The objectives of this study were to establish the different developmental trajectories of hyperactive-impulsive behaviors on the basis of both mother and father ratings at 19, 32, 50, and 63 months, and to examine the predictive validity of these trajectories with respect to later hyperactive-impulsive behaviors, as rated by teachers in the first 2 years of school. Hyperactive-impulsive behaviors were assessed in a population-based sample of 1,112 twins (565 boys and 547 girls) at 19, 32, 50, and 63 months of age. The results revealed a differentiated and consistent view of developmental trajectories of hyperactive-impulsive behaviors derived from these repeated assessments, with 7.1% of children seen by mothers (7% for fathers) as displaying high and stable hyperactive-impulsive behaviors. According to mother ratings, children on a high-chronic trajectory were more likely than other children to display hyperactive-impulsive behaviors at 72 and 84 months according to their teachers. Repeated measures over time and father-based trajectories significantly added to the prediction teacher later ratings of hyperactive-impulsive behaviors. These results support the predictive validity of parental assessment of hyperactive-impulsive behaviors during the preschool years and their use to identify children at risk for further evaluation and possible intervention.

Children who experience traumatic brain injury (TBI) often show cognitive impairments postinjury, some of which recover over time. We examined the recovery of motor response inhibition immediately following TBI and over 2 years. We assessed the role of injury severity, age at injury, and lesion characteristics on initial impairment and recovery while considering the role of pre-injury psychiatric disorder. Participants were 136 children with TBI aged 5-16 years. Latency of motor response inhibition was measured with the stop-signal task within 1 month of the injury and again at 3, 6, 12, and 24 months. The performance of the TBI participants at each measurement occasion was standardized with 117 children of similar age, but without injury. Residualized latency scores were calculated. Growth curve analyses showed an initial impairment in response inhibition and improvement over the 2 years following injury. Younger TBI patients were initially more impaired although they exhibited greater recovery of response inhibition than did older TBI patients. Longer duration of coma, but not reactivity of pupils or Glasgow Coma Scale score, predicted initial deficit. Lesion characteristics or pre-injury attention deficit hyperactivity disorder did not predict initial impairment or recovery. Replication with longitudinal testing of a comparison group of children sustaining extracranial injury is necessary to confirm our findings.

The average funding of long-term care in Quebec, Canada, currently covers < 70% of the care hours required, which means that 30% of needs are unmet. The aims of this study were to understand how nurses, when they are in a position to do so, assign care hours, which needs are unmet by care dimensions and whether dimensions with unmet needs vary with client profiles. One-hundred-and-four nurses working in long-term care facilities participated in the study. They filled out individual questionnaires containing three case studies in the form of vignettes. When obliged to cut 30% of the care hours, the nurses ensured that treatment and diagnostic methods were done as prescribed and that vital feeding and elimination functions were preserved. However, they made the choice to cut some mobility and personal-care activities and, especially, communication with patients, families and other professionals. In this, they partly follow the theoretical care prioritization approach of Lefebvre and Dupuis, who take into account the degree of discomfort caused by the situation, the problem's place in Maslow's hierarchy of needs and the availability of a solution. Thus, although the choices made by the nurses follow a logical pattern, they could result in medium-term deterioration in the functional autonomy of their older patients. The overall consequences of these decisions are discussed.

Topiramate is an antiepileptic drug, recently also used in the treatment of psychiatric diseases. Inasmuch as topiramate and valproate, which are currently used for aggressive behavior, share several pharmacological mechanisms (positive modulatory effect on the GABA activity and negative modulatory effect on glutamatergic neurotransmission), the objective of the present study was to compare the pharmacological effects of topiramate with those of valproate and their combination in patients with psychiatric disorders showing marked aggression and agitation. A retrospective, case-controlled, mirror-image study was carried out in a sample of 45 inpatients affected by schizophrenia, schizoaffective and bipolar disorder, and hospitalized in a maximum-security Canadian psychiatry hospital. Overt Aggression Scale, Agitation-Calmness Evaluation Scale, number and intensity of psychotic episodes, number of episodes of withdrawal from group activities per week, and number of therapeutic isolation per week and of strict surveillance intervention per week were evaluated before and after the treatments. Results indicate that patients treated with topiramate show a decrease in the average score of the Overt Aggression Scale, a decrease of episodes of agitation and of strict surveillance interventions. This effect was similar to the group treated with valproate or with the combination of valproate-topiramate. However, valproate therapy, but not topiramate therapy, decreased the intensity of agitation episodes measured by the Agitation-Calmness Evaluation Scale; valproate and the combination topiramate-valproate decreased the number of psychotic disorganization episodes as well. These results suggest that topiramate could be a valid medicine in the control of aggression in psychosis. Double-blind, randomized, placebo-controlled studies need to further assess this pharmacological indication.

Le trouble déficitaire de l’attention avec hyperactivité (TDAH) représente le problème de comportement le plus fréquemment diagnostiqué chez les enfants d’âge scolaire. Bien que de plus en plus d’enfants d’âge préscolaire se retrouvent en consultation clinique pour des symptômes typiques du TDAH, peu d’études ont porté sur la nature, l’évaluation et le traitement du trouble à cet âge. Cette recension des écrits porte sur la nature, l’évaluation et le traitement du TDAH au préscolaire. Les principales thématiques passées en revue sont : la prévalence, la symptomatologie, l’étiologie, les comorbidités, les conséquences sur le développement normal et l’adaptation de l’enfant, l’évolution des symptômes du préscolaire au scolaire, les difficultés reliées au diagnostic, les modalités d’évaluation, le traitement psychosocial et le traitement pharmacologique.

This qualitative study took place in Quebec City, Quebec, Canada. The main objective was to evaluate satisfaction with a transitional program aimed at keeping seniors in the community while waiting for admission to a public long-term care facility. Semistructured interviews were conducted with 4 types of informants: seniors, family members, facility managers, and hospital or community care coordinators. Results show that satisfaction varies according to groups of informants but seniors are the most satisfied of all.

Behavioral problems and overweight in French-Canadian preschoolers: A cross-sectional study. This cross-sectional study examines the relationship between internalizing and externalizing behaviours and overweight in preschool children from Quebec City aged between 3 and 5 years. A total of 330 parents completed the French-Canadian version of the Child Behavior Checklist for Ages 1.5-5. Based on their body mass index, gender, and age (all self-reported data from the parent), children were classified as normal weight (3 rd to 85 th percentile) or overweight (> 85 th percentile). Normal weight girls showed higher total internalizing scores than their overweight counterparts. Normal weight girls also had higher scores for the anxious/depressed and withdrawn subscales than overweight girls. No significant difference was observed between normal weight and overweight children for externalizing behaviours. Longitudinal studies are needed to better understand the emergence and direction of the relationship between behavioural problems and overweight in preschool children and the mechanisms involved.

Introduction: Research on quality of life exclusively in the context of extreme prematurity and preschool is almost non-existent. Objective: The purpose of this descriptive correlational study was to describe the quality of life of children born extremely premature, during infancy, according to maternal perception. The specific objectives were to describe the different dimensions of the quality of life of children born extremely premature and to explore the relationships between certain sociodemographic and clinical variables and quality of life. The study was based on Callista Roy's adaptation model (1976). Method: Forty-two parents of children born extremely premature and aged 2 to 5 years responded to the PedsQL 4.0 during telephone interviews. Results: Overall, the results show that the children have a good quality of life, as perceived by the mothers. Physical functioning was the most optimal dimension of quality of life, while emotional functioning was the least optimal. Furthermore, children from nuclear families have a better global quality of life than children from other family types. Discussion and conclusion: Extreme prematurity requires careful monitoring by nurses to ensure healthy development of toddlers and therefore good quality of life. Future research is needed to further document the quality of life of children born extremely premature at preschool age.