Methods: This review followed Arksey and O’Malley’s methodological framework for conducting scoping reviews which entail setting research questions, selecting relevant studies, charting the data and synthesizing the results. FPRISMA guidelines were adopted and several databases were searched including MEDLINE;EMBASE;web of science. This review contains literature from 2012 to 2019 on problem-solving-based intervention which intended to caregivers. Results: 41 publications representing 27 unique problem-based interventions. Problem-solving-based intervention has different extent effects on caregiver emotion status, burden and quality of life. Conclusions: Problem-solving intervention is promising in caregiver intervention which could reduce caregiver depression, anxiety and burden.

Genome-wide association studies of hypertension:Achievements,difficulties and strategies

Estimated from family studies,the heritability of hypertension ranges from 31%to 68%.Linkage studies and candidate gene association studies were once widely used to investigate the genetic mechanisms of hypertension.However,results from these studies could only explain 1%-2%heritability.With the technological advances and subsequently the accomplishment of the Human Genome Project,genome-wide association studies(GWA studies)have been applied to find genome-wide significant signals for many common diseases.Current GWA studies of hypertension have identified dozens of hypertension or blood pressure associated variants.However,different GWA study identified different variants and the results could hardly be replicated in other studies.Therefore,a debate took place on whether GWA studies will unlock the genetic basis of hypertension and whether we shall continue throwing millions of dollars on GWA studies.This review gives a short introduction to the history of genetic study on hypertension and summarizes the current findings for GWA studies of hypertension or blood pressure.Finally,we will discuss that debate and try to find alternative strategies and technologies that may hold a greater chance to make progress in understanding the genetic risk factors of hypertension and blood pressure regulation.

The Strengths and Difficulties Questionnaire： A Pilot Study on the Reliability and Validity of the Self-report Version to Measure the Mental Health of Zambian Adolescents

The study had the objective of exploring the feasibility of using the self-report SDQ-Y （youth version of strengths and difficulties questionnaire） to assess the emotional and behavioural well being of adolescents in Zambia. This was a cross sectional study of Lusaka school children （n = 420） aged 11-15 years using the self-report SDQ-Y and a demographic questionnaire. It was found that compared to a UK normative sample, Zambian adolescents were almost twice as likely to have total difficulties scores in the abnormal range （O.R. 1.9）. It was found that there was a significant difference in the total SDQ scores （Z = -2.67, P = 0.008） with children reporting health problems having significantly higher scores. Children reporting health problems also had significantly more emotional problems （Z = -2.78, P = 0.005）. There was a trend for children with health problems to score higher on the hyperactivity scale （Z = -1.9 P = 0.053）. The internal consistency of SDQ subscales ranged from low to moderate. It can be concluded that SDQ is a useful instrument for use with Zambian adolescents, in particular, the total difficulties score and the emotional difficulties score performed well in this sample and could potentially be used to screen for mental health problems or to examine the impact of interventions.

An Analysis and Corresponding Strategies of Memory Difficulties Caused by Psychological Factors in Consecutive Interpreting

This paper is composed of three parts.The first part presents Gile’s effort model and memory mechanism in consecutive interpreting.In the second part and the third part,the author analyzes the psychological factors that cause memory difficulties and proposes corresponding strategies on the basis of the analysis.At last,the author draws a conclusion based on the discussion of the whole paper that sufficient preparation,appropriate pressure and perceived memory can avoid memory difficulties caused by psychological factors.

Repair of Complex Post-Traumatic Facial Dislocations: Indications, Therapeutic Difficulties and Results at Treichville University Hospital, Abidjan, Cote d’Ivoire

Introduction: Complex post-traumatic facial disfigurements are caused by civilian or ballistic trauma. Their repercussions are functional, aesthetic and psychological. The initial emergency or secondary management of facial damage is difficult. The objective is to report, through the clinical observation of three patients, the results of the management of complex facial dislocations in a context of limited technical resources. Patients and methods: Three complex post-traumatic facial dislocations were managed between May 2006 and June 2017. Results: Primary treatment and secondary repair were established on a case-by-case basis. Local autoplasty was the indication of choice. Multidisciplinary management resulted in satisfactory functional and cosmetic outcomes. Two of the patients were lost to follow-up before the end of treatment. Discussion: The complete management of facial dislocations remains difficult and complex, in an extreme exercise situation. In an emergency, the priority is to save the life of the injured person. Several factors are involved in the therapeutic decision: the choice of the maxillofacial reconstruction technique, the availability of the technical platform, the financial capacity and the psychological state of the patient and his entourage. Sequential and multidisciplinary treatment gives satisfactory results in terms of morphology, function and aesthetics, despite the limited technical resources available. Psychological support is an essential complement for successful socio-professional and family reintegration.

Determinants of Male Coital Difficulties among Attendees of the Gynae Clinic at a Tertiary Health Center in North-Central Nigeria

Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.

Difficulties in Implementing Supply Mechanism of Rural Public Goods in the Context of Urban-rural Integration

Through in-depth interviews and questionnaires,we take Mianyang City,Aba Prefecture,and Suining City in Sichuan Province as the study object,to analyze the relationship between the basic situation of farmers and the supply mechanism implementation of rural public goods.The research results show that the younger the farmers,the higher the educational level,the higher the annual household income,and the higher the enthusiasm in participating the discussion of the supply of rural public goods.And the correlation between farmers'annual household income and participation in the supply of public goods is the highest.Finally corresponding countermeasures and proposals are put forth based on farmers' educational level and annual household income,the two difficulties in supply mechanism implementation of rural public goods.

Recommendations for Solving Difficulties in Investigation of Environmental Pollution Cases in China

Environmental pollution has caused wide social concern,and it demands immediate attention to striking at the crime in the environmental pollution. At present,there are difficulties of putting a case on file,collecting evidence,judicial identification,and presumption of causal relationship in investigation of environmental pollution cases. In accordance with current situations,it came up following recommendations:(i) widely collecting case clues to solve the difficulty of putting a case on file;(ii) improving the ability of collecting evidence and standardizing the evidence collection,to solve the difficulty of evidence collection.(iii) including the environmental pollution judicial identification system,and unifying the identification standards,to solve the difficulty in identification. It is recommended to use the epidemiological causal relationship theory combined with enough high-quality evidences to solve the difficulty in presumption of causal relationship.

Reliability and validity of the Strengths and Difficulties Questionnaire in Greek adolescents and their parents

The Strengths and Difficulties Questionnaire (SDQ) is a brief screening measure of emotional and behavioural difficulties in children and adolescents. The aim of this study was to assess reliability and validity of the Greek version of the SDQ. A representative Greek sample of 1194 adolescents (aged 11 to 17 years) and their parents completed the SDQ along with other measures. Internal consistency reliability was determined by calculation of the Cronbach α coefficient. Varimax Orthogonal Transformation was conducted to test the factor structure of the questionnaire. Validity was further examined by investigating the correlation of the SDQ with the KIDSCREEN questionnaire and its association with demographic factors. The inter-rater agreement between parent and self-reports was analyzed with Pearson’s correlation coefficient. Intra-class correlation coefficients (ICCs) were computed to determine test-retest stability. For both parent and the self-report SDQ versions, most items loaded onto their predicted factors in consistency with the originally proposed five-factor structure. Internal consistency reliability was acceptable with a Cronbach α above 0.70 for all SDQ scales except for conduct and peer problems. Inter-rater correlations ranged from 0.33 to 0.45. Test-retest stability was good (ICCs > 0.60). Correlation coefficients between the SDQ and KIDSCREEN questionnaire were significant. Small effect sizes (d > 0.5) of the socioeconomic status were found for all of the SDQ scale mean scores. In conclusion, the SDQ was found to have satisfying psychometric properties and could be suitable for assessing emotional and behavioural problems in Greek adolescents.

An fNIRS-Based Study on Prefrontal Cortex Activity during a Virtual Shopping Test with Different Task Difficulties in Brain-Damaged Patients

We developed a Virtual Shopping Test with three different task levels for assessment of daily cognitive function using virtual reality technology. The objective of present study was to investigate the difference on task performance, brain activation and subjective assessment in relation to the difficulty levels of the tasks. Subjects were asked to buy specific 2 items in Task 1, 4 items in Task 2, and 6 items in Task 3 at a virtual mall. The tasks and questionnaires were conducted on 10 convalescent brain-damaged patients and 6 healthy young adults. Hemodynamic changes in the prefrontal cortex (PFC) during activation due to the tasks were examined using functional near-infrared spectroscopy. As the result, the mean total time was significantly longer for the patients than for healthy subjects. PFC showed a greater response for related Task 2 than Task 1 in shopping and moving phase in patient group. The patients evaluated Tasks 1 and 2 are more difficult and bring more psychological load than healthy adults subjectively. That is, although the healthy adults did not show large difference in their task performances as well as PFC responses, they can evaluate the differences between three task levels, subjectively, while which could not be for the patients means that patients could not distinguish the difference of the tasks, subjectively. The results suggest that 4-item shopping task might be enough difficulty level that causes brain activation for the brain-damaged patients.

Difficulties and Countermeasures of Developing Irrigation and Water Conservancy in New Era

This paper expounds the great significance of irrigation and water conservancy for the agricultural development. Vigorously developing irrigation and water conservancy can promote high yield and stable yield of grain, effectively increase farmers' income, alleviate the impact of drought on agricultural production, be conducive to the adjustment of agricultural production structure, and promote county economic development. The difficulties of developing irrigation and water conservancy in new era are analyzed as follows: the subject of liabilities defaults seriously; it lacks effective input security system; the quality of project degenerates badly; the agricultural technological development is slow. Corresponding policy suggestions are put forward as follows: make the input subject of irrigation and water conservancy clear; form stable investment channels; strengthen the organizing and guiding functions of grass-roots government; reinforce the coordination and management of capital; strengthen the promotion of agricultural technology; quicken the pace of reform of irrigation and water conservancy.

The Difficulties of Congenital Syphilis Diagnosis about 3 Cases at Libreville, Gabon

First described embryo fetopathy, congenital syphilis remains a public health problem mostly in developing countries. The diagnosis mainly based on bacteriological and immunological evidence of mother-child couple is not always easy, as it is shown in our three clinical cases. Those three clinical observations demonstrate the difficulties encountered in the diagnosis of congenital syphilis in our country where only the TPHA (Treponema Pallidum Haemaglutination Assay) and VDRL (Venereal Disease Research Laboratory) tests are the only ones to be routinely carried out. Actually, these tests can be negative at the earliest stage of the syphilis or in case of zonal phenomenon. In addition, maternal antibodies could be found in child blood, even if the baby is in good health. At last, the child could have been contaminated belatedly while tests were negative at the third month of pregnancy. Congenital syphilis still exists in our developing countries and, in order to better manage this pathology, a proposition of an efficient algorithm is submitted.