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Background and aims: Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio‐economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. Design: Secondary analysis of survey data. Setting: A cross‐sectional nation‐wide exhaustive 12‐day survey in March 2017 of French youth aged 17–18.5 years participating in the national mandatory civic information day. Participants: A total of 13 314 adolescents answering a pen‐and‐paper questionnaire about their own tobacco consumption and the smoking of their parents. Measurements Risk ratios (RRs) were computed using modified Poisson regressions, and population‐attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. Findings Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50–1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99–2.36) when both parents smoked, compared with non‐smoking parents; the risk associated with living in a non‐intact family was 1.35 (95% CI = 1.26–1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10–1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68–1.98) and RR = 2.10, 95% CI = 1.92–2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. Conclusion: In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio‐economic status is small in comparison. [ABSTRACT FROM AUTHOR]

Evidence is accumulating of the negative impact of the COVID‐19 pandemic and related public health measures on mental health. In this emergent field, there has been little research into the role of risk perception on depressive symptoms and the contribution of health‐care resources to model risk perception and mental health. The aim of this paper is to describe the relationship between individual‐level perception of risk and depression, controlling for a set of confounders and for country‐level heterogeneity. A cross‐sectional and observational online survey was conducted using a non‐probability snowball sampling technique. We use data on 11,340 respondents, living in six European countries (Italy, Sweden, United Kingdom, France, Poland, Czech Republic) who completed survey questionnaires during the first months of the pandemic. We used a fixed‐effect approach, which included individual and macro‐level variables. The findings suggest that a high proportion of people suffering from depression and heightened risk perception is positively associated with reporting depressive symptoms, even if this relationship varies significantly between countries. Moreover, the association is moderated by contextual factors including health‐care expenditure as a percentage of Gross Domestic Product, hospital beds for acute care, and number of medical specialists per head of population. Investment in health care offers a concrete means of protecting the mental health of a population living under pandemic restrictions. [ABSTRACT FROM AUTHOR]

We investigated the effects of readymade versus self‐generated graphic organizers (GOs) on learning, comparing the performances of undergraduates (N = 81) tasked with learning a multimedia document. This document was either presented on its own (control group), with a readymade GO, or with a blank GO that students had to fill in either before or during the learning of the document. In line with previous research, adding a readymade GO increased students' memorization and transfer scores, compared with controls. By displaying the main ideas in the text and their hierarchical relations, GOs act as visual aids to learning. Results showed that self‐generating a GO was no more beneficial than viewing a readymade GO when students were placed in a dual‐task situation (generation + learning). However, when the students' information processing was guided by sequencing these tasks (generation then learning), they outperformed the control and readymade groups on memorization and comprehension. Lay Description: What is already known about this topic: Graphic organizers (GOs) consist in visual displays showing the main ideas of a text and their interrelations.Adding GOs to pedagogical document have been shown to improve students' learning.However, self‐generating GOs has been proven to be detrimental for learning in several studies. What this paper adds: In previous studies, self‐generation of graphic organizers (GOs) have often been carried out while learning, however this task should be separated from the learning task.In the present study, students' learning performances increased when the self‐generated task was separated from the learning task compared to a condition with a readymade GO.These benefits on learning were not observed when the self‐generated activity was not guided. Implications for practitioners: Graphic organizers gathering all the key elements of a multimedia document and highlighting the structure of this document should be used in order to increase students' learning.Students should not be placed in double‐task situation when learning from a pedagogical document.In‐task guidance should be provided when self‐generative tasks are performed. [ABSTRACT FROM AUTHOR]

To develop and validate the Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire, a new specific instrument with the goal of sensitively measuring vulnerability to sport‐specific stressful situations among elite athletes. Five hundred and thirty‐one competitive elite athletes (mean age = 17.6 ± 4.4 years) completed the Ford Insomnia Response to Stress Test (FIRST) questionnaire and the IRSST, a six‐item questionnaire developed to assess the level of sleep disturbance in response to the commonly experienced sport‐specific stressful situations. A development and validation process including substantive, structural, and external stages was used in the present study. One eigenvalue of the exploratory factor analyses was greater than 1.0 (i.e., 2.91, 48.52% of explained variance) whereas the scree test provided evidence for a one‐factor solution, with all the six items achieving a loading of 0.40 or higher on the factor. Cronbach alpha was 0.77 and provided evidence for the reliability of the IRSST score. The correlation between IRSST and FIRST scores was 0.47 (p < 0.001, moderate effect size). These results provide strong evidence for construct validity, indicating that the IRSST is a promising scale for assessing the likelihood of sleep disruption due to sports‐related stressful situations. The results of reliability and correlational analyses provided further evidence of the promising psychometric properties of the IRSST. We believe that the IRSST could provide to the sport and sleep science communities a sleep screening tool for use in this unique population. Highlights: The Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire is a promising new specific instrument for assessing the likelihood of sleep disruption due to sports‐related stressful situationsThe IRSST could provide to the sport and sleep science communities a sleep screening tool for use in the unique population of competitive elite athletesThe IRSST can be used to identify athletes with sleep difficulties related to sports‐specific stressful situations (e.g., training, competition, injury) [ABSTRACT FROM AUTHOR]

Recent research suggests that inducing fixed (rather than malleable) beliefs about groups leads to more negative attitudes toward out-groups. The present paper identifies the underlying mechanism of this effect. We show that individuals with a fixed belief about groups tend to construe intergroup settings as threatening situations that might reveal shortcomings of their in-group (perceived threat). In the present research, we measured (Study 1) and manipulated (Study 2) participants' lay theories about group malleability. We found that the extent to which individuals had an entity (versus an incremental) group theory influenced the level of threat they felt when interacting with out-group members, and that perceived threat in turn affected their level of ethnocentrism and prejudice. These findings shed new light on the role of lay theories in intergroup attitudes and suggest new ways to reduce prejudice. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Information seeking (IS) has become a critical activity in video‐based environments. Up to now, the effects of support on information seeking (i.e., scaffolding) have seldom been assessed. The twofold aim of the current study was to (a) assess the effects of scaffolding on IS in videos and (b) determine the characteristics of the users' mental models after an IS activity with or without scaffolding. We divided 50 participants into two groups that either did or did not benefit from initial scaffolding during an IS task. Both groups then had to perform a localization task without any further access to scaffolding. Results showed that scaffolding the video by providing a table of contents and markers on a timeline helped students to engage in highly efficient IS, but they had less accurate mental representations of the video than those without scaffolding. The hypothesis that scaffolding provides a usable but external model was therefore supported. Lay Description: What is already known about this topic: Videos are increasingly used in learning.Searching for information in videos may be a complex activity.So far, very few studies have been conducted on the potential effect of scaffolding videos during an information‐seeking (IS) task. What this paper adds: In this study, we put in place the scaffolding of the video by adding a table of contents and markers on the timeline.Structuration and segmentation have positive effects on the performance in IS, in terms of response success, time spent on each search, relevance, and perceived difficulty.Scaffolding has a negative impact on the users' internal representations of the video. Implications for practice: Incorporating a table of contents and a structured timeline into a video facilitates the search activity.Without scaffolding, the search activity is longer and cognitively more costly.Paradoxically, users have a poorer representation of the video (i.e., poorer mental model) after the IS task when they were given scaffolding.Future studies should focus on the benefits of providing structuring and segmentation in learning tasks. [ABSTRACT FROM AUTHOR]

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Abstract: The objectives of this study were to estimate the age of complementary feeding introduction (CFI) and investigate the related health, demographic, and socio‐economic factors. Analyses were based on 10,931 infants from the French national birth cohort ELFE, born in 2011. Health, demographic, and socio‐economic data concerning infants and parents were collected at birth (face‐to‐face interviews and medical records) and 2 months (telephone interviews). Data on milk feeding and CFI practices were collected at birth and 2 months then monthly from 3 to 10 months using online or paper questionnaires. The associations between both health and social factors and CFI age were tested by multivariable multinomial logistic regressions. The mean CFI age was 5.2 ± 1.2 months; 26% of the infants started complementary feeding before 4 months of age (CF < 4 months), 62% between 4 and 6 months of age, and 12% after 6 months of age (CF > 6 months). CF < 4 months was more likely when mothers smoked, were overweight/obese, younger (<29 years), and used their personal experience as an information source in child caregiving and when both parents were not born in France. CF < 4 months was less likely when the infant was a girl, second‐born, when the mother breastfed longer, and had attended at least one birth preparation class. Mothers of second‐born infants and who breastfed their child longer were more likely to introduce CF > 6 months. Couples in which fathers were born in France and mothers were not born in France were less likely to introduce CF > 6 months. CF < 4 months occurred in more than 25% of the cases. It is important to continue promoting clear CFI recommendations, especially in smoking, overweight, young, not born in France, and nonbreastfeeding mothers. [ABSTRACT FROM AUTHOR]

Breastfeeding is recommended until 6 months of age, but a wide range of infant formula is available for nonbreastfed or partially breastfed infants. Our aim was to describe infant formula selection and to examine social- and health-related factors associated with this selection. Analyses were based on 13,291 infants from the French national birth cohort Etude Longitudinale Française depuis l'Enfance. Infant diet was assessed at Month 2 by phone interview and monthly from Months 3 to 10 via internet/paper questionnaires. Infant formulas were categorized in 6 groups: extensively or partially hydrolysed, regular with or without prebiotics/probiotics, and thickened with or without prebiotics/probiotics. Associations between type of infant formula used at 2 months and family or infant characteristics were assessed by multinomial logistic regressions. At Month 2, 58.1% of formula-fed infants were fed with formula enriched in prebiotics/probiotics, 31.5% with thickened formula, and 1.4% with extensively hydrolysed formula. The proportion of formula-fed infants increased regularly, but the type of infant formula used was fairly stable between 2 and 10 months. At Month 2, extensively hydrolysed formulas were more likely to be used in infants with diarrhoea or regurgitation problems. Partially hydrolysed formulas were more often used in families with high income, with a history of allergy, or with infants with regurgitation issues. Thickened formulas were used more with boys, preterm infants, infants with regurgitation issues, or in cases of early maternal return to work. The main factors related to the selection of infant formula were family and infant health-related ones. [ABSTRACT FROM AUTHOR]

Flashbulb memories are vivid autobiographical memories of the circumstances where an individual first learns about emotionally significant public events. Our paper assesses whether these memories were triggered by the attacks of Friday 13 November 2015 in Paris. Two hundred and ninety-one participants answered a web-based questionnaire that assessed their memory of the circumstances in which they first learned of the attacks. The questionnaire also assessed vividness, rehearsal, emotion, surprise and novelty. The results showed substantial and vivid recall of the context in which the participants first learned of the event. This recall was associated with fair rehearsal, negative emotional valence, surprise, and novelty. Regression analysis showed that the flashbulb recall was predicted by negative emotion. Negative emotion seems to play a key role in the formation of flashbulb memories, at least those associated with the Paris attacks. [ABSTRACT FROM AUTHOR]

Objectives: To examine the characteristics of the first Advanced Practice Nurses in France and to compare the French model to international standards. Background: Common barriers and facilitators to their integration in healthcare provision have been identified internationally. In France, the legislative framework was introduced in 2016, and the first graduates entered the workforce in 2019. Methods: The French model was examined in comparison with Hamric's conceptual framework and to the International Council of Nurses' guidelines and definitions. A cross‐sectional survey was also conducted, using three self‐administered online questionnaires. Two were distributed to 2019 and 2020 graduates and a third to the accredited programme directors. The characteristics of advanced practice nursing graduates were described and compared based on employment status and field of practice (primary vs secondary/tertiary care). Results: Although the French model of advanced practice nursing meets Hamric's primary criteria and core competencies, it does not differentiate between Nurse Practitioner and Clinical Nurse Specialist roles. Of the 320 students enrolled in one of the 11 accredited training programmes 165 participated in the survey. Mean age was 40, and mean prior nursing experience was 15 years. By February 2021, 30% of respondents were still employed as Registered Nurses. Barriers to practice included insufficient income generation (primary care), the lack of position creation (secondary/tertiary care), the physician‐dependent patient referral process and delays in prescription credentials approval. Conclusions: The implementation of advanced practice nursing in France faces several barriers. Legislative adjustments and greater financial incentives to practice seem warranted. Relevance to clinical practice: as in other countries, France introduced advanced practice nursing to respond to the Public Health challenge of improving access to quality health care in the context of increasing chronic disease prevalence and limited resource allocation. Facilitating its integration in the healthcare provision landscape seems paramount. [ABSTRACT FROM AUTHOR]

Background: Direct support workers (DSWs) accompany adults with autism spectrum disorder (ASD) and intellectual disability (ID) in residential care homes. Such DSWs, without specialised ASD training, are exposed to chronic stress linked to supporting ASD‐ID clients and must adjust by coping strategies adapted to the needs of the residents. Nevertheless, difficulties adjusting constitute a burnout risk for DSWs, characterised by high levels of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment. We aimed to describe the burnout of DSWs who support adults with ASD‐ID and to identify personal variables (experience and specialised training for ASD) and transactional variables (perceived stress and coping strategies) that could predict and mediate burnout. Method: In total, 125 DSWs accompanying ASD‐ID adults on a daily basis were included. Each participant answered four questionnaires measuring burnout, sociodemographic and professional variables, coping strategies and perceived stress. Results: Five per cent of DSWs were in a state of burnout. Eighteen, six and fifty‐nine per cent showed high average scores of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment, respectively. Being older, specialised training in ASD, stress perceived as a challenge and problem‐focused coping strategies were associated with low levels of depersonalisation and loss of a sense of personal accomplishment. Conclusions: Understanding the burnout process of ASD‐ID DSWs may require the assessment of the organisational characteristics linked to the quality of life of the DSWs and the recognition of their specific needs when facing difficulties. The necessary ASD‐focused training and support depends on an appraisal that would be individualised to adult ASD‐ID DSWs. [ABSTRACT FROM AUTHOR]

Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department‐level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed‐effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. The 2010–2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers. Key points: While some maternal characteristics previously known to be positively associated with breastfeeding (BF) in France were more frequent in 2016 than 2010, any BF initiation rate in maternity units in France decreased by 2 points (from 68.7% to 66.7%), and exclusive BF by 8 points (from 60.3% to 52.2%). Even greater decreases (4.5 and 9.6 points, respectively) were observed after adjusting for the characteristics of mothers, newborns, maternity units, and departments.Between 2010 and 2016, the largest decreases in adjusted exclusive BF initiation rates were observed in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

Background: Taking into account international studies interested in the development of evidence-based practice (EBP) in the speech and language therapy field, this survey investigated key issues with regard to students' perception of EBP. Aims: To determine how final-year students in France conceive EBP; to know if they feel competent in this area; to investigate any barriers to the use of EBP; and to assess their intention of using the EBP approach in their professional practice after graduating. Methods & Procedures: Between January and April 2019, 182 advanced French students from 15 French speech-language university training centres (SLUTC) completed an online survey addressing these questions. Outcomes & Results: The results show that 68.7% of students in the sample had a positive perception of the EBP. Between 54.9% and 73.6% of students felt rather competent to apply part of the approach, and 17% were sure to implement it in their own practice later on. Step 3 'Critically evaluating the evidence' was the most difficult. Regardless of the different EBP steps, the most important barrier for students who felt competentwas the lack of practice; for students who did not feel competent, the major barriers were both the lack of theoretical knowledge and the lack of practice. A total of 61% of students reported not seeing EBP being practised by their clinical practice placements supervisors; 55% reported never having used their EBP knowledge during their clinical practice placements. Conclusions & Implications: The students interviewed had a positive perception of EBP. Nevertheless, these results demonstrate a need to improve the EBP curricula and to include EBP in clinical education, under the guidance of clinical practice placements supervisors. [ABSTRACT FROM AUTHOR]

Background: Quality care during childbirth requires that health care providers have not only excellent skills but also appropriate and considerate attitudes and behavior. Few studies have examined the proportion of women in Western countries expressing dissatisfaction with such inappropriate or inconsiderate behavior. This study evaluated this proportion in a sample presumably representative of French maternity units. Methods: This prospective multicenter study, using data from a selfadministered questionnaire, took place in 25 French maternity units during one week in September 2018. The primary outcome measure was mothers' self‐reported dissatisfaction with blatantly inappropriate behavior (ie, inappropriate attitude, inadequate respect for privacy, insufficient gentleness of care, and/or inappropriate language) by health care workers in the delivery room. The secondary outcome was their self‐reported dissatisfaction with these workers' inconsiderate behavior (ie, unclear and inappropriate information, insufficient participation in decision‐making, or deficient consideration of pain). Results: Of 803 potentially eligible women, 627 completed the questionnaire after childbirth; 5.62% (35/623, 95% CI: 3.94‐7.73) reported dissatisfaction with blatantly inappropriate behaviors and 9.79% (61/623, 95% CI: 7.57‐12.40) with inconsiderate behaviors. The main causes of dissatisfaction reported by women in this survey were the inadequate consideration of their pain and the failure to share decision‐making. Conclusions: Most of the women were satisfied with how health care workers behaved towards them in the delivery room. Nonetheless, health care staff must be aware of women's demands for greater consideration of their expressions of pain and of their voice in decisions. [ABSTRACT FROM AUTHOR]

Background: Many critically ill children can be fed orally at some point during their paediatric intensive care (PICU) stay, but reduced appetite and other factors may impact their intake. At home, oral feeding is usually delivered by parents, so involving parents more actively during mealtimes in the PICU may contribute to improved patient/family satisfaction. Aim: To assess the impact of a new "room service" initiative involving parents on mealtime quality and on both family and health care professional (HCP) satisfaction. Methods: A prospective, single‐centre, before‐and‐after intervention study was designed as part of a PICU quality‐of‐care improvement programme in 2013 to 2016. Two questionnaires assessing oral nutrition practices and family/HCP overall satisfaction were disseminated among the parents of critically ill children capable of oral feeding during their PICU admission and among the whole PICU HCP team (nurses, nurse assistants, and medical doctors). Categorical variables were compared using the chi‐square test, and Likert scales were compared between groups with the Mann‐Whitney‐Wilcoxon test. Results: the pre‐intervention surveys were completed by 97 of 130 (75%) HCPs and 52 families and the post‐intervention surveys by 74 of 130 (57%) HCPs and 54 families. After the intervention, a marked improvement was observed in the overall quality of meal service rating by both HCPs and families (medians and IQR: 5 (5‐7) to 7 (7, 8) and 6 (6‐8) to 8 (7‐9), respectively; P <.01) and also in parents' involvement; in children's, families', and HCP satisfaction; in meal‐dedicated facilities and equipment; and in perception that oral nutrition is an important aspect of PICU care. Conclusions: Implementation of an improved "room service" initiative in the PICU was feasible and improved the perceived quality of care and satisfaction around oral feeding. This family‐centred care initiative can be integrated in an overall quality improvement strategy. [ABSTRACT FROM AUTHOR]

Background: Worldwide, numerous surveys have investigated practices and knowledge about caries management in adults, but few are available for children. Aim: The present cross‐sectional survey aimed to assess the restorative thresholds (RTs) in primary and permanent molars in children used by a population of dentists treating children and practicing in France. Design: The study population consisted of French dentists treating children (Fr‐DTCs) who were registered in the French Society of Pediatric Dentistry (n = 250). A specific questionnaire was developed. Descriptive and statistical analyses were performed. Results: Response rate was 80.4% (n = 201). Considering that an appropriate RT is at the stage of a moderate lesion (occlusal: International Caries Detection and Assessment System 4; approximal: lesion involving the external third of dentine), more than 50% of respondents showed a tendency for iatrogenic treatment, except for occlusal carious lesions in primary molars. Inappropriate invasive strategies were more often reported for occlusal lesions in permanent than primary molars. Moreover, for both molar types, these inappropriate RTs were more often chosen for approximal than occlusal lesions. Conclusions: The present survey suggested that Fr‐DTCs tend to overtreat in terms of caries management in both primary and permanent molars. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives: The objective was to measure the quality of clinical practice for the management of cystitis in adult women in general practice by collaborating with quality circles and the regional centre for antibiotic counsel. Method: This descriptive cross‐sectional study was performed in 2018 in Normandy, France. A questionnaire composed of clinical vignettes was used to evaluate practices of general practitioners (GPs) with regard to cystitis classified into four categories: simple, at risk of complication, recurrent, and caused by multidrug‐resistant bacteria. The 2017 French Infectious Diseases Society's guidelines were used as a reference. Results: A total of 142 GPs participated in the study (45.5% of the solicited). Fosfomycin‐trometamol and pivmecillinam were cited as first‐line treatments for simple cystitis by 134 (94%) and 38 (27%) participants, respectively. For at risk of complication cystitis, the treatments cited were cefixime by 64 participants (45%), ofloxacin by 50 (35%), pivmecillinam by 49 (35%), fosfomycin‐trometamol by 38 (27%), nitrofurantoin by 36 (25%), and amoxicillin‐clavulanic acid by 28 (20%). Mean compliance rates were 85% for simple cystitis, 39% for at risk of complication cystitis, 60% for recurrent cystitis and 14% for cystitis caused by multidrug‐resistant bacteria. Two criteria had less than 10% of the compliant answers: comprehensive knowledge of cystitis complication risk factors (9%) and positivity thresholds of urine cultures (10%). Conclusions: In this study, diagnostic means, follow‐up testing, and simple cystitis treatment (with fosfomycin predominantly mentioned) were broadly compliant. The use of critical antibiotics was too frequent for at risk of complication cystitis. There may be a need to improve the knowledge of professionals on antibiotic resistance and appropriate antibiotic use. [ABSTRACT FROM AUTHOR]

Background: Developed in 2015, the Victorian Institute for Sport Assessment for Gluteal Tendinopathy (VISA-G) is the first patient-reported outcome measure tool specifically designed to measure the severity of disability associated with greater trochanteric pain syndrome. There is currently no French version of the VISA-G questionnaire.Objective: To translate the VISA-G questionnaire into French (VISA-GF) and to test its psychometric performances.Design: Cross-sectional study, validation study.Setting: Clinics in Liège, Belgium and in France.Patients: Participants with greater trochanteric pain syndrome and control asymptomatic participants.Interventions: Not applicable.Main Outcome Measures: French translation of the VISA-G and psychometric performances of the questionnaire tested using internal consistency, construct validity and test-retest reliability with a 7-day interval.Results: The eight items of the VISA-G questionnaire were translated without any difficulties. The psychometric validation study included 106 participants (median age 53 [58-64] years old, 65 women [61.3%]). The questionnaire discriminates well between pathologic (n = 52) and asymptomatic participants (n = 54). Moreover, we found a good internal consistency and excellent test-retest reliability for the VISA-GF questionnaire. We also confirmed the construct validity and did not find any floor or ceiling effects.Conclusions: The VISA-GF has been shown to be a valid and reliable way to measure the severity of disability associated with greater trochanteric pain syndrome in French-speaking participants. [ABSTRACT FROM AUTHOR]

Rationale, aim, and objective: "Periodontal medicine" is based on evidence of interactions between periodontal disease and overall health. The aim of the present study was to assess awareness of oral‐systemic disease relationship among French general practitioners (GPs) and clarify how this influences their practices in a wider effort to better integrate oral health concerns into global health care delivery. Method: GPs registered in the north of France were invited to complete an online self‐administered questionnaire through local divisions of the French Medical Board. The questionnaire was divided into four sections: socio‐demographic aspects, knowledge, practices, and an overview. Results: The questionnaire was completed by 253 GPs. Among these, 75% were aware of the association between periodontitis (PD) and diabetes, and 53% to 59% were aware of the impact of PD on cardiovascular diseases, inflammatory bowel diseases, and respiratory infections. Few GPs identified PD as a possible risk factor of rheumatoid arthritis and Alzheimer disease (35.18% and <15%, respectively); 74.31% of GPs reported never asking their patients about their periodontal health. However, a personal history of PD and professional experiences seem to influence the medical practices of GPs to include oral examination. GPs largely self‐rated their knowledge of the oral‐systemic disease connection as being insufficient and were favourable to completing an up‐to‐date training course (86.56%). Conclusion: French GPs' knowledge about the association of PD with systemic diseases seems to be fair, but discrepancies in their daily clinical routine were found. Promisingly, a positive attitude was observed towards improving their knowledge of oral‐systemic diseases link. These results indicate the importance to reinforce collaboration between medical doctors and oral health care specialists. [ABSTRACT FROM AUTHOR]

Background: Questionnaire surveys have been undertaken worldwide to investigate practices and knowledge related to deep carious lesion (DCL) management in permanent teeth, and there is a lack of data in primary teeth. Aim: A cross‐sectional questionnaire survey was undertaken to describe the management strategies for DCL of vital primary teeth, focusing on the different caries removal techniques, among dentists practicing pediatric dentistry (DPPDs) in France. Their behavior was compared to members one registered to European Academy of Pediatric Dentistry (EAPD). Design: A questionnaire was electronically administrated (2018–2019) to members of the Collège des Enseignants en Odontologie Pédiatrique (CEOP), the Société Française d'Odontologie Pédiatrique (SFOP), and the EADP. Descriptive and statistical analyses were performed. Results: Response rate was, respectively, for CEOP, SFOP, and EAPD about 74%, 29%, and 15%. About half of the respondents (53%) would perform a complete caries removal into one step when 12% would indicate a stepwise technique: 68% of the DPPDs practicing in France would perform complete caries removal in one step when the preferred option in the other EAPD members was the selective excavation (44%) (P <.001). Conclusions: Complementary education of French dentists in the domain of caries management appears necessary regarding current recommendations. [ABSTRACT FROM AUTHOR]

Although several studies have shown a positive association between socio‐economic position and size at birth, not enough is known about the modifiable factors that may be involved. We aimed to investigate whether maternal prepregnancy body mass index (BMI), smoking, diet, and depression during pregnancy mediate the positive association between maternal education and birth size. Weight and length z‐scores specific for gestational age and sex were calculated for 1,500 children from the EDEN mother–child cohort. A mediation analysis of the associations between maternal education and birth size was conducted with a counterfactual method, adjusted for recruitment centre, parity, maternal height, and age. In the comparison of children of mothers with low versus intermediate education levels, maternal smoking during pregnancy explained 52% of the total effect of education on birth weight. Similar findings were observed with birth length z‐score (37%). The comparison of children of mothers with high versus intermediate education levels yielded a non‐significant total effect, which masked opposite mediating effects by maternal BMI and smoking during pregnancy on both birth weight and length. Prepregnancy BMI and maternal smoking during pregnancy mediate the positive association between maternal education and birth weight and length z‐scores. These mediators, however, act in opposite directions, thereby masking the extent to which healthy prenatal growth is socially differentiated. [ABSTRACT FROM AUTHOR]

Background: Behavioral economic approaches have revealed several characteristics of alcohol demand (e.g., intensity, elasticity, and essential value) in university students; however, these approaches have not yet examined alcohol demand among students outside of the United States. The current study examined alcohol demand among student samples in the United States and France using a hypothetical alcohol purchase task (APT) and a novel APT Choice task, in which nonalcoholic beverages were concurrently available at a fixed low price. Methods: Participants at each site (United States, n = 132; France, n = 132) were asked to complete an Internet‐based survey including the APT, APT Choice, Alcohol Use Disorders Identification Test, Daily Drinking Questionnaire, and Drinking Motives Questionnaire‐Revised Short Form. Group demand functions were produced for each of the 2 samples in both country‐specific and standardized drink units, and the exponential demand equation was fitted to each of the APT and APT Choice demand curves. Slope analyses were performed on the Non‐Alcoholic Cross‐Price demand to assess substitutability. Results: APT data revealed that in both samples, alcohol price and consumption were inversely related and demand measures were significantly associated with other alcohol measures. In addition, the availability of a nonalcoholic alternative reduced alcohol demand in both samples, with evidence of substitutability revealed by increases in cross‐price consumption. Conclusions: Low‐cost alcohol is associated with increased alcohol consumption in both French and U.S. university students, and concurrent availability of a nonalcoholic beverage within the APT both reduces alcohol demand and demonstrates behavioral economic substitutability. These findings will inform future studies investigating behavioral and environmental factors underlying transcultural differences and specific prevention efforts. Samples of students in the U.S. and France completed a hypothetical alcohol purchase task (APT) and a novel APT Choice task, in which non‐alcoholic beverages were also available at a fixed low price. Low‐cost alcohol was associated with greater reported alcohol consumption in both samples, and the availability of a non‐alcoholic beverage reduced alcohol demand and demonstrated behavioral economic substitutability, particularly among the French students. These findings indicate cultural similarities—and differences—in alcohol demand amonguniversity students. [ABSTRACT FROM AUTHOR]

Abstract: Background: The detection of specific language impairment (SLI) in children growing up bilingually presents particular challenges for clinicians. Non‐word repetition (NWR) and sentence repetition (SR) tasks have proven to be the most accurate diagnostic tools for monolingual populations, raising the question of the extent of their usefulness in different bilingual populations. Aims: To determine the diagnostic accuracy of NWR and SR tasks that incorporate phonological/syntactic complexity as discussed in recent linguistic theory. The tasks were developed as part of the Language Impairment Testing in Multilingual Settings (LITMUS) toolkit, in two different national settings, France and Germany, and investigated children with three different home languages: Arabic, Portuguese and Turkish. Methods & Procedures: NWR and SR tasks developed in parallel were administered to 151 bilingual children, aged 5;6–8;11, in France and in Germany, to 64 children in speech–language therapy (SLT) and to 87 children not in SLT, whose first language (L1) was Arabic, Portuguese or Turkish. Children were also administered standardized language tests in each of their languages to determine likely clinical status (typical development (TD) or SLI), and parents responded to a questionnaire including questions about early and current language use (bilingualism factors) and early language development (risk factors for SLI). Monolingual controls included 47 TD children and 29 children with SLI. Results were subjected to inter‐group comparisons, to diagnostic accuracy calculation, and to correlation and multiple regression analyses. Outcomes & Results: In accordance with previous studies, NWR and SR identified SLI in the monolingual children, yielding good to excellent diagnostic accuracy. Diagnostic accuracy in bilingual children was fair to good, generally distinguishing children likely to have SLI from children likely to have TD. Accuracy was necessarily linked to the determination of clinical status, which was based on standardized assessment in each of the child's languages. Positive early development, a composite risk factor for SLI, and not variables related to language exposure and use, generally emerged as the strongest predictor of performance on the two tasks, constituting additional, independent support for the efficacy of NWR and SR in identifying impairment in bilingual children. Conclusions & Implications: NWR and SR tasks informed by linguistic theory are appropriate for use as part of the diagnostic process for identifying language impairment in bilingual children for whom the language of assessment is different from the home language, in diverse sociolinguistic contexts. [ABSTRACT FROM AUTHOR]

Introduction: Slowly progressive, genetic neuromuscular diseases (gNMDs) often lead to important motor deficiencies and functional limitations. The Quality of Life in Genetic Neuromuscular Disease Questionnaire (QoL-gNMD) is a new health-related quality-of-life questionnaire developed for these patients. The purpose of the present study was to validate the French version of the QoL-gNMD and to calibrate its measurement system.Methods: Both the QoL-gNMD and a validated generic questionnaire (WHOQOL-BREF) were administered to patients. Validation was performed using item response theory. The partial credit model (Rasch) was used to calibrate each domain.Results: Three hundred fifteen adult patients were included. All 3 domains showed adequate psychometric properties (internal consistency: person separation index >0.77; repeatability: test-retest intraclass correlation coefficient >0.75, scalability coefficient >0.38) and fitted the partial credit model. The QoL-gNMD also demonstrated adequate concurrent validity with the WHOQOL-BREF.Discussion: The QoL-gNMD showed adequate psychometric properties and can be used in clinical settings. Although not anchor-based, the minimum detectable change tables help in interpreting score change. Muscle Nerve 56: 1085-1091, 2017. [ABSTRACT FROM AUTHOR]

Aims To develop an empirically derived short version of the Hypoglycaemia Fear Survey II that still accurately measures fear of hypoglycaemia. Methods Item response theory methods were used to generate an 11-item version of the Hypoglycaemia Fear Survey from a sample of 487 people with Type 1 or Type 2 diabetes mellitus. Subsequently, this scale was tested on a sample of 2718 people with Type 1 or insulin-treated Type 2 diabetes taking part in DIALOG, a large observational prospective study of hypoglycaemia in France. Results The short form of the Hypoglycaemia Fear Survey II matched the factor structure of the long form for respondents with both Type 1 and Type 2 diabetes, while maintaining adequate internal reliability on the total scale and all three subscales. The two forms were highly correlated on both the total scale and each subscale (Pearson's R > 0.89). Conclusions The short form of the Hypoglycaemia Fear Survey II is an important first step in more efficiently measuring fear of hypoglycaemia. Future prospective studies are needed for further validity testing and exploring the survey's applicability to different populations. [ABSTRACT FROM AUTHOR]

Aims To assess the effectiveness of the 2015 version of the French Évin Law that was implemented in 1991 with the objective of protecting young people from alcohol advertising. Design Data were obtained from survey questions measuring exposure and receptivity to alcohol advertisements that were introduced for the first time in the 2015 European School Survey Project on Alcohol and Other Drugs (ESPAD). Participants and setting A representative sample of 6642 10th-12th grade students (mean age 17.3 years) were interviewed in 198 schools in France by a self-administered questionnaire. Measurements Information was collected on alcohol advertising exposure in different media (outside billboards, internet, etc.) and receptivity to recent advertisements (attractiveness, incentive to drink, etc.). Findings The majority of students declared that they had been exposed at least once a month to alcohol advertisements in supermarkets (73.2%), in movies (66.1%), magazines and newspapers (59.1%), on billboards in streets (54.5%), and on the internet (54.1%). Concerning the last recalled advertisements, 27.8% remembered the beverage type, 18.2% the brand, 13% felt like having a drink after having seen the advertisement and 19.6% found the advertisement attractive (boys ranked significantly higher than girls for all these indicators; P-value < 0.05). Conclusion The 2015 version of the French Évin law does not appear to protect young people effectively from exposure to alcohol advertising in France. [ABSTRACT FROM AUTHOR]

Background and aims To identify the nature of visual alcohol references in alcohol advertisements during televised broadcasts of the 2014 FIFA World Cup Tournament matches and to evaluate cross-national differences according to alcohol marketing policy restrictiveness. Design Content analysis using the Delphi method and identification of in-game sponsorships. Setting Television broadcasts of the 2014 FIFA World Cup in Argentina, Brazil, Canada, Finland, France, Mexico, Spain and the United States. Cases Eighty-seven alcohol advertisements; 20 matches. Measurements Quantitative rating scales, combined with the Delphi rating technique, were used to determine compliance of the alcohol advertisements with the International Alliance for Responsible Drinking's (IARD) Guiding Principles. Recordings of five matches from four countries were also used to identify the number of in- and out-of-game alcohol brand appearances. Findings A total of 86.2% of all unique alcohol advertisements contained at least one violation of IARD's Guiding Principles, with violation rates ranging from 72.7% (Mexico) to 100% (Brazil). Countries with the least restrictive marketing policies had a higher prevalence of violations in guidelines designed to protect minors. There were 2.76 in-game alcohol brand appearances and 0.83 out-of-game alcohol brand appearances per minute. Brand appearances did not differ across countries or according to a country's marketing policy restrictiveness. Conclusions Self-regulation and statutory policies were ineffective at limiting alcohol advertising during the 2014 FIFA World Cup Tournament television broadcasts. Most advertisements contained content that violated the self-regulation codes, and there were high levels of within-broadcast brand appearances. [ABSTRACT FROM AUTHOR]

Studies suggest that stimulation of the left dorsolateral prefrontal cortex (DLPFC) reduces food craving in bulimic patients, but evidence supporting repetitive transcranial magnetic stimulation (rTMS) as a therapeutic tool is lacking. We investigated the safety and therapeutic efficacy of an adjunct high-frequency rTMS programme targeting the left DLPFC. Forty-seven women with bulimia nervosa were randomised to a real or sham stimulation group. The real group underwent 10 rTMS sessions, each consisting of 20 trains of 5 seconds with 55-second intervals between trains, at a frequency of 10 Hz. The main outcome was the number of binge episodes in the 15 days following the end of stimulation. Overall, no significant improvement in bingeing and purging symptoms was noted after the programme. rTMS was well tolerated. This suggests that 10 sessions of high-frequency rTMS to the left DLPFC provide no greater benefit than placebo. Future studies should consider methodological issues as well as alternative targets. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Intermittent catheterisation (IC) is considered the gold standard for bladder dysfunction‐related voiding problems following spinal cord injury (SCI). Despite this, up to 50% of individuals were no longer using IC 5 years after discharge from the rehabilitation centre. Hence, we initiated the IC Education Programme to offer standardized IC training and improve adherence. The programme was a European initiative undertaken by eight rehabilitation centres in Norway, France and Italy. The aim of this study is to evaluate the effectiveness of the IC Education Programme. The control group comprised individuals with SCI discharged from one of the participating rehabilitation centres using IC up to 1 year before the Education Programme was initiated. A questionnaire was sent by post to this group before the IC Education Programme started. The second group comprised individuals who had participated in and been discharged using the IC Education Programme; they received the questionnaire up to 1 year after programme initiation. Anonymous responses from the two groups were compared to assess outcomes such as ongoing use of IC, satisfaction with training and attitude towards bladder issues. Three hundred sixteen responses (from 500 questionnaires sent) were received from the control group (63%) and 84 (of 142) from the IC Education Programme group (59%). The IC Education Programme significantly increased the percentage of individuals still using IC during the first year at home (99 vs. 83% for the Education Programme and control groups, respectively; p < 0·05) and improved satisfaction with training in IC. Individuals who had participated in the IC Education Programme were also significantly less bothered by bladder issues than the control group (overall SF‐Qualiveen index 1·58 vs. 1·76, respectively; p = 0·032). The IC Education Programme improved the standard of care following SCI as it enabled more individuals to continue with IC up to 1 year after discharge, and improved training satisfaction. [ABSTRACT FROM AUTHOR]

Objectives To investigate the association between hearing loss, hearing aid use, and cognitive decline. Design Prospective population-based study. Setting Data gathered from the Personnes Agées QUID study, a cohort study begun in 1989-90. Participants Individuals aged 65 and older (N = 3,670). Measurements At baseline, hearing loss was determined using a questionnaire assessing self-perceived hearing loss; 137 subjects reported major hearing loss, 1,139 reported moderate problems (difficulty following the conversation when several persons talk at the same time or in a noisy background), and 2,394 reported no hearing trouble. Cognitive decline was measured using the Mini-Mental State Examination ( MMSE), administered at follow-up visits over 25 years. Results Self-reported hearing loss was significantly associated with lower baseline MMSE score (β = −0.69, P < .001) and greater decline during the 25-year follow-up period (β = −0.04, P = .01) independent of age, sex, and education. A difference in the rate of change in MMSE score over the 25-year follow-up was observed between participants with hearing loss not using hearing aids and controls (β = −0.06, P < .001). In contrast, subjects with hearing loss using a hearing aid had no difference in cognitive decline (β = 0.07, P = .08) from controls. Conclusion Self-reported hearing loss is associated with accelerated cognitive decline in older adults; hearing aid use attenuates such decline. [ABSTRACT FROM AUTHOR]

Objectives To examine the frequency and determinants of underperception of naps in older adults referred for a sleep assessment. Design Prospective study. Setting Outpatient geriatric sleep clinic. Participants Individuals aged 60 and older referred for insomnia complaints or suspected sleep apnea (N = 135). Measurements Tests included clinical interview, sleepiness scale, anxiety and depression scale, Insomnia Severity Index ( ISI), Mini-Mental State Examination ( MMSE), and overnight polysomnography, followed by multiple sleep latency tests. At the end of each of four nap opportunities, participants answered whether they had slept during the test. Nap underperception was defined as two or more unperceived naps. Results Of the 105 participants who napped at least twice, 42 (40%) did not perceive at least two naps. These participants had lower MMSE scores ( P = .01) and were more likely to be taking benzodiazepines ( P = .008) than the 63 participants who did not underperceive their naps but had similar demographic characteristics, sleep diagnoses, depression and anxiety scores, and polysomnography measures. Both groups had similarly short mean daytime sleep latencies (9.7 ± 4.5 minutes and 9.8 ± 3.7 minutes), but participants who underperceived their naps scored lower on the Epworth Sleepiness Scale (5.6 ± 4.0, vs 9.6 ± 4.8, P < .001). An ISI of 11 or greater, a MMSE score of 26 or less, and a sleepiness score of 8 or less were each independently associated with underperception of naps. The combination of these three factors yielded a positive predictive value of 93% and a negative predictive value of 71% for nap underperception. Conclusion Older adults referred for sleep consultation with cognitive impairment and greater insomnia symptoms frequently underperceive naps, leading them to underestimate their level of sleepiness. In such cases, objective measures of daytime sleepiness would be better than the Epworth Sleepiness Scale. [ABSTRACT FROM AUTHOR]

Objectives To examine the associations between amyloid- β brain deposition and physical activity ( PA) in elderly adults without dementia and to investigate whether the association has a dose-response relationship. Design Cross-sectional study. Setting French community-dwelling people. Participants Elderly adults with normal or mildly impaired cognition (mean age 74.7 ± 4.2; 60.4% female) with available information on current self-reported PA and amyloid- β brain deposition measured using positron emission tomography ( PET) using the PET-ligand florbetapir F 18 (n = 268). Measurements A standardized uptake value ratio ( SUVR) was obtained for each subject. Participants were divided according to amyloid plaque cortical retention defined according to a SUVR cutoff of 1.10 ( SUVR+ vs SUVR−). Results Bivariate and multivariate analyses showed that PA was not significantly associated with SUVR. SUVR+ and SUVR− participants did not differ in terms of volume (continuous PA variables) and levels (categorical PA variables) of PA. PA was not correlated with SUVR in apolipoprotein E ε4 carriers or noncarriers. PA was not associated with cognitive function. Conclusion Although PA protects against dementia, there is no solid evidence that this protection involves a reduction in amyloid- β brain deposition. Further studies are needed to determine whether PA (ideally measured at several time-points using objective measures) is involved in the pathophysiology of Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Background Data on the characteristics of consumers of phytosterol-enriched products and modalities of consumption are rare. An observational study evaluating the lifestyle characteristics and cardiovascular risk ( CVR) profile of phytosterol-enriched yogurt consumers was performed in France. Methods Subjects were recruited from general practitioners via electronic medical records. Data were obtained from 358 consumers and 422 nonconsumers with 519 subject questionnaires (243 consumers, 276 nonconsumers; 67% response). Results Consumers had more cardiovascular risk factors than nonconsumers (2.0 ± 1.5 versus 1.6 ± 1.4; P < 0.001) and a higher 10-year SCORE cardiovascular risk (1.8 ± 2.0% versus 1.6 ± 2.2%; P = 0.008); they were older ( P = 0.030) and had a higher incidence of hypercholesterolaemia ( P < 0.001) and family or personal history of heart disease ( P = 0.023/ P = 0.026, respectively). Among consumers not on cholesterol-lowering medication, 99% were eligible for lifestyle interventions and 56% were eligible for lipid-lowering drug according to European guidelines. Consumers had a healthier lifestyle, with a higher (fruit/vegetable - saturated fatty acid) score than nonconsumers ( P = 0.035), focused more on low-intensity leisure activity ( P = 0.023), spent more time travelling by foot or bicycle ( P = 0.012) and were more likely to act to reduce CVR. Phytosterol-enriched yogurt intake conformed to recommendations in two-thirds of consumers and was mainly consumed because of concerns over cholesterol levels and CVR. Conclusions The higher cardiovascular disease risk profile of phytosterol-enriched yogurt consumers corresponds to a population for whom European guidelines recommend lifestyle changes to manage cholesterol. The coherence of the data in terms of risk factors, adherence to lifestyle recommendations and the consumption of phytosterol-enriched yogurt conforming to recommendations reflects a health-conscious consumer population. [ABSTRACT FROM AUTHOR]

Background and aims It is well established that craving increases following exposure to substance-related 'cues', but the role of life-styles or substance use habits that are unique to each person remains poorly understood. This study examines the association of substance-specific and personal cues with craving and substance use in daily life. Design Ecological momentary assessment was used during a 2-week period. Setting Data were collected in a French out-patient addiction treatment centre. Participants A total of 132 out-patients beginning treatment for alcohol, tobacco, cannabis or opiate addiction were included. Measurements Using mobile technologies, participants were questioned four times per day relative to craving, substance use and exposure to either substance-specific cues (e.g. seeing a syringe) or personal cues unique to that individual (e.g. seeing the specific person with whom the substance is used). Findings Craving intensity was associated with the number of concurrently assessed substance-specific cues ( t = 4.418, P < 0.001) and person-specific cues ( t = 4.006, P < 0.001) when analysed jointly within the same model. However, only person-specific cues were associated with increases in craving over subsequent hours of the day ( t = 2.598, P < 0.05). Craving intensity, in turn, predicted increases in later substance use ( t = 4.076, P < 0.001). Causal mediation analyses demonstrated that the association of cues with later substance use was mediated by craving intensity (mediated effect = 0.007, 95% confidence interval = 0.004-0.011). Conclusions Unique person-specific cues appear to have a robust effect on craving addictive substances, and the duration of this association may persist longer than for more general substance-specific cues. Mobile technologies provide new opportunities for understanding these person-specific risk factors and for providing individually tailored interventions. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the differential impact of a computer-based comprehension training programme according to second graders' comprehender profiles. These profiles differed in the children's abilities to process three types of textual information: literal information, text-connecting inferences and gap-filling inferences. The results showed that all the profiles improved significantly after the training on the question type that had caused them the greatest amount of difficulty on the pretest. In addition, factors that could a priori predict the effectiveness of the programme were investigated by comparing children who benefited from the instruction (responders) with those who did not benefit (nonresponders). Before instruction, these children differed in their lexical knowledge level and logical reasoning skills, but not in their memory or comprehension-monitoring abilities. The results support the claim that children with comprehension difficulties form a heterogeneous group and emphasize the need to examine the differential impact of comprehension instruction according to the characteristics of poor comprehenders. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives High-alert medications ( HAMs) are medications that are associated with a high risk of serious harm if used improperly. The objective of this study was to identify paediatric HAM used in our institution and to identify safety measures for their use. Methods The list of HAM and the list of safety measures that were introduced in our department were based on (1) a literature search; (2) a survey of health care professionals in our department including doctors, head nurses, nurses and pharmacists; and (3) the drug steering committee. Results We found four lists of HAM based on a literature search, including 27 classes of pharmaceutical agents, and 63 common drug names. The response rate of the survey was 20.7% (230 of 1113). Some of the HAMs included in our list were not identified by the literature search. These included neuroleptic drugs, anti-malarial agents, antiviral agents, anti-retroviral agents and intravenous acetaminophen. The drug steering committee selected 17 HAM and highlighted 53 safety measures involving seven broad aspects of pharmacological management. Conclusions This project was part of the new safety strategies developed in a paediatric hospital. We set out to make a list of HAM relevant to paediatrics with additional safety measures to prevent medication errors associated and a 'joker' system. The various safety measures, such as double-checking of HAM prescriptions, should be reviewed during the year following their implementation. This list, which was developed in our hospital specifically for use in paediatrics, can be adapted for use in other paediatric departments. [ABSTRACT FROM AUTHOR]

Objectives To examine whether living alone predicted hospitalizations, nursing home admission, weight loss, and death in individuals with mild to moderate Alzheimer's disease ( AD) over 2 years of follow-up. Design Data are from the Plan de Soin et d'Aide dans la maladie d'Alzheimer study, a 24-month trial with a cluster randomization of memory clinics in two arms: a multidomain intervention and usual care. Setting Memory clinics in France (N = 50). Participants Community-dwelling individuals with AD with a Mini-Mental State Examination score between 12 and 26 and an identified caregiver. Measurements A neurogeriatric evaluation was conducted twice a year in the intervention group and annually in the control group. Hospitalizations, nursing home admission, weight loss, and death occurring during the past year were recorded. Information on sociodemographic characteristics, clinical conditions, therapy, and physical and cognitive status was recorded. Results At inclusion, 348 (30.8%) of the 1,131 participants lived alone. Living alone did not increase the risk of mortality or weight loss in individuals with mild to moderate AD, but significant associations with risk of hospitalization (hazard ratio ( HR) = 1.33, 95% confidence interval ( CI) = 1.01-1.74) and institutionalization ( HR = 2.53, 95% CI = 1.84-3.47) were reported. A protective effect of physical function on institutionalization and mortality was found. Conclusion These results might support clinicians in making decisions about institutionalization of individuals with AD living alone or improving home health care, such as increasing screening and managing functional impairment in this complex population. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to investigate the association between body-weight ( BW) perception, weight preoccupation and behaviour, including weight control practices and compulsive over-eating episodes, across gender and actual BW classes. Design This study used a cross-sectional observational study. Participants A large, nationally representative sample of 6404 ninth-grade French adolescents was randomly selected from schools throughout France. Methods Weight and height were measured, and BW preoccupation, BW control practices and compulsive over-eating were self-reported using standardized questionnaires. Results Nearly one-third of adolescents misperceived their BW. Misperception was more frequent among girls than boys (42.2% vs. 27.3%, P < 0.01). Underestimation of BW among overweight adolescents, like BW overestimation among underweight adolescents, was associated with less preoccupation with weight and fewer weight control practices than accurate perception of BW. Normal weight adolescents who overestimated their BW were more likely to declare weight preoccupations ( ORa = 8.66 [6.67-11.25]), dieting ( ORa = 4.81 [3.68-6.27]) and recurrent compulsive over-eating episodes ( ORa = 2.36 [1.72-3.23]) compared with their counterparts who correctly estimated their BW. Conclusion Our study underlines the role of these associations in each category of actual BW (underweight, normal weight and overweight) in a large national sample. [ABSTRACT FROM AUTHOR]

Objective/Background This study aims to compare differences in pain beliefs according to headache type, chronic vs episodic migraine, in a large cohort of patients, using the Pain Beliefs and Perceptions Inventory ( PBPI), and to identify possible predictive factors of the same pain beliefs. Methods All patients referring for the first time at our center in 2011 were screened using PBPI and the Hamilton Anxiety and Depression Scale (a total of 1032 patients). PBPI is a 4-subscale questionnaire that explores a patient's personal beliefs on their subjective experience of pain. Headache patients also completed the Headache Impact Test ( HIT-6) and a 30-day headache diary. For all participants, age, gender, duration of pain were collected. The sample was narrowed down to 899 as we experienced a nonresponse rate of 12.8%. For the purpose of this study, 2 groups were identified: chronic and episodic migraine, consisting of 116 and 126 patients, respectively, which were compared using Student's t-test; correlation analyses were conducted to investigate the relationship between variables before running a model selection based on Akaike's Information Criterion to identify possible predictive factors of different pain beliefs. Patients below 18 years of age and those diagnosed with other painful conditions were excluded from the analysis. Results Beliefs from chronic and episodic migraine patients were very similar, with only a difference in beliefs related to constancy of pain ( Mean value ± SD 0.5 ± 1.1 vs −0.6 ± 1.1, P < .001). Predictive factors were depression and HIT-6 scores for all PBPI subscales apart from Self-Blame, which showed a stronger relation to anxiety scores. Number of days with headache per month was correlated to higher constancy values. Diagnosis was a predictive factor for any particular belief. Discussion This is the first study, to our knowledge, that addresses differences and predictive factors in pain beliefs according to headache diagnosis. A deeper knowledge of beliefs pattern in patients could lead to better-tailored psychological management. [ABSTRACT FROM AUTHOR]

Objectives To describe the characteristics of nursing home residents diagnosed with atrial fibrillation ( AF) and eligible for oral anticoagulants who did not receive these drugs and to detail the conditions that physicians who decide not to prescribe anticoagulants take into account. Design Cross-sectional. Setting Nursing home. Participants Nursing home residents with a history of AF (N = 1,085). Measurements Data were collected on clinical characteristics, geriatric syndromes, and antithrombotic regimen. Multivariate logistic regression was used to identify factors associated with nonprescription of anticoagulants. A standardized questionnaire was submitted to physicians in charge of patients with AF, to detail conditions associated with their medical decision not to prescribe anticoagulants. Results History of AF was present in 1,085 nursing home residents (10.1%), mean age 87, with a mean CHA2 DS2- VASc score of 5.1 ± 1.4. Of these residents with AF, 544 (50.1%) did not receive anticoagulants. Recurrent falls (odds ratio ( OR) = 4.9, 95% confidence interval ( CI) = 2.4-9.9, P < .001), past history of bleeding ( OR = 3.62, 95% CI = 1.54-8.51, P = .003), paroxysmal AF ( OR = 3.5, 95% CI = 1.83-6.66, P < .001), and advanced age ( OR = 1.1, 95% CI = 1.01-1.17, P = .02) were significantly associated with not prescribing anticoagulants. Recurrent falls (47%), cognitive impairment (22.6%), and advanced age (16.4%) were the main reasons for not prescribing anticoagulants. Conclusion The prevalence of AF in a cohort of very old nursing home residents was 10%. Anticoagulation was prescribed in fewer than 50% of eligible cases despite high individual risk of stroke. Geriatric syndromes, especially falls and cognitive disorders, were the main reported contraindications for prescribing anticoagulants. Physicians caring for those residents wrongly thought that paroxysmal AF caused fewer thromboembolic events than permanent AF, which explains lower rates of anticoagulant prescription in individuals with paroxysmal AF. [ABSTRACT FROM AUTHOR]

Objectives To identify factors associated with driving restriction in elderly men and women. Design Prospective cohort study of French drivers from 2003 to 2009. Setting The Three-City Cohort of Bordeaux, a prospective study of 2,104 people aged 65 and older. Participants Five hundred twenty-three drivers with a mean age of 76 (273 male, 250 female). Measurements Sociodemographic characteristics, driving habits, health variables, cognitive evaluation and dementia diagnosis. Predementia was defined as no dementia at one follow-up and dementia at the next follow-up. Results Over the 6-year period, 54% of men and 63% of women stopped driving or reduced the distance they drove. Predementia, Parkinson's disease, older age, and a high number of kilometers previously driven were common restriction factors in both sexes. Prevalent dementia, depressive symptomatology, a decline in one or more instrumental activities of daily living, and poor visual working memory were specific factors in men. In women, low income, fear of falling, slow processing speed, and severe decline in global cognitive performance all affected driving restriction. Conclusion Older women restricted their driving activity more than older men, regardless of the number of kilometers previously driven, physical health, and cognitive status. Factors affecting driving restriction differed according to sex, and women were more likely to stop driving than men in the period preceding a dementia diagnosis. [ABSTRACT FROM AUTHOR]

Older patients represent an increasing population in emergency department (ED) with underlying diseases and longer ED length of stay, which are potential risk factors of pressure ulcers (PUs). The aim of the study was to determine the prevalence and incidence rates of PUs in an Emergency Department and to analyse variables related to PUs occurrence. The study was carried out in the Emergency Department of Bordeaux (France), and included 602 patients from 1 to 15 June 2010. All the potential body sites of pressure were examined at admission and discharge for all the patients by trained nurses. Comorbidity score, list of treatment, length of stay (hours), PUs (including stage I) and C-reactive protein (CRP) level were systematically recorded. A total of 47 (7·8%) patients had prevalent PUs at admission and 74 (12·3%) at discharge. The cumulative incidence was 4·9% and the incidence density was 5·4 per 1000 patients per hour. In multivariate analysis, higher comorbidities (OR 1·3; P = 0·014) and CRP levels (OR 1·005; P = 0·017) were both independent risk factors for developing PU. In conclusion, these data show that even a very short stay to the ED is sufficient to induce PUs especially stage I. [ABSTRACT FROM AUTHOR]

In this article the authors discuss a user satisfaction survey of a quantified self-questionnaire for elderly people administered online. The recommended use of self-administered questionnaires (SAQs) to improve the health and functional status of adults, statistics on participants' perceived ease of use and appreciation of the quality of of visual presentation of a digitized SAQ on a Web platform, according to age, and the role of quantified self (QS) in care management are discussed