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Biomedical subjects

R Hébert

Publications and source records attributed to R Hébert.

At least 55 records · Page 3Linked to original sources
PubMed1997

Reliability of the Modified Mini-Mental State Examination in the context of a two-phase community prevalence study.

Data collected through the Canadian Study of Health and Aging were analyzed to estimate the reliability of the Modified Mini-Mental State (3MS) Examination when used in the context of a two-phase community prevalence study. During the screening phase of the study, subjects were tested in their home by a lay interviewer, either in English or French. All subjects scoring 77 or under on the 3MS and a sub-sample of those scoring over 77 were reassessed by a nurse during a clinical examination, following which subjects were classified as normal, cognitively impaired but not demented, or demented. Results indicate substantial reproducibility of the 3MS, slightly higher than that of the Mini-Mental State Examination from which it is derived. The english versions of these tests appear slightly more reproducible than their French counterparts.

Aged↗
PubMed1997

The Canadian Study of Health and Aging: risk factors for vascular dementia.

BACKGROUND AND PURPOSE: The Canadian Study of Health and Aging (CSHA) was conducted in communities and institutions in 10 Canadian provinces. One objective of the study was to study risk factors for vascular dementia (VaD). METHODS: This was a population-based case-control study. It included 129 patients clinically diagnosed with VaD with duration of symptoms no more than 3 years and 535 control subjects, frequency matched by age group, study center, and residence in community or institution, who were clinically confirmed to be cognitively normal. Odds ratios (ORs) were calculated using unconditional logistic regression for potential risk factors for VaD. RESULTS: Risk of VaD was associated with history of arterial hypertension (OR, 2.08; 95% confidence interval, 1.29 to 3.35). Other significantly elevated ORs were seen for history of alcohol abuse (2.45), history of heart condition (1.71), use of aspirin (3.10), and occupational exposure to pesticides and herbicides (2.60), as well as liquid plastic or rubber (2.59). The OR for less than 6 years of education compared with 10 or more years was 4.02. CONCLUSIONS: The study confirmed some previously reported risk factors for VaD, such as history of heart disease. Higher levels of education seemed to lower the risk or delay onset of symptoms of VaD. Use of aspirin may be a predictor of survival rather than a risk factor. The occupational associations, particularly with pesticides and fertilizers, need further study.

Aged↗
PubMed1996

Refusal and information bias associated with postal questionnaires and face-to-face interviews in very elderly subjects.

Our objectives were (1) to analyze the refusal bias associated with postal questionnaires and face-to-face interviews and (2) to compare responses elicited from a postal questionnaire with those provided by a face-to-face interview in subjects over 75 years of age. Our methods included a postal questionnaire sent to a representative sample of community-dwelling elderly individuals (n = 842). All subjects were also invited to participate in an in-home interview conducted by a trained nurse. One hundred and six subjects (12.6%) were nonrespondents to the postal questionnaire. These nonrespondents were more cognitively impaired, more disabled, and showed a higher 1-year mortality rate (13.2 versus 5.2%) than respondents. Late respondents who needed a reminder letter were similar to nonrespondents. One hundred and eighty-seven subjects (22.2%) refused to participate in the home interview. These nonparticipants were similar to the participants on age, sex, 1-year mortality rate, and responses given to all but two postal questions. Comparison of postal questionnaire responses and face-to-face responses revealed that agreement was substantial to moderate for factual information (kappa = 0.41 to 0.80) but poor for clinical information (depression, cognitive impairment, disability). A short index including age, sex, and six questions on disability was useful in identifying disabled subjects by a postal questionnaire. Our conclusion is that nonresponse bias is evidenced when postal questionnaires are utilized in the very elderly population and caution should be used when interpreting health data obtained by this technique. Refusal bias from face-to-face interviewing is less important in this population.

Activities of Daily Living↗
PubMed1996

Predictive validity of a postal questionnaire for screening community-dwelling elderly individuals at risk of functional decline.

Screening elderly individuals who are at risk of functional decline in the community is essential in order to implement effective programmes of assessment and surveillance in a context of secondary prevention. The postal questionnaire technique consists of sending a simple questionnaire to all elderly individuals living in a defined area in order to identify those who are at risk. The objective of this study was to develop a postal questionnaire and to test its capacity to predict functional decline in community-dwelling elderly people. A 21-item postal questionnaire was sent with a birthday card to a representative sample of community-dwelling individuals over the age of 75 years (n = 842). One month after sending the questionnaire, all subjects were contacted by a nurse for an in-home interview (n = 655) that included assessment of functional autonomy. One year later, the subjects (n = 607) were reassessed by the same nurse. Of the eligible subjects, 87.4% returned the postal questionnaire. During the year following the completion of the postal questionnaire, 43 subjects died, 13 were institutionalized and 109 had experienced a significant decrease on the autonomy scale, for a total annual occurrence of functional decline of 27.2%. Age and 14 of the 21 items of the questionnaire were associated with a significant relative risk of functional decline. The relative risk associated with not responding to the questionnaire was 2.1. A stepwise logistic regression analysis showed that six items were independent predictors of functional decline. This 6-item Sherbrooke Postal Questionnaire identifies as positive 56% of the population with 75% sensitivity and 52% specificity. We conclude that a postal questionnaire is a feasible and valid technique for screening elderly individuals at risk for functional decline.

Activities of Daily Living↗
PubMed1996

Development and validation of an evaluation instrument for medical students in tutorials.

PURPOSE: To develop and explore the validity of the Tutotest, the first standardized instrument designed to assess the skills and attitudes of medical students working in tutorials in a problem-based learning curriculum. METHOD: The Tutotest, consisting of 44 items rated on a four-point Likert-type scale, was developed from well-defined theoretical frameworks after consultation with students and teachers at the Université de Sherbrooke Faculty of Medicine. In 1988-89, 40 tutors were asked to use the Tutotest to evaluate a total of 100 students at the end of each of the four units of the first-year curriculum. Data were analyzed to examine the homogeneity and reliability of the instrument, explore its factorial structure, and document its correlation with students' grades. RESULTS: A total of 28 tutors (70%) conducted Tutotest evaluations; of a possible 400 evaluations, 270 (67.5%) were returned with complete data. Exploratory factor analysis revealed that the Tutotest was structured around four factors that accounted for 82% of the variance: effectiveness in the group (23 items), communication and leadership skills (13 items), scientific curiosity (four items), and respect for colleagues (four items). The Tutotest had a Cronbach's alpha coefficient of .98 and a split-half coefficient of .98. The intraclass correlation coefficient was estimated to be .46 and would reach up to .81 after averaging five Tutotest evaluations. Tutotest scores showed good correlation (r = .64) with the official tutor's global evaluation and a moderate correlation (r = .39) with students' written examination results. CONCLUSION: The Tutotest was found to be a standardized reliable and valid instrument that can significantly improve the evaluation of students' skills and attitudes during tutorials. Although lengthier than the usual tutor evaluation form, the Tutotest is a good compromise between an unreliable short global scale and a more comprehensive but impractical instrument.

Academic Medical Centers↗
PubMed1996

Hand sensibility of healthy older people.

OBJECTIVE: To develop normative data for four hand sensibility modalities in older subjects. DESIGN: Cross-sectional. SETTING AND PARTICIPANTS: Three hundred and sixty community-dwelling subjects of both sexes, aged 60 to 94, randomly selected from the electoral list of the city of Sherbrooke, Quebec, Canada. MEASUREMENTS: Touch/pressure threshold (Semmes-Weinstein monofilaments), static and moving two-point discrimination (Mackinnon-Dellon Disk-Criminator), tactile recognition (Modified Pick-up test), and thumb kinesthesia. RESULTS: A reduction with age was found in the performance of the study subjects, with the exception of the kinesthesia test. The values obtained in this study are clearly lower than the norms proposed for adults, underlining the importance of using reference values developed for the target clientele. CONCLUSION: The norms will help clinicians to differentiate better between normal and pathological changes in sensibility with age.

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PubMed1995

Upper extremity performance test for the elderly (TEMPA): normative data and correlates with sensorimotor parameters. Test d'Evaluation des Membres Supérieurs de Personnes Agées.

OBJECTIVES: Objectives of this study were to develop normative data for the Test d'Evaluation des Membres Supérieurs de Personnes Agées (TEMPA) and determine its relation to upper extremity sensorimotor parameters such as fine and gross dexterity, coordination, strength, endurance, range of motion, and several types of sensibility. DESIGN: Cross-sectional study. SETTING: Community-dwelling subjects. PARTICIPANTS: Three hundred sixty healthy subjects randomly recruited by age and sex strata (60 to 69, 70 to 79, and 80 or older). MAIN OUTCOME MEASURES: Length of execution of the tasks in the TEMPA. RESULTS: Normative data are reported by gender and age group. The time taken to execute the tasks increased significantly with age. The women were faster on the tasks requiring a higher degree of fine dexterity, whereas the task requiring a lesser degree of fine dexterity and sensibility and more grip strength was accomplished faster by the men. Subjects who were more active and described themselves as being in excellent or good health performed better. CONCLUSION: The norms will help clinicians differentiate better between normal and pathological aging in upper extremity performance.

Aged↗
PubMed1995

Upper-extremity motor co-ordination of healthy elderly people.

Motor co-ordination is an important prerequisite to adequate upper-extremity performance. With the ageing of the population, more and more elderly people are at risk of acquiring upper-extremity motor inco-ordination following sensorimotor deficit. The main objective of the study was to develop normative data on upper-extremity motor co-ordination for elderly people. Three hundred and sixty subjects aged 60 and over were randomly selected and evaluated with the Finger-Nose Test. The results revealed a linear decline in the performance of this test with age. Younger, more active and subjectively healthier subjects presented better motor co-ordination. Some differences were found between sexes and sides. The normative data will help clinicians to identify pathological reduction in motor co-ordination in an elderly population.

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PubMed1995

Reliability of the revised functional autonomy measurement system (SMAF) for epidemiological research.

The Functional Autonomy Measurement System (SMAF) is an instrument designed to assess disabilities related to 29 functions with a four-point scale (from 0: independent to -3: dependent). For epidemiological studies, a total score and five sub-scores can be obtained. A revised version was developed adding a -0.5 level to many items to indicate an activity accomplished independently but with difficulty. The objective of the study was to verify the test-retest and inter-rater reliability of the total score and sub-scores of the SMAF. Ninety subjects were randomly recruited in nine different residential settings ranging from home to long-term-care hospitals. Half of the subjects were assessed by the same nurse within a 2-week interval (test-retest) and the other half were assessed twice by two different nurses within the same interval (inter-rater). Results show intra-class correlation coefficients (ICC) of 0.95 and 0.96 for the total scores on test-retest and inter-rater reliability, respectively. The ICC were over 0.74 for all sub-scores for both types of reliability. A small systematic bias was present for two SMAF subscores on the inter-rater reliability. The addition of a new level did not modify the reliability of the scale.

Activities of Daily Living↗
PubMed1995

Epidemiology of vascular dementia.

Vascular dementia (VaD) is the second commonest dementia after Alzheimer's disease (AD). Epidemiological studies of this condition suffer from many shortcomings related to definition of the disease, diagnostic criteria and assessment of subjects. The prevalence of VaD increases linearly with age and varies greatly from country to country, ranging from 1.2 to 4.2% of people over 65 years old, even after adjustment for age and sex. The incidence of VaD is more homogeneous than prevalence and is estimated at 6-12 cases per 1,000 persons over 70 years per year. The mean duration of the disease is around 5 years and survival is less than for the general population and for AD. The major risk factors for VaD appear to be hypertension, diabetes, heart disease and stroke. Although some of these risk factors are modifiable, there is no study on efficacy of prevention of VaD.

Age Factors↗
PubMed1995

The Purdue Pegboard Test: normative data for people aged 60 and over.

Manual dexterity is frequently evaluated in rehabilitation services to estimate hand function. Several tests have been developed for this purpose, including the Purdue Pegboard, which measures fine manual dexterity. The goals of the study were to verify the test-retest reliability with subjects aged 60 and over without upper limb impairment, and to develop normative data based on a random sample of healthy older community-living individuals. The results show that the test-retest reliability is good (intra-class correlation coefficients from 0.66 to 0.90, depending on the subtest). Norms are presented to help clinicians involved in rehabilitation services to better differentiate real dexterity deficits from those that may be attributed to normal ageing.

Aged↗
PubMed1995

Comparison of the Jamar dynamometer and the Martin vigorimeter for grip strength measurements in a healthy elderly population.

Grip strength is considered to be a good indicator of upper limb strength. The Jamar dynamometer and the Martin vigorimeter are two instruments frequently used to assess grip strength in clinical and research settings. The purpose of this study was to compare these instruments for assessing grip strength in 360 people aged 60 to 94 years, randomly selected from the electoral list. Anthropometric data were also collected. Data analyses were done using the maximum value on 3 trials with each instrument. Although the Martin vigorimeter is a pressure measure implying a dynamic movement as opposed to the static strength measure of the Jamar dynamometer, results indicate a very high correlation between the two measures. Grip strength measured by the Jamar dynamometer is even more dependent on hand anthropometry than measurements with the Martin vigorimeter.

Aged↗
PubMed1994

Efficacy of a sensory integration program on behaviors of inpatients with dementia.

OBJECTIVES: Dementia is the disease most frequently leading to admission in long-term care institutions, primarily because persons with this disease exhibit several behavioral problems. The objective of this study was to measure the efficacy of the sensory integration program developed by Ross and Burdick in improving the functioning of persons with dementia. METHOD: Forty subjects with dementia (28 women, 12 men, mean age of 78.4 years) in three different institutional settings in Quebec City, Canada, were randomly assigned to the study (n = 22) or control (n = 18) group. Subjects in the study group participated in three 45-min sessions of a sensory integration program per week for 10 weeks. Outcomes were measured using the Revised Memory and Behavior Problems Checklist and the Psychogeriatric Scale of Basic Activities of Daily Living. RESULTS: The sensory integration program had no significant effect on the behaviors of the study group. CONCLUSION: Before this type of program is labeled inefficacious, other studies are necessary to determine whether modifying the frequency of sessions, the number of subjects, and the measuring instruments would lead to similar results.

Activities of Daily Living↗
PubMed1994

Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies.

Manual dexterity is a skill frequently evaluated in rehabilitation to estimate hand function. Several tests have been developed for this purpose, including the Box and Block Test (BBT) that measures gross manual dexterity. The goal of the present study was to verify the test-retest reliability and construct validity of the BBT with subjects aged 60 and over with upper limb impairment. The second objective of this research was to develop normative data based on a random sample of healthy elderly community-living individuals. The results show that the test-retest reliability is high (intraclass correlations coefficients of 0.89 to 0.97) and the validity of the test is shown by significant correlations between the BBT, an upper limb performance measurement and a functional independence measurement. The norms will help rehabilitation clinicians to differentiate better between real difficulties and those that may be attributed to normal aging.

Activities of Daily Living↗
PubMed1987

Effect of transient neonatal hypothyroidism on the free aspartic acid, glutamic acid, and GABA content of different central auditory regions in the rat.

The aspartic acid, glutamic acid, and gamma-aminobutyric acid (GABA) contents were determined in four central auditory system regions in rats with transient neonatal hypothyroidism compared with control ones: the ventral and dorsal parts of the cochlear nucleus, the central nucleus of the inferior colliculus, the auditory cortex, and in an extra-auditory structure, the substantia nigra pars reticulata. The animals were sacrificed at 50 days of age, brain tissue samples were taken out by microdissection, and the free amino acids were extracted. The amino acid content was assessed by double-isotope labelling following two-dimensional thin-layer chromatography separation. GABA content was significantly decreased in both cochlear nucleus regions and glutamic acid was elevated in the inferior colliculus. Neonatal hypothyroidism had no significant effect on the aspartic acid levels in the regions studied. The results suggest an effect of neonatal hypothyroidism on regional contents of free amino acids known as candidate neurotransmitters in the auditory system.

Animals↗
PubMed1986

Auditory brainstem response audiometry in congenitally hypothyroid children under early replacement therapy.

Using auditory brainstem response audiometry, we evaluated 34 congenital hypothyroidism children under thyroid hormone therapy and 24 age- and sex-matched controls between 5 and 12 yr of age. Two main auditory brainstem response abnormalities were encountered: first, prolonged wave I latencies, secondary to a peripheral impairment, were found in seven congenital hypothyroidism children (20%): three of these showed signs of serious otitis media, unilaterally in two and bilaterally in the other, at the time of the evaluation. Second, shortened I-V interpeak latencies were observed in 10 children (29%). No correlation was found between the interpeak latencies and the L-thyroxine serum values at the time of the test or just prior to treatment initiation. Also, there was no correlation with estimated bone age at treatment initiation or with the Griffiths global mental development quotients assessed at 5 yr of age. These preliminary results suggest a significant incidence of auditory brainstem response abnormalities in treated hypothyroid children.

Audiometry↗
PubMed1985

Permanent defects in rat peripheral auditory function following perinatal hypothyroidism: determination of a critical period.

Rats were treated with propylthiouracil (PTU) for 10-day periods beginning at different ages. Daily injections of L-thyroxine (T4) were administered concurrently with PTU to a group of rats which served as one control group. Peripheral auditory function was evaluated by the brainstem response audiometry (BSRA) technique performed at 12, 16, 25 and 120 days of age. PTU treatment significantly increased wave I latency (cochlear nerve compound action potential) in adult rats when administered from 3 days before delivery through 6 days of age, but was without permanent effect (wave I latencies and thresholds) when administered for 10 days starting at 10 days after birth. T4 replacement during the first 10 postnatal days prevented permanent abnormalities. These data suggest that the period of greatest vulnerability to thyroid hormone depletion in the peripheral auditory system extends from at least 3 days before delivery through between 5 and 10 days of age.

Animals↗