The ETVSS did not show adequate discrimination but demonstrated excellent calibration in this population of patients 2 years and older. According to decision-curve analyses, the ETVSS is marginally useful in clinical scenarios in which 60% or 70% success rates are the thresholds for preferring ETV to CSF shunt. Previous history of CSF shunt and age were not associated with worse outcomes, whereas posthemorrhagic and postinfectious causes of the hydrocephalus were significantly associated with reduced success rates following ETV.
What constitutes a 'normal' child? Throughout the nineteenth century public health and paediatrics played a leading role in the image and conception of children. By the twentieth century psychology had moved to the forefront, transforming our thinking and understanding. André Turmel investigates these transformations both from the perspective of the scientific observation of children (public hygiene, paediatrics, psychology and education) and from a public policy standpoint (child welfare, health policy, education and compulsory schooling). Using detailed historical accounts from Britain, the USA and France, Turmel studies how historical sequential development and statistical reasoning have led to a concept of what constitutes a 'normal' child and resulted in a form of standardization by which we monitor children. He shows how western society has become a child-centred culture and asks whether we continue to base parenting and teaching on a view of children that is no longer appropriate.
OBJECTIVEChronic subdural hematoma (CSDH) is a common neurosurgical condition that can result in significant morbidity. The incidence of epileptic events associated with CSDH reported in the literature varies considerably and could potentially increase morbidity and mortality rates. The effectiveness of antiepileptic prophylaxis for this indication remains unclear. The primary objective of this study was to assess the relevance of anticonvulsant prophylaxis in reducing seizure events in patients with CSDH.METHODSAll consecutive cases of CSDH from January 1, 2005, to May 30, 2014, at the Hôpital de l’Enfant-Jésus in Quebec City were retrospectively reviewed. Sociodemographic data, antiepileptic prophylaxis use, incidence of ictal events, and clinical and radiological outcome data were collected. Univariate analyses were done to measure the effect of antiepileptic prophylaxis on ictal events and to identify potential confounding factors. Multivariate logistic regression was performed to evaluate factors associated with epileptic events.RESULTSAntiepileptic prophylaxis was administered in 28% of the patients, and seizures occurred in 11%. Univariate analyses showed an increase in the incidence of ictal events in patients receiving prophylaxis (OR 5.92). Four factors were identified as being associated with seizures: septations inside the hematoma, membranectomy, antiepileptic prophylaxis, and a new deficit postoperatively. Antiepileptic prophylaxis was not associated with seizures in multivariate analyses.CONCLUSIONSAntiepileptic prophylaxis does not seem to be effective in preventing seizures in patients with CSDH. However, due to the design of this study, it is difficult to conclude definitively about the usefulness of this prophylactic therapy that is widely prescribed for this condition.
This paper presents how the medico-hygienist model of childhood, which had prevailed throughout the nineteenth century, was replaced at the turn of the twentieth century by the novel developmental model, which arose in the first decades of the 1900s and was later systematised by Piaget, Spock, etc. The medico-hygienist model revolved around core constituents such as regulation, firmness and discipline, standardisation whose historical specificity could be, according to Elias, related to the civilising process.The developmental model, on the other hand, is linked to the systematic scientific investigation of childhood and pertains, foremost, to the proposition that growing up was best figured in the concept of development: the figure of the child as a human who develops consistently in time and space. The key element can be worded as follows: Why is such child maturation almost universally constructed as development?The second crucial idea of the model consists in understanding child development in terms of a (rather linear) sequence of particular stages. The equation of child maturation, both physically and psychologically, with development is crystallised in the figure of a uniform, inevitable and universal sequence of developmental stages and, accordingly, its schedule; therefore, maturation, development, stages and sequences are closely connected to children's socialisation.My aim is to trace developmental thinking in its historical specificity by bringing to light some neglected social processes that contribute to the regulation of children and the transformation of generational relationships. These processes have always occurred in various societies, and yet I am trying to put forward an original perspective that pertains to the intersection of developmental thinking and social change. I attempt here to introduce a historic juncture of developmental thinking and social transformations that moulded children. I also attempt to track down the historical roots of the developmental framework: how it became the central principle by which we think about children today.
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