Explore the vast range of titles available.

Background Care providers working with adolescents with anorexia nervosa (AN) encounter difficulties inherent in the illness (denial, ambivalence) and those related to the fact that it is most often the parents who bring adolescents to care units. Our aim was to study attitudes towards care among adolescents with AN treated in a specialised day hospital using an analysis of letters written before and after treatment. Methods Adolescents (12–20 years old) treated for AN in a specialised day hospital, providing multidisciplinary care while enabling a return to schooling inside the facility were included. We analysed 50 admission letters and 23 goodbye letters using general inductive analysis. A mirror analysis was conducted. Results In the admission letters, symptoms, calls for help, and reports on the adolescents’ care trajectories were central themes. Among the categories noted in both the admission and the goodbye letters, some were similar, some mirrored others and a few differed. Conclusions This study highlights how ambivalence and motivations towards care, recovery and illness all interact. It also shows the evolution of the adolescents’ positions via their narratives on their experience of care, the constraints involved and its benefits for them. The results are discussed in a care perspective.

Background Myotonic dystrophy type 1 (DM1) is a rare, inherited chronic progressive disease as well as an autosomal dominant multi-systemic disorder. It is probably one of the most common adult forms of muscular dystrophy, with a prevalence of approximately 10 per 100,000 people affected. With 733 million people in Europe, we estimate that 75,000 people in Europe are affected with DM1. Methods/Design OPTIMISTIC is a multi-centre, randomised trial designed to compare an intervention comprising cognitive behavioural therapy (CBT) plus graded exercise therapy against standard care. Participants will be recruited from myotonic dystrophy clinics and neuromuscular centres in France, Germany, the Netherlands and the United Kingdom. A sample size of 208 individuals is needed. To allow for some potential loss to follow-up, a total of 296 male and female patients aged 18 years and older with genetically proven classical or adult DM1 and suffering from severe fatigue (only DM1 patients with a Checklist Individual Strength (CIS) subscale fatigue severity score ≥35 are likely to benefit from the intervention), able to walk independently and able to complete the trial interventions will be included. The primary outcome of the study is the score on the DM1-Activ scale, which is a measure of activity and participation for patients with DM1. Secondary outcomes include the 6-minute walk test, objective physical activity measured with an accelerometer, quality of life and cognitive measures. The trial will also collect data on potential effect modifiers of the short- and long-term clinical response, including pain, muscular impairment and cognitive-behavioural variables. In addition, OPTIMISTIC will identify genetic factors that predict outcome and potential biomarkers as surrogate outcome measures that best explain the observed clinical variation. Discussion OPTIMISTIC will not only provide effectiveness data on an intervention that could fill a treatment-gap for DM1 patients but will also improve our understanding of the relevant determinants of the prognosis of DM1. Trial registration Registration number: Cinicaltrials.gov NCT02118779 ; registered 11 April 2014.

Human-driven environmental changes shape ecological communities from local to global scales. Within cities, landscape-scale patterns and processes and species characteristics generally drive local-scale wildlife diversity. However, cities differ in their structure, species pools, geographies and histories, calling into question the extent to which these drivers of wildlife diversity are predictive at continental scales. In partnership with the Urban Wildlife Information Network, we used occurrence data from 725 sites located across 20 North American cities and a multi-city, multi-species occupancy modelling approach to evaluate the effects of ecoregional characteristics and mammal species traits on the urbanization–diversity relationship. Among 37 native terrestrial mammal species, regional environmental characteristics and species traits influenced within-city effects of urbanization on species occupancy and community composition. Species occupancy and diversity were most negatively related to urbanization in the warmer, less vegetated cities. Additionally, larger-bodied species were most negatively impacted by urbanization across North America. Our results suggest that shifting climate conditions could worsen the effects of urbanization on native wildlife communities, such that conservation strategies should seek to mitigate the combined effects of a warming and urbanizing world. Multi-species occupancy modelling using camera-trap data from 725 sites across 20 North American cities shows how environmental and climate characteristics interact with species traits to influence the effects of urbanization on wildlife communities.

Les contraintes de l’impératif évènementiel sont inévitables. Elles se reflètent sur la production culturelle contemporaine et sur les musées. Mais qu’est-ce qu’un évènement en muséologie ? Lorsque l’évènementiel entre dans les musées d’art, comment cela influence-t-il les collections, la mise en récit de l’art qui se déploie jusque dans la présentation et la conception patrimoniale des œuvres ? Le retour aux collections auquel nous assistons depuis quelques décennies donne lieu à de nouvelles pratiques muséales et curatoriales et confirme l’avènement d’un temps convulsif évènementiel qui vient ébranler le cours tranquille et le temps figé du récit canonique des collections dites « permanentes ». Réinventer la collection : l’art et le musée au temps de l’évènementiel est composé de cinq parties qui invitent à un déplacement de sens et d’idées autour des collections faisant écho aux formules dynamiques, interrogatives et inclusives que tendent à adopter les musées. Les recherches qui y sont publiées ont, pour la grande majorité, été menées dans le cadre des activités du Groupe de recherche et de réflexion CIÉCO, fondé en 2014. Les différents chapitres interrogent l’impact de l’évènementiel sur les collections ou analysent des stratégies muséales qui cherchent à valoriser les collections par les ressorts évènementiels. Cet ouvrage, qui vient combler une importante lacune dans l’étude sur les collections, s’adresse à quiconque s’intéresse au patrimoine, aux musées, aux expositions, aux œuvres d’art que ce soit dans la perspective de l’histoire de l’art, de la muséologie, des arts visuels, de l’architecture, de l’ethnographie ou de la sociologie.

Background Cytogenetic evaluation is a key component of the diagnosis and prognosis of chronic lymphocytic leukemia (CLL). We performed oligonucleotide-based comparative genomic hybridization microarray analysis on 34 samples with CLL and known abnormal karyotypes previously determined by cytogenetics and/or fluorescence in situ hybridization (FISH). Results Using a custom designed microarray that targets >1800 genes involved in hematologic disease and other malignancies, we identified additional cryptic aberrations and novel findings in 59% of cases. These included gains and losses of genes associated with cell cycle regulation, apoptosis and susceptibility loci on 3p21.31, 5q35.2q35.3, 10q23.31q23.33, 11q22.3, and 22q11.23. Conclusions Our results show that microarray analysis will detect known aberrations, including microscopic and cryptic alterations. In addition, novel genomic changes will be uncovered that may become important prognostic predictors or treatment targets for CLL in the future.

In the second part of a two-part article regarding the lead hazards for pregnant women and children, here, Cleveland et al describe recommendations for prenatal screening and strategies for dealing with lead exposure when it occurs: education, reduction in environmental exposure, treatment options, and developmental surveillance. Research has shown that blood lead levels in pregnant women well below the Centers for Disease Control and Prevention's \"level of concern\" of 10 micrograms per deciliter can cause miscarriage, premature birth, low birth weight, and subsequent developmental delays in their children.