Biomedical subjects

Annie Rochette

Publications and source records attributed to Annie Rochette.

17 recordsLinked to original sources

PubMed2006

'Optimal' participation: a reflective look.

PURPOSE: There is mounting interest by professionals working in the rehabilitation sciences related to the concept of participation, especially given the increasing numbers of individuals worldwide living with chronic illnesses. It is now internationally agreed that participation level is influenced by both personal and environmental factors. The question arises as to the meaning of 'optimal' participation. The main objective of this article is to provide a reflective look at the concept of participation and the meaning of 'optimality' for individuals with and without disability and to explore both in relation to response shift. METHOD: Similarities in definitions of participation are first examined. Normal participation level is discussed leading to an 'optimal' level based on normality. Cases are used to illustrate normality as well as how 'optimal' participation can be achieved through a transition period despite disabilities caused by a health condition such as a stroke. RESULTS: 'Optimal' participation would rely on a perfect fit between an individual's reality (how activities and roles are actually realised) and expectations of how activities and roles should be accomplished. A transition period, including a response shift, following an acute event or onset of a chronic condition can lead to an optimal participation level despite persisting disabilities. CONCLUSIONS: A better understanding of the meaning of optimal participation and its association to response shift is important to clinical practice. Interventions aimed at optimizing participation through assisting clients who are experiencing a response shift can then be designed to maximize participation and concomitantly, quality of life in those with chronic health conditions.

Activities of Daily Living↗

PubMed2006

Predictors of long-term participation after stroke.

PURPOSE: (1) To explore factors that predict long-term participation after stroke (2-4 years after discharge from rehabilitation), and (2) to determine factors that predict both short- and long-term participation. METHODS: Biopsychosocial data of people who had had a stroke were measured at discharge from an intensive rehabilitation unit using valid instruments. Six months later (n=102) as well as 2-4 years later (n=66), social participation of the survivors was measured in their living environments. Participation was estimated with the Assessment of Life Habits (LIFE-H), which includes 12 categories of daily activities and social roles. RESULTS: From multivariate regression analyses, the best predictors of long-term participation after stroke appear to be age, comorbidity, motor coordination, upper extremity ability and affect. Age, comorbidity, affect and lower extremity coordination are the best predictors of participation after stroke at both measurement times. CONCLUSIONS: With the exception of age, these factors may be positively modified and thus warrant special attention in rehabilitation interventions.

Activities of Daily Living↗

PubMed2006

Adaptation and coping following a first stroke: a qualitative analysis of a phenomenological orientation.

Stroke can have consequences in all areas of a person's life. If not coped with optimally, this life event will have a deleterious effect on the quality of life. The aim of this study was to improve understanding of appraisal and coping, post-stroke. Ten individuals were purposely recruited upon admission for a first stroke to participate in this qualitative study. Participants were asked to share their personal experiences with regard to their efforts to deal with the consequences of the stroke. In-depth interviews were transcribed verbatim and the content was analyzed using a rigorous method, inspired by a phenomenological orientation. Seven themes related to appraisal (unpredictability, overwhelming, feeling out of control, threat, turning point, acceptance/resignation and future prospects) and five themes related to coping (active and passive compensation, escape, change how the situation is perceived and utilization of resources) emerged from the content analysis of the in-depth interviews. In conclusion, since returning to the previous life style and activities is rather improbable, changing how the situation is perceived appears to be the most effective way of coping, in order to reach a state of acceptance/resignation favourable to an optimal quality of life.

Adaptation, Psychological↗

PubMed2006

Amastin peptide-binding antibodies as biomarkers of active human visceral leishmaniasis.

Amastin surface proteins belong to a large family of developmentally regulated proteins comprising up to 45 members that have recently been discovered in the genus Leishmania and are highly similar to the amastin proteins in Trypanosoma cruzi. All members of the amastin gene family contain a highly conserved 11-amino-acid (aa) signature at the N terminus, which is unique to the amastin proteins and to the Trypanosomatidae family. Recent studies have demonstrated that this region is highly protective in a mouse model. The goal of the present study was to evaluate the potential of the 50-aa N-terminal domain of amastin proteins harboring the conserved 11-aa amastin signature peptide as a relevant immune biomarker of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). We report here the amastin-binding total immunoglobulins (IgG) and/or IgG subclasses in the sera of patients at different stages of CL (n=90) and VL (n=41). In CL cases, there is no significant difference in seroreactivities between active, recovered, and nonhealed cases. However, the amastin peptide-reactive antibodies were present at high titers in 19 of 20 sera collected from patients with active VL compared to sera from patients recovered from VL and asymptomatic cases of VL. These data suggest that the amastin signature peptide could represent a relevant biomarker for the serodiagnosis of VL and, most importantly, that it could permit differentiation among the different stages of the disease.

Adolescent↗

PubMed2006

Long-term changes in participation after stroke.

BACKGROUND AND PURPOSE: People who have had a stroke may have difficulty resuming some of their previous activities, which leads to a decline in their participation in daily activities and social roles. The purposes of this study were to compare participation 6 months (T1) and between 2 and 4 years (T2) after discharge from a rehabilitation unit and to verify if any changes were associated with changes in personal and environmental factors. METHOD: Participation of people who had had a stroke was measured at T1 and T2 with the Assessment of Life Habits. RESULTS: A significant reduction (p < .001) in participation in daily activities was observed, specifically in the following categories: nutrition, p < .001; fitness, p = .004; personal care, p < .001; and housing, p = .001. However, participation in social roles was maintained during this period (p = .10). The increased perception of technology as a facilitator (environmental factor) over time explained a part of the decline in participation (R2 = 0.13). CONCLUSION: Factors associated with the reduction in participation in daily activities should be further studied in order to prevent this decline.

Activities of Daily Living↗

PubMed2005

Distinct 3'-untranslated region elements regulate stage-specific mRNA accumulation and translation in Leishmania.

We recently characterized a large developmentally regulated gene family in Leishmania encoding the amastin surface proteins. While studying the regulation of these genes, we identified a region of 770 nucleotides (nt) within the 2055-nt 3'-untranslated region (3'-UTR) that regulates stage-specific gene expression at the level of translation. An intriguing feature of this 3'-UTR regulatory region is the presence of a approximately 450-nt element that is highly conserved among several Leishmania mRNAs. Here we show, using a luciferase reporter system and polysome profiling experiments, that the 450-nt element stimulates translation initiation of the amastin mRNA in response to heat shock, which is the main environmental change that the parasite encounters upon its entry into the mammalian host. Deletional analyses depicted a second region of approximately 100 nucleotides located at the 3'-end of several amastin transcripts, which also activates translation in response to elevated temperature. Both 3'-UTR regulatory elements act in an additive manner to stimulate amastin mRNA translation. In addition, we show that acidic pH encountered in the phagolysosomes of macrophages, the location of parasitic differentiation, triggers the accumulation of amastin transcripts by a distinct mechanism that is independent of the 450-nt and 100-nt elements. Overall, these important findings support the notion that stage-specific post-transcriptional regulation of the amastin mRNAs in Leishmania is complex and involves the coordination of distinct mechanisms controlling mRNA stability and translation that are independently triggered by key environmental signals inducing differentiation of the parasite within macrophages.

3' Untranslated Regions↗

PubMed2005

Validation of a new lower-extremity motor coordination test.

OBJECTIVE: To determine the test-retest reliability and construct validity of a new lower-extremity motor coordination test, the Lower Extremity MOtor COordination Test (LEMOCOT). DESIGN: To test reliability, subjects with impairments in at least 1 lower extremity were evaluated twice by the same evaluator. To test construct validity, the LEMOCOT scores obtained from subjects who had had a stroke were correlated with physical, functional, cognitive, and perceptual tests. SETTING: Geriatric day hospital and functional intensive rehabilitation unit. PARTICIPANTS: In the reliability test, 29 people (mean age, 69.6y; range, 28-87y); in the construct validity, 144 people who recently had had a stroke. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: In addition to the LEMOCOT, the following measures were used for construct validity: the Fugl-Meyer Assessment (motor function), Berg Balance Scale, 5-m walking test, 2-minute walking test, Functional Autonomy Measurement System, Modified Mini-Mental State Examination, and Motor-Free Visual Perceptual Test. RESULTS: Intraclass correlation coefficients (ICCs) indicated that test-retest reliability is good (right-side ICC=.88; left-side ICC=.83). The construct validity of the LEMOCOT was demonstrated by obtaining high correlations with physical and functional tests ( r range, .62-.79; P <.001) and no correlations with cognitive ( r =.11, P =.20) or visual perceptual tests ( r =.15, P =.08) and by discriminating between subjects discharged to long-term care versus other living environments ( P <.001). CONCLUSIONS: The LEMOCOT is a simple lower-extremity motor coordination test that showed good test-retest reliability and construct validity. It can be used in clinical and research settings, specifically with people who have had a stroke. Other studies should be carried out to confirm its psychometric properties.

Adult↗

PubMed2005

Characterization and developmental gene regulation of a large gene family encoding amastin surface proteins in Leishmania spp.

The ability of Leishmania amastigotes to survive within the drastic environmental changes encountered in the phagolysosomes of mammalian macrophages is heavily dependent on the developmental regulation of a variety of genes. The identification of genes that are expressed preferentially in the mammalian stage of the parasite should increase our understanding of the molecular mechanisms regulating stage-specific gene expression and of the determinants that control its intracellular survival and contribute to its pathogenesis. We report here detailed sequence characterization and structural organization of the amastin gene family in Leishmania major and Leishmania infantum and the study of their developmental gene regulation throughout the parasite's life cycle. Amastin surface proteins represent the largest developmentally regulated gene family reported so far in Leishmania comprising up to 45 members. All the members of the amastin gene family in both Leishmania and Trypanosoma species share a similar structural organization and contain a highly conserved 11 amino acid extracellular domain, which is unique to amastin proteins. The majority of the amastin gene homologs are specifically expressed in the amastigote stage of the parasite. Three distinct RNA elements were identified in the 3'-untranslated regions (3'UTR) of the amastin transcripts. The majority of these transcripts contain a conserved 450 nt cis-acting 3'UTR element shown previously to regulate stage-specific gene expression at the level of translation, which suggests that several amastin homologs may be regulated by a similar mechanism of translational control inside the macrophage. These findings further highlight the unique features of gene expression control in Leishmania.

3' Untranslated Regions↗

PubMed2005

Participation after stroke compared to normal aging.

OBJECTIVE: To examine the reduction in participation of people who have had a stroke compared with healthy people with normal aging. DESIGN: Participation of people who had a stroke was compared with participation of healthy subjects. SUBJECTS/PATIENTS: Forty-six people who had a stroke for 2-4 years and 46 healthy participants matched on age, sex and living environment. MEASUREMENTS: Participation was estimated with the Assessment of Life Habits (LIFE-H). The LIFE-H (short version 2.1) is composed of 58 daily activities and social roles associated to the 12 categories of the Disability Creation Process model. The LIFE-H gives separate scores for each category, for 2 main subsections "Daily activities" and "Social roles" and a total score. RESULTS: Scores of healthy subjects did not reach the maximum value (9/9) of the LIFE-H, their mean scores varying from 6.3 to 8.6, according to the categories. These scores are higher than of the participants with stroke for all categories (scores varying from 3.9 to 6.5; p-values from 0.002 to <0.001), except the interpersonal relationships category (score of 7.8 vs 8.0) where no difference was found (p=0.49). The disruption in participation after stroke varies according to the categories of the LIFE-H, but is more important in the daily activities categories. CONCLUSION: The comparison of the scores obtained by the 2 groups suggests that a part of the reduction in participation in daily activities and social roles after stroke is attributable to normal aging and not entirely to the stroke itself. It helps to focus interventions on activities and roles disruption domains that are really attributable to stroke.

Activities of Daily Living↗

PubMed2004

The ribosomal RNA gene promoter and adjacent cis-acting DNA sequences govern plasmid DNA partitioning and stable inheritance in the parasitic protozoan Leishmania.

Detailed analysis of the Leishmania donovani ribosomal RNA (rRNA) gene promoter region has allowed the identification of cis-acting sequences involved in plasmid DNA partitioning and stable plasmid inheritance. We report that plasmids bearing the 350 bp rRNA promoter along with the 200 bp region immediately 3' to the promoter exhibited a 6.5-fold increase in transformation frequency and were transmitted to daughter cells as single-copy molecules. This is in contrast to what has been observed for plasmid molecules in this organism so far. Moreover, we show that these low-copy-number plasmids displayed a remarkable mitotic stability in the absence of selective pressure. The region in the vicinity of the RNA pol I transcription initiation site, and also in the adjacent 200 nt, displays a complex structural organization and shares sequence similarity to the yeast autonomously replicating consensus sequence and centromere DNA elements. Deletion analyses indicated that these elements were necessary but not sufficient for plasmid DNA partitioning and stable inheritance, and that the rRNA promoter region was required for optimal function. These results suggest an interplay between RNA pol I transcription, DNA replication, DNA partitioning and mitotic stability in trypanosomatids. This is the first example of defined DNA elements for plasmid partitioning and stable inheritance in the protozoan parasite Leishmania.

Animals↗

PubMed2004

Measuring social participation: reliability of the LIFE-H in older adults with disabilities.

PURPOSE: Much more attention should be paid to instruments documenting social participation as this area is increasingly considered a pivotal outcome of a successful rehabilitation. The purpose of this study was to document the reliability of a participation measure, the Assessment of Life Habits (LIFE-H), in older adults with functional limitations. METHODS: Eighty-four individuals with physical disabilities living in three different environments were assessed twice with the LIFE-H, an instrument that documents the quality of social participation by assessing a person's performance in daily activities and social roles (life habits). RESULTS: The intraclass correlation coefficients (ICC) computed for intrarater reliability exceeded 0.75 for seven out of the 10 life habits categories. For interrater reliability, the total score and daily activities subscore are highly reliable (ICC </=0.89), and the social roles subscore is moderately reliable (ICC = 0.64). 'Personal care' is the category with the highest ICC, and for five other categories ICCs are moderate to high (< 0.60). CONCLUSION: LIFE-H is a valuable addition to instruments that mostly emphasize the concepts of function or functional independence. It is particularly meaningful to evaluate the participation of older adults in significant social role domains such as recreation and community life. It may be considered among the instruments having the best fit with the ICF definition of participation (the person's involvement in a life situation) and a majority of its related domains.

Activities of Daily Living↗

PubMed2004

Social participation of older adults in Quebec.

BACKGROUND AND AIMS: Measuring social participation of older adults is an important issue, since this concept includes not only daily activities (e.g.: feeding, personal care, mobility) but also social roles (e.g.: interpersonal relationships, leisure). The purpose of this study was to determine whether or not increased age is associated with a decrease in social participation. The study also explored relationships between social participation and some personal and environmental characteristics. METHODS: The Assessment of Life Habits (LIFE-H) was used to document social participation in 189 community-dwelling people aged 55 and over. The LIFE-H (short version 3.1) is composed of 77 daily activities and social roles associated with the 12 categories of the Disability Creation Process model. RESULTS: Social participation significantly decreases with advancing age (p < 0.001). Scores are reported for each category of the LIFE-H, by mean and standard deviation and also by percentiles for each of the following age groups: 55-64, 65-74, 75-84 and 85+. Gender is associated with participation in four LIFE-H categories, with women obtaining significantly higher scores in Nutrition (p < 0.001) and Interpersonal relationships (p = 0.007) and men in Housing (p = 0.002) and Mobility (p = 0.03). Lastly, participation is poorly associated with personal and environmental characteristics. CONCLUSION: This study will help clinicians and researchers to better understand the concept of participation, and particularly to distinguish between changes in participation due to normal aging and those attributable to pathological aging.

Aged↗

PubMed2004

Validity of the Assessment of Life Habits in older adults.

OBJECTIVE: To study the construct validity of a participation scale, the Assessment of Life Habits, with older adults having functional limitations. More specifically, the study aimed to verify the ability of the Assessment of Life Habits to discriminate between clienteles in 3 living environments, and to compare participation scores to functional independence scores obtained with the Functional Autonomy Measurement System (Système de mesure de l'autonomie fonctionnelle). DESIGN: Participants were evaluated once with the Assessment of Life Habits and the Functional Autonomy Measurement System. SUBJECTS: Eighty-seven older adults (mean age 78.0 years (8.2)) living in 3 types of environment: own home, private nursing home or long-term care centre. RESULTS: Results suggest that the Assessment of Life Habits scores discriminate between different levels of participation according to the living environments of the participants. The Assessment of Life Habits measures some similar aspects to the Functional Autonomy Measurement System scale but also additional concepts not included in the Functional Autonomy Measurement System. CONCLUSION: This study supports the validity of the Assessment of Life Habits as a participation measure. It suggests the importance of going beyond disability measures to evaluate the overall functioning of older adults correctly.

Activities of Daily Living↗

PubMed2004

Development and validation of a scale for rating motor compensations used for reaching in patients with hemiparesis: the reaching performance scale.

BACKGROUND AND PURPOSE: Recent movement analysis studies have described compensatory movement strategies used by people with hemiparesis secondary to stroke during reaching and grasping tasks. The purpose of this article is to describe the development of a new scale--the Reaching Performance Scale (RPS)--for assessing compensatory movements for upper-extremity reaching in people with hemiparesis secondary to stroke. SUBJECTS: Twenty-eight individuals with hemiparesis, with a mean age of 54.9 years (SD=18.6), participated. METHODS: The study design involved scale development with expert panels and criterion standards for validity. Participants were evaluated on the new scale as well as other clinical tests for validity. They were videotaped while performing reaching and grasping movements. RESULTS: The RPS scores correlated with measurements of grip force and Chedoke-McMaster Stroke Assessment and Upper Extremity Performance Test for the Elderly (TEMPA) scores. The RPS discriminated patients with different impairment levels according to the Chedoke-McMaster Stroke Assessment. Preliminary intrarater and interrater reliability coefficients were acceptable for the whole scale. Mean kappa values on individual scale components for 3 raters represented a mean of 67% (SD=13.5%) agreement. DISCUSSION AND CONCLUSION: Although the RPS shows some types of validity, more rigorous tests of reliability are needed for meaningful conclusions. This study is a first step in validating the scale to assess efficacy of intervention for motor recovery of the arm.

Adult↗

PubMed2003

Comparison of changes in upper and lower extremity impairments and disabilities after stroke.

The aims of this study were to determine if the changes in impairment and disability measures for the upper and lower extremities were equivalent during the post-stroke rehabilitation period and whether the rates of change were maintained 6 months after discharge from rehabilitation. A prospective cohort study design was used. One-hundred-and-thirty-two people who had sustained a stroke and who were enrolled in an intensive functional rehabilitation programme were recruited. Upper and lower extremity impairments and disabilities were evaluated at admission, at discharge from rehabilitation and 6 months later. During active rehabilitation, the changes in both extremities were smaller for the impairment measures (standardized response mean (SRM), 0.37-0.63) than the disability measures (SRM, 0.76-1.05). While the changes in upper and lower extremities were equivalent for impairment measures, they were larger in the lower extremity for disability measures, indicating that the rate of functional improvement was faster in the lower extremity during active rehabilitation. After discharge, however, while the rate of motor recovery in the lower extremity dropped (SRM, 0.54-0.18), it was maintained in the upper extremity (SRM, 0.45 and 0.42). Present findings indicate that functional (disability) measures improve faster than impairment measures in both extremities during the active rehabilitation period and suggest that motor recovery occurs at a different rate in the upper and lower extremities, with that of the upper extremity occurring later and extending into the period after discharge from active rehabilitation.

Aged↗

PubMed2003

Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap.

OBJECTIVES: (1) To examine the relationships between measures of impairment and disability for the arm and leg with a measure of handicap and (2) to identify the impairment or disability most strongly related to handicap situations. DESIGN: Prospective cohort study. SETTING: Intensive functional rehabilitation unit and community. PATIENTS: One hundred and two persons who had a stroke. MAIN OUTCOME MEASURES: Arm and leg impairments and disabilities were evaluated with reliable and valid tests at discharge from rehabilitation. Six months later, handicap situations were evaluated with the Assessments of Life Habits (LIFE-H). RESULTS: Arm and leg impairments and disabilities are correlated with handicap situations. Disability of the leg is more strongly associated with handicap than arm disability. Arm and leg disabilities are not statistically more strongly related to handicap than arm and leg impairments. CONCLUSIONS: The high correlations found between handicap situations and the impairment and disability measures of the leg provide new information that support the importance of mobility to promote integration after stroke.

Aged↗

PubMedDate not supplied

Comparison of two functional independence scales with a participation measure in post-stroke rehabilitation.

The objectives of the study were to compare the association and responsiveness of the functional autonomy measurement system (SMAF) and functional independence measure (FIM) as outcome measures addressing functional independence in stroke patients involved in an intensive rehabilitation program and to compare their relationships with a social participation measure after rehabilitation period. One hundred and thirty-two people who had a stroke were evaluated with the SMAF and FIM during the rehabilitation period (T1: admission; T2: discharge; n=132) and twice after discharge (T3=2 weeks; n=118; T4=6 months later; n=102). At T3 and T4, a participation measure, the assessment of life habits (LIFE-H), was added. The main findings are: (1) the total scores on the SMAF and FIM are strongly correlated together (r=0.93 to 0.95; p<0.001); 2) the responsiveness of both functional independence scales is similar even though the SMAF total score is more responsive to change than the FIM total score (standardized response mean: 1.20 vs. 0.97; p<0.01); (3) the SMAF and FIM are related similarly to the daily activities domain of the participation scale; and finally (4) the social roles domain of the participation scale is less related to the SMAF and MIF than the daily activities domain; however, the SMAF score is more related to the social roles domain than the MIF. Our results support the need to use supplementary measures, such as participation measure, that cover not only physical function but also the other domains of participation, such as interpersonal relationships and leisure, that can be disrupted following a stroke.

Activities of Daily Living↗