We aimed to describe the hierarchical structure of Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) and trajectories of dependency before death in an elderly population using item response theory methodology. Data were obtained from a population-based French cohort study, the Personnes Agées QUID (PAQUID) Study, of persons aged ≥65 years at baseline in 1988 who were recruited from 75 randomly selected areas in Gironde and Dordogne. We evaluated IADL and ADL data collected at home every 2-3 years over a 24-year period (1988-2012) for 3,238 deceased participants (43.9% men). We used a longitudinal item response theory model to investigate the item sequence of 11 IADL and ADL combined into a single scale and functional trajectories adjusted for education, sex, and age at death. The findings confirmed the earliest losses in IADL (shopping, transporting, finances) at the partial limitation level, and then an overlapping of concomitant IADL and ADL, with bathing and dressing being the earliest ADL losses, and finally total losses for toileting, continence, eating, and transferring. Functional trajectories were sex-specific, with a benefit of high education that persisted until death in men but was only transient in women. An in-depth understanding of this sequence provides an early warning of functional decline for better adaptation of medical and social care in the elderly.
Apathy is rarely identified as a problem in NH. Emotional blunting was the only dimension sensitive to change. Failure to improve residents' level of interest could be explained by the difficulties encountered in accessing information regarding the subjects' personal interests. But it remains possible to modify residents' emotional reactivity and staff's perceptions of residents' behaviors and emotions.
Ontologies are useful tools for sharing and exchanging knowledge. However ontology construction is complex and often time consuming. In this paper, we present a method for building a bilingual domain ontology from textual and termino-ontological resources intended for semantic annotation and information retrieval of textual documents. This method combines two approaches: ontology learning from texts and the reuse of existing terminological resources. It consists of four steps: (i) term extraction from domain specific corpora (in French and English) using textual analysis tools, (ii) clustering of terms into concepts organized according to the UMLS Metathesaurus, (iii) ontology enrichment through the alignment of French and English terms using parallel corpora and the integration of new concepts, (iv) refinement and validation of results by domain experts. These validated results are formalized into a domain ontology dedicated to Alzheimer's disease and related syndromes which is available online (http://lesim.isped.u-bordeaux2.fr/SemBiP/ressources/ontoAD.owl). The latter currently includes 5765 concepts linked by 7499 taxonomic relationships and 10,889 non-taxonomic relationships. Among these results, 439 concepts absent from the UMLS were created and 608 new synonymous French terms were added. The proposed method is sufficiently flexible to be applied to other domains.
Limiting exposure to environmental hazards during preconception and pregnancy is essential for preventing adverse pregnancy outcomes or developmental defects in offspring. However, the perception of environmental risk and the behavioral changes of women planning or having a pregnancy have rarely been investigated, except for a few risk factors. We thus performed a cross-sectional study of French postpartum women hospitalized in the Bordeaux University Hospital in 2017 by proposing a self-administrated survey. The main objective was to assess their level of awareness concerning a large panel of environmental hazards and modifications in their behavior during pregnancy in occupational and household environments. Among the 121 respondents, most identified the environment as a major factor for a healthy pregnancy but recognized a lack of knowledge regarding environmental risk factors. The internet, television, and magazines were their main sources of information. Most women modified some of their practices at work or home. These measures were rarely implemented in consultation with a health practitioner, which raises concerns about the relevance of the adjustments made. Our findings highlight the need to improve the quality of information available to women and to help them implement preventive measures in consultation with physicians.
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