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Introduction: Preschool children develop early literacy skills that are predictive of their reading acquisition.Purpose of research: This study aims to use a short screening tool to examine emergent literacy performances. It includes 4-5-year-old children (N = 14,820) schooled in public and private schools in France. A number of public schools are labelled as with educational needs (Priority education network, REP). Children were assessed in three domains, letter-name knowledge, phonological skills and vocabulary., Results: It is shown that children schooled in REP have poorer scores than children schooled out of REP. We observe no significant difference between scores in children schooled in private schools and public schools out of REP. A significant effect of gender and age is observed, the first in favor of girls and the second in favor of older children. The effect of gender diminishes with the age, the difference between girls and boys becoming smaller. Finally, we examined the distribution of performances in the three domains of children who obtained the lowest scores., Conclusions: A short screening tool to examine directly the literacy skills in preschool children is an opportunity to define and coordinate preventive actions and appropriate early interventions to help lessen difficulties in learning to read.

Introduction: Though still under-diagnosed, chronic obstructive pulmonary disease (COPD) currently affects nearly 3.5 million people in France. The present study presents the results of continuing medical education sessions on COPD screening by electronic mini-spirometry., Methods: From April 2013 to December 2015, the sessions involved 73 health professionals. The study analysed three questionnaires administered before, after, and long after sessions led by experts within a professional associative network., Results: The sessions proved efficient in increasing the participants' theoretical knowledge. It increased the percentage of correct answers regarding the nature of COPD (90 % vs. 81%), the functions, features, and outputs of mini-spirometers, and the treatment recommendations. The sessions led to non-negligible changes in everyday medical practice regarding the acquisition of a mini-spirometer (+13 devices), the presentation of COPD to the patients (+33 practitioners), the dialogue on tobacco use (+32 practitioners), vaccination (+33 practitioners), and compliance with the treatment recommendations (+43 practitioners)., Conclusion: These results encourage both holding and following up such sessions. The specialized professional environment ensures knowledge updates and offers subsequent assistance. Further improving these sessions will increase their benefits in terms of diagnosis, treatment, and health economy., (Copyright © 2019. Published by Elsevier Masson SAS.)

Introduction: Screening for COPD is currently considered to be insufficient. Electronic mini-spirometers allow screening for COPD in general practice., Objectives: To assess the prevalence of COPD in a population of at-risk patients in general practice (GP) and to identify the high-risk factors for the disease., Methods: A cross-sectional study was performed in a GP setting. Patients aged between 40 and 75years with a history of smoking, occupational exposure to toxic substances or chronic respiratory symptoms were offered airflow assessments by electronic mini-spirometry. For any value of FEV1/FEV6 less than 70 %, screening for COPD was considered as positive., Results: Of the 778 patients seen during routine consultations, 273 (35.1 %) fulfilled the inclusion criteria. The test was positive in 128 of the eligible patients (46.9 %). The prevalence of proven COPD (ratio<70 %) was 13.9 % (38 patients). The high-risk factors were age over 60years (P=0.03), body mass index over 28 (P=0.04), smoking history of more than 30pack-years (P<0.0001), presence of clinical signs (P<0.0001) and industrial exposure to toxic substances (P=0.03)., Conclusions: Targeted screening of patients with risk factors for COPD can be performed in a GP setting. An electronic mini-spirometer is a reliable and inexpensive screening tool., (Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Fundus photographs using non-mydriatic digital cameras for diabetic retinopathy screening have been studied in France during the past 10 years. Nevertheless, the different screening modalities have not been compared. The main goal of this study was to compare patient recruitment with two different screening modalities, and secondarily to compare diagnostic effectiveness and cost. A retrospective study analyzed data from the Diabetes Midi Pyrenees Network in 2005 and between 2006 and 2010. In 2005, a vehicle with digital camera traveled through a rural department in order to screen diabetic patients whose last fundus examination was performed greater than 1 year previously. Between 2006 and 2010, general practitioners sent their diabetic patients whose last fundus examination was performed greater than 1 year previously to a "local" screening site. In the two cases, fundus photographs were made by trained operator at screening site and analyzed by an ophthalmologist. The "mobile" screening recruited 698 patients, and the "local" screening 345 patients. Patients recruited by "mobile" screening were older than those recruited by "local" screening. They were preferentially men and suffered from diabetes from far longer The diagnostic performance of "local" screening was 26.8%, and it was 28.6% for "mobile" screening (p = 0.47). The cost of screening was higher for "mobile" screening: 116 Euro against 61 Euro for "local" screening. "Mobile" screening could allow more patient recruitment than "local" screening when geographic and demographic constraints are more important.

Water diffusion analysis in magnetic resonance imaging (MRI) provides an elective visualization of fiber tract orientations in cerebral white matter, especially for optic tracts. We explored 25 patients from 18 to 45 years of age, with normal MRI in 20 subjects, and radiological anomalies in five. On a 1.5 Tesla MRI apparatus, diffusion tensor acquisitions were performed in 5 minutes 58 seconds with an EPI Single Shot sequence covering the entire brain. Image displacements were precluded by patient information and adequate fixation, then digitally corrected on workstations. Volume merging and fiber tract extraction were achieved using dedicated software (Volume-One and dTV). A directional depiction was obtained for all areas in the white matter, in particular for white matter junctions. Coming from the lateral geniculate body, the optic tracts were directed posteriorly toward the occipital cortex, with numerous connections to extrastriate associative areas, and through the corpus callosum and the fornix. Diffusion tractography requires optimization of volume displacements, before and secondary to MRI acquisitions. Our diffusion tensor acquisition, with image optimization in a short-duration sequence can be routinely applied to all patients, for a specific analysis of functional connections between cortical areas of cerebral white matter.

Quality assurance is an essential process which should be applied for any organised breast cancer screening program since mammography it the only test available for an early diagnosis. It should also assess the quality of diagnostic and treatment processes in order to ascertain that the quality of the screening program would not be altered by the procedures which take place after the screening. Quality assurance must be applied to each component of the screening process: equipment, radiographers (technicians) as well as radiologists. It is a multidisciplinary approach following a well defined protocol, which should be supervised by a coordination unit, the Breast Cancer Screening Foundation in Canton of Vaud. Performances of the Vaud program show clearly at what extend multiple reading method improves the quality of screening. It seems that there is no inconvenient to involve radiologists who wish to participate without any selection to the reading process provided that there is in place a team of 2nd and 3rd readers who benefit of an appropriate training and experience.

The aim of this study is to specify the role of rapid tests in the screening of childhood urinary tract infection. During the period between july to december 1998, 572 urinary samples were collected from pediatric out-patient in Hôpital d'Enfants de Tunis and aged from 1 month to 15 years. Only 75 samples (12.5%) were culture positive. The predictive value of leucocytes or nitrites test was 97.2%. These results allowed the use of rapid test in the screening of urinary tract infection in children. However, if clinical symptoms are present, the culture of urine must be associated to the rapid test.

Polysomnography in an attended hospital laboratory setting is the gold standard for the diagnosis of sleep-related breathing disorders. However, this method is expensive and waiting lists are long. Portable recording devices that can be used at home have been recently developed to improve upon the problems of polysomnography. We review the recent portable devices validated by polysomnography and discuss their precise role in the assessment of sleep-related respiratory disorders.

Repeated screening for asymptomatic bacteriuria using a reagent strip-test was conducted in a population of 859 pregnant women. The women performed 4,125 tests at home, and 2,867 tests were performed by the nursing staff at the antenatal clinics. The tests done by the women at home had a higher predictive value than the tests done in the antenatal clinics (24% versus 10%). The sensitivity was 47%, specificity 90% and negative predictive value 98.8%. The tests performed by the women at home were well accepted and detected.

The urodynamic techniques useful for the diagnostic assessment of vesicosphincteric disorders are uroflowmetry, measurement of abdominal, urethral and vesical pressure and electromyography. Uroflowmetry is a very widely used screening examination, as it is atraumatic. Other techniques are more invasive, but provide more pathophysiological information. The methodology is recalled for each of these examinations. The parameters to be analysed are described in detail. The value and limitations of these modalities are emphasised. Combined examinations allow a better understanding of vesicosphincteric equilibria and disequilibria and reveal the concepts of compliance, detrusor pressure, isometric detrusor contractions, hyper and hypoactivity, and pressure transmission.

Hearing impairment should be detected in early childhood. Among available screening techniques, acoustic oto-emission testing is a rapid, reliable, noninvasive method which specifically investigates peripheral hearing but does not provide data on auditory nerve centers. This functional test should be carried out within a few days of birth in infants with risk factors for hearing impairment.

Phadiatop, a new test for detecting hypersensitivity to airborne allergens, was used in 83 children aged 9 months to 6 years with recurrent respiratory manifestations, i.e. recurrent expiratory obstruction and/or recurrent respiratory infections. A good correlation was found between this test and both the prick tests (95%) and the specific IgE assays (91% for RASTS of classes greater than or equal to 1, and 95% for RASTS of classes greater than or equal to 2). However, the correlation was less strong with the total IgE level (68%). The overall correlation with the specialist's prediction based on history and physical evaluation was excellent (94%). In this study, Phadiatop was found to have a 90% sensitivity and a 98% specificity. Furthermore, this test costs 40% less than the often used strategy combining skin tests and determinations of total and specific IgE levels. In the age group studied, Phadiatop is most useful above the age of two, since in younger patients true respiratory allergies are fairly infrequent in recurrent ENT and lower respiratory tract infections, whereas infections are far more common.