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N. Ruffieux A. K. Njamnshi A. Wonkam C.-A. Hauert J. Chanal V. Verdon 《Child neuropsychology》2013,19(2):143-160
Background: Some of the major complications of sickle cell disease (SCD) occur in the brain and apart from overt stroke, patients also present with cognitive impairments. We sought to evaluate the prevalence of cognitive deficits as well as their biological predicting factors in young SCD patients in Cameroon. Methods: The cognitive performances of Cameroonian SCD young patients were evaluated using a neuropsychological test battery assessing four domains of cognitive functioning (executive functions, attention, memory, and sensory-motor skills) previously adapted and normalized on healthy subjects in Yaoundé. Findings: Up to 37.5% of the 96 SCD patients aged 6 to 24 years (M?=?13.5, SD?=?4.9) had mild-to-severe cognitive deficits. The cognitive deficits tend to increase with age. There was a significant effect of SCD on executive functions and attention, whereas SCD patients performed as well as controls on memory and sensory-motor skills tests. Structural equation models showed a significant association between (a) severe anemia and lower executive functioning, (b) low fetal hemoglobin levels and lower executive functioning and attention, (c) history of cerebrovascular accidents and lower performances in executive functioning, sensory-motor skills, and memory, (d) pathological electroencephalogram and lower attention, and (e) abnormal Transcranial Doppler and lower memory. Conclusion: SCD patients in Cameroon presented a very high prevalence of cognitive deficits, with a specific impairment of executive functions and attention. Routine neuropsychological evaluation for early detection of cognitive deficits in SCD patients could represent a cost-effective tool to implement in resource-limited contexts such as in sub-Saharan Africa. 相似文献
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Ambroise Wonkam Caryl Zameyo Mba Dora Mbanya Jeanne Ngogang Raj Ramesar Fru F. Angwafo III 《Journal of genetic counseling》2014,23(6):948-956
Sickle Cell Disease (SCD) is a debilitating illness that affects quality of life. Studies of the psychosocial burden of SCD on patients have been rarely reported in Africa. We used a quantitative method, with face-to-face administered questionnaires, to study indices of psychosocial stressors on adult SCD patients in Cameroon. The questionnaire included a 36-item stress factors scale evaluating general perceptions of stress and five main stressors’ domain: disease factors, hospital factors, financial factors, family factors and quality of personal-life factors. Items pertaining to psychosocial stressors involved four response options with increasing severity: 0, 1, 2 or 3. Non-parametric tests were used for analysis. The majority of the 83 participants were urban dwellers, female, 20–30 years old, single, unemployed, with at least a secondary or tertiary education. Median age at diagnosis was 100 months; 47.8 % had >3 painful vaso-oclusive crises annually. Only 4.8 % had been treated with hydroxyurea. The majority reported moderate to severe difficulty coping with SCD. The “degree of clinical severity” category displayed the highest median score (2.0), while familial stressors showed the lowest (0.8). Being female, married, with low education level, an additional affected sibling and low direct income were significantly associated with specific stressors’ categories. In Cameroon, there is an urgent need to implement policies that ensure affordable access to health-care and practices to reduce SCD morbidity and improve patients’ quality of life. 相似文献
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Wonkam A Njamnshi AK Mbanya D Ngogang J Zameyo C Angwafo FF 《Journal of genetic counseling》2011,20(5):476-485
Little is known about attitudes of parents of Sickle Cell Anemia patients in sub-Saharan Africa regarding prenatal genetic
diagnosis and termination of an affected pregnancy. In this study, structured face-to-face interviews were conducted with
a sample of 130 parents in Cameroon that had at least one living child with Sickle Cell Anemia. The majority of participants
lived in urban areas (89%), were female (80%), Christian (93%), married (60.2%) in monogamous households (81.1%), were employed
(61.7%), and had at least a secondary or tertiary education (82%). The majority of parents accepted the principle of prenatal
genetic diagnosis for Sickle Cell Anemia (89.8%) and termination of pregnancy (62.5%). Acceptance of the principle of pregnancy
termination increased with unemployment (p < .01) and single marital status (p < .05). The results of this study suggest Cameroonian parents with children affected with Sickle Cell Anemia generally accept
the principles of prenatal diagnosis and in some cases termination of a pregnancy affected with Sickle Cell Anemia. Additional
findings, policy and practice implications, and research recommendations are presented. 相似文献
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Charlene M. Alexander Ashley N. Hutchison Kelly M. Clougher Holly A. Davis Dustin K. Shepler Yves Ambroise 《Journal of counseling and development : JCD》2014,92(4):489-498
The purpose of this study was to examine the Choose Respect dating violence prevention program (Centers for Disease Control and Prevention, 2006b , n.d.‐a) with secondary students in St. Lucia. Multivariate analysis of variance results indicated that the Choose Respect program had a positive influence on participants’ attitudes about control in relationships. Significant gender and school effects were found. Implications of these findings for primary prevention efforts targeting dating violence in St. Lucia and limitations of the study are discussed. 相似文献
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Caster Semenya won the eight-hundred-meter title in the Berlin World Athletics Championships in 2009. Few hours after, Caster
was at the center of a harsh contestation on gender. The International Association of Athletics Federations started an investigation,
which was not respectful of her privacy. Caster’s case highlights the need for an improvement in the awareness of genetic
counseling principles amongst professionals, the public and various stakeholders. We critically examine the historical steps
of gender verification in the Olympics, the violation of genetic counseling principles in Caster’s case and outline some reflections
on the complexity of the genetics of Disorders of sex development (DSD). Variability in both genotypes and phenotypes in DSD
may not allow any etiological or functional classification at this point in time that could permit uncontroversial gender
verification for fairer sport participation. We strongly suggest revisiting the pertinence of gender verification, and the
process whereby this is done. 相似文献
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