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L'enjeu de cet article est d'analyser, comme cela a déjà été réalisé avec des adultes dans leur domaine professionnel, la façon dont les jeunes à l'école perçoivent leur environnement de travail. L'objectif principal vise à étudier l'opérationnalisation du modèle théorique << exigences professionnelles-ressources >> (Job Demands-Resources [JD-R]) de Demerouti et al. (2001) en contexte scolaire. L'objectif secondaire est de valider une échelle adaptée au contexte scolaire qui permette à la fois de déterminer le niveau d'exigences et le niveau de ressources perçus par les élèves au sein de l'école. Dans une première étude, une échelle a été adaptée, puis remplie par 414 collégiens et lycéens. Les résultats des analyses factorielles exploratoires, puis confirmatoires, indiquent une structure en deux dimensions (exigences/ ressources) à trois facteurs chacun (physique, motivationnelle et cognitive) conformément à la version d'origine. Les propriétés psychométriques de l'échelle s'avèrent satisfaisantes. À l'aide d'analyses en pistes causales, la seconde étude réalisée avec 56 élèves a permis de mettre en avant la relation entre le modèle JD-R transposé à l'école et l'épuisement (burnout) scolaire. Les données recueillies à trois moments révèlent que les exigences et les ressources au T1 prédisent celles au T2, comme il était présumé. Toutefois, seules les ressources au T2 prédisent le burnout au T3. En définitive, l'analyse des processus révèle les effets du niveau de ressources perçu par les élèves au T1 sur le burnout scolaire au T3, et un effet des exigences qui n'est pas significatif. Pour conclure, le modèle a été partiellement validé mettant en avant des relations entre l'évolution des exigences, des ressources et leurs effets sur le burnout. Mots-clés : élèves du secondaire, exigences, ressources, épuisement scolaire, burnout The aim of this article is to analyze, as has been done with adults in their professional field, how young people in school perceive their work environment. The main objective is to study the operationalization of the theoretical model 'Job Demands-Resources (JD-R)' of Demerouti and al. (2001) in the school context. The secondary objective is to validate a scale adapted to the school context that makes it possible to determine the level of both demands and resources as perceived by the students within the school. In a first study, a scale was adapted, then administered, to 414 middle and high school students. The results of exploratory and then confirmatory factor analyses indicated a two-dimensional structure (demands/resources) with three items each (physical, motivational and cognitive) in accordance with the original version. The psychometric properties of the scale were found to be satisfactory. Using causal path analyses, the second study with 56 students highlighted the relationship between the JD-R model transposed to schools and school burnout. The results collected at three points in time reveal that the demands and resources at T1 predict those at T2, as was assumed. However, only resources at T2 predict burnout at T3. In the end, the process analysis reveals the effects of students' perceived level of resources at T1 on school burnout at T3, but indicates no significant effect of demands. In conclusion, the model was partially validated showing relationships between changes in demands, resources and their effects on burnout. Keywords: secondary school students, demands, resources, school burnout, Introduction Les chiffres sont alarmants. Selon le Bureau international du Travail (BIT, 2017), un travailleur succombe toutes les quinze secondes à une maladie professionnelle ou après un accident du travail, [...]

Background: Adapted physical activity programs have shown promising results in reducing the physical, social and psychological side effects associated with breast cancer, but the extent to which they can be effectively adopted, implemented and maintained is unclear. The aim of this study is to use the framework to guide the planning and evaluation of programs according to the 5 following keys: Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework to evaluate a fencing program under the French acronym RIPOSTE (Reconstruction, Image de soi, Posture, Oncologie, Santé, Thé rapie, Escrime) literally in English (Reconstruction, Self-Image, Posture, Oncology, Health, Therapy, Fencing). This program is an innovative intervention focused on improving the quality of life (QoL) of breast cancer surgery patients through fencing. Methods: A convergent mixed methods pilot study was conducted to preliminary evaluate the different RE-AIM dimension of the pilot program. Twenty-four participants who have just undergone surgery for invasive breast cancer were randomly allocated in two groups: one group started immediately after their inclusion (Early RIPOSTE group) and the other started 3 months following their inclusion (Delayed RIPOSTE group). Participants answered a questionnaire at inclusion and at the end of the program on QoL, shoulder functional capacity, fatigue, anxiety-depression and physical activity. Results: RIPOSTE program was able to reach mainly young and dynamic participants, attracted by the originality of fencing and keen to improve their physical condition. Regarding effectiveness, our results suggest a trend to the improvement of QoL, shoulder functional capacity, fatigue and anxietydepression state, even without any significant differences between the Early RIPOSTE group and the Delayed RIPOSTE group. Discussions: The cooperation, exchanges and cohesion within the group greatly facilitated the adoption of the program, whereas interruptions during school vacations were the main barriers. The intervention was moderately well implemented and adherence to the protocol was suitable. Conclusion: RIPOSTE is an acceptable and effective program for involving breast cancer survivors in physical activity, that needs to be tested at a larger scale to investigate its effectiveness, but has the potential to be transferred and scaled up worldwide. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this study was to compare the responsiveness of the European Organization for Research and Treatment (EORTC) quality of life questionnaires (QLQ-C30, QLQ-CR38) and the Functional Assessment of Cancer Therapy-colorectal version 4 questionnaire (FACT-C). Method This prospective study included 127 patients with colorectal cancer: 71 undergoing chemotherapy and 56 radiation therapy. Responsiveness statistics included the Standardized Response Mean (SRM) and the Effect Size (ES). The patient's overall assessment of his/her change in state of health status was the reference criterion to evaluate the responsiveness of the QoL questionnaires. Results 34 patients perceived their health as stable and 17 as improved between the first and the fourth courses of chemotherapy. 21 patients perceived their health as stable and 22 as improved between before and the last week of radiotherapy. The responsiveness of the 3 questionnaires differed according to treatments. The EORTC QLQ-C30 questionnaire was more responsive in patients receiving chemotherapy, particulary functional scales (SRM > 0.55). The QLQ-CR38 and the FACT-C questionnaires provided little clinically relevant information during chemotherapy or radiotherapy. Conclusion The EORTC QLQ-C30 questionnaire appears to be more responsive in patients receiving chemotherapy.

The COVID-19 pandemic is putting a strain on health systems around the world. Healthcare workers, on the front lines of the epidemic, are facing major and potentially traumatic stressful events, overwhelming their ability to cope and their resources. The objective of this article will be to show how the use of the URG-EMDR protocol in a telemental health setting has proven to be feasible and effective in the treatment of a group of healthcare professionals working in nursing homes or hospital services that were highly mobilized during the acute phase of COVID-19. 17 participants, registered nurses (N = 7) and licensed practical nurses (N = 10), were remotely treated using the URG-EMDR protocol in a single session. The assessment focused on anxiety and depressive symptoms (HAD scale) and the level of perceived disturbance (SUD). An additional evaluation of the satisfaction with the remote psychotherapy intervention was conducted. As the URG-EMDR protocol has already proven itself during emergency interventions, it is interesting to note that its remote use in the treatment of healthcare providers caring for COVID-19 patients allows for an improvement in the emotional state and a decrease in perceived disturbance, in a single session. This result is maintained 1 week after the intervention, despite the continued professional activities of the participants and the continuity of the event. Moreover, the remote therapy setting was judged satisfactory by the patients, even if it required adjustments and certain recommendations for practice. The remote use of the URG-EMDR protocol opens up innovative perspectives for early interventions and the prevention of the development of psychological disorders in the long term following a situation of acute stress. [ABSTRACT FROM AUTHOR]

Objective: The past decade has seen a rapid increase in the publication of studies using trajectory analysis to describe the course of osteoarthritis (OA) symptoms. The aim of this systematic review was to describe the distinct trajectories for OA outcomes and the predictors of these trajectories. Methods: Medline and PsycInfo databases were searched for relevant studies. Selection criteria were 1) patients ≥18 years of age, 2) patients at high risk of or diagnosed with knee or hip OA, 3) studies aiming to identify homogeneous subgroups with distinct trajectories of clinical outcomes, and 4) methodology and analysis designed to identify trajectories (longitudinal design and repeated measures). The search was limited to publications in English or French. Results: Of the 5,177 abstracts retrieved, 44 studies met the inclusion criteria; 21 described the disease progression before surgery. The most frequent outcomes were pain and physical function. Up to 6 trajectories of pain were found for hip and knee OA. For function, between 1 and 5 trajectories were identified for knee OA. Low educational level, high body mass index, and high number of comorbidities were the most reported predictors of bad evolution. Conclusion: Although studies were heterogeneous (outcome, subgroup number, and composition), they revealed stable OA trajectories over time. This finding suggests that OA is a chronic disease that does not inevitably worsen in terms of patient‐reported symptoms. [ABSTRACT FROM AUTHOR]

Objective: To review homogeneous subgroups with a distinct course of clinical outcomes, to review the course of clinical outcomes in the study population as a whole, where applicable, and to determine the patient characteristics associated with the distinct courses after total knee or hip arthroplasty. Methods: MEDLINE and PsycInfo databases were searched for relevant studies. Selection criteria were patients ≥18 years old, patients at high risk of or diagnosed with knee or hip osteoarthritis, studies aiming to identify homogeneous subgroups with distinct trajectories or describe the mean change of clinical outcomes, and methodology and analysis designed to identify trajectories (longitudinal design and repeated measures). Results: Of the 5,128 abstracts retrieved, 23 met inclusion criteria. Most studies (12 of 23) focused on the mean course of outcomes after knee arthroplasty, and the most frequent outcomes reported were pain and physical function. Statistical approaches used, the number of trajectories, and predictors identified were heterogeneous across studies. Strong evidence was found that female sex, a high body mass index, poor mental health, a high number of painful sites, high preoperative pain level, a low preoperative lower‐extremity functioning, and knee arthroplasty were predictors of bad evolution. Conclusion: Few studies have used trajectory analysis to describe the course of clinical outcomes in homogeneous subgroups of patients. Yet this approach could lead to the identification of predictors of poor postsurgery outcomes that are specific to patients and thus to earlier identification of poor responders to total arthroplasty. [ABSTRACT FROM AUTHOR]

Women with breast cancer are increasingly being cured of the disease but fatigue remains the most frequently reported symptom. The aims of our study were to identify distinct trajectories in four fatigue dimensions during 2 years after breast cancer surgery and to explore the demographic, clinical and personality characteristics associated with these profiles. We included women from the prospective longitudinal multicenter FATSEIN cohort in France. They completed the Multidimensional Fatigue Inventory for nine follow‐ups over 24 months after surgery. A group‐based trajectory model identified distinct trajectories in each fatigue dimension. Multinomial logistic regression determined the factors associated with each profile. From the 459 women followed, 3–5 fatigue trajectories were revealed in each fatigue dimension, from its absence to its severest degree. In our multivariate analysis, the risk of severe fatigue was decreased in all dimensions by a high quality of life before surgery (measured by the European Organization for Research and Treatment of Cancer 30‐item QoL questionnaire; e.g., for general and physical fatigue: OR = 0.93, 95% CI 0.91, 0.96), especially a high physical and emotional functions for general and physical fatigue, and a high cognitive function for mental fatigue. Both severe mental fatigue and severely reduced motivation worsened with low optimism before surgery (e.g., for mental fatigue: OR = 0.93, 95% CI 0.89, 0.97). Severely reduced activities increased by having chemotherapy (OR = 9.41, 95% CI 2.28, 38.79). Targeting women at risk for severe fatigue can provide early preventive and curative treatment and appropriate psychological support. What's new? Today breast cancer is increasingly being cured, but adverse effects persist, with fatigue being the most frequently reported symptom. In this longitudinal prospective study of long‐term, self‐reported fatigue trajectories of breast cancer survivors, fatigue increased after surgery, peaked at the end of chemotherapy, and then decreased up until 18 months before slightly rising again. The risk of severe fatigue was decreased by a high quality of life before surgery. Severe mental fatigue and severe reduced motivation both worsened with low optimism before surgery. The findings may help provide early preventive and curative treatment for women at risk for severe fatigue. [ABSTRACT FROM AUTHOR]

Obesity has been associated with an increased risk of developing acute myeloblastic leukaemia (AML). The outcome of AML patients could thus be dependent on their nutritional status that can be evaluated by the simple measurement of serum albumin (SA) and body mass index (BMI). These two parameters could have a value as prognostic factors to guide patients' management. We evaluated the association between SA levels, BMI, and survival, evaluated as overall survival (OS) and event-free survival. Furthermore, we investigated the association between BMI, SA, and other prognostic factors of interest in AML. This retrospective single-center study included 159 patients diagnosed with AML at Nancy Hospital between 2005 and 2013, treated with aracytine and anthracycline. Forty-four percent of patients presented with normal weight while 56% were obese/overweight. Serum albumin levels were <30 g/L for 49 patients, and ≥30 g/L for 110. Thirty-four patients with low SA levels were also obese. Favourable OS was associated with SA levels ≥30 g/L (HR = 0.467; 95% CI 0.230-0.946; P = .034) but was not impacted by the BMI. Serum albumin levels appear to be an independent prognostic factor in AML and a better parameter than BMI for evaluating the nutritional status of patients at diagnosis. [ABSTRACT FROM AUTHOR]

A systematic review of articles using qualitative methods to generate questionnaire items identified in MEDLINE and PsycINFO from 2000 to 2014 was carried out. Articles were analyzed for (a) year of publication and journal domain, (b) qualitative data collection methods, (c) method of data content analysis, (d) professional experts' input in item generation, and (e) debriefing of the newly developed items. In total, 371 articles were included and results showed (a) an acceleration of published articles, (b) individual interviews and focus groups were common ways of generating items and no emergent approach was identified, (c) the content analysis was usually not described (43% of articles), (d) experts were involved in eliciting concepts in less than a third of articles, (e) 61% of articles involved a step of further submission of newly developed items to the population of interest. This review showed an insufficient reporting of qualitative methods used to generate new questionnaires despite previous recommendations. [ABSTRACT FROM AUTHOR]

La littérature dans le champ des ACEs (Adverse Childhood Experiences) a permis, depuis l'étude princeps réalisée en 1998 par Felitti et son équipe, de rendre compte du lien entre le vécu d'adversité durant l'enfance et l'émergence de problématiques de santé à l'âge adulte. Cette relation entre l'histoire de vie et la santé s'appuie sur un modèle du risque cumulatif. Depuis, différents modèles ont été proposés, mais pour la plupart des études, le modèle cumulatif de l'adversité reste principalement considéré. Bien que pertinent, il présente des limites importantes qui doivent être prises en compte. Il apparaît donc essentiel de disposer d'un état des lieux des modèles existants dans la littérature en tenant compte de leurs intérêts et de leurs limites afin de mieux appréhender les relations entre adversité vécues durant l'enfance et santé à l'âge adulte. Au regard de ce constat, l'objectif de cet article est de dresser un état des lieux des modèles les plus pertinents dans la littérature afin d'en saisir l'importance pour la recherche dans le domaine. Enfin, nous mettrons en perspective les données de la littérature pour proposer le déploiement d'une recherche plus précise dans le champ des ACEs. The literature in the field of ACEs (Adverse Childhood Experiences) has, since the seminal study begun in 1998 by Felitti and his team, provided the link between childhood adversity and the emergence of health problems in adulthood. This relationship between life history and health is based on a cumulative risk model. Since then, different models have been proposed, but for most studies, the cumulative adversity model is the main one considered. This model, although relevant, has important limitations that must be taken into account. It therefore seems essential to take stock of the existing models in the literature in consideration of their interests and their limitations in order to better understand the relationship between adversity experienced during childhood and health in adulthood. The objective of this article is to provide an overview of the most relevant models in the literature so as to understand their importance for research in the field. Finally, we will put the data of the literature into perspective to propose the deployment of more precise research approaches in the field of ACEs. [ABSTRACT FROM AUTHOR]

Fatigue is the most prevalent symptom in breast cancer. It might be perceived differently among patients over time as a consequence of the differing patients' adaptation and psychological adjustment to their cancer experience which can be related to response shift ( RS). RS analyses can provide important insights on patients' adaptation to cancer but it is usually assumed that RS occurs in the same way in all individuals which is unrealistic. This study aimed to identify patients' subgroups in which different RS effects on self-reported fatigue could occur over time using a combination of methods for manifest and latent variables. The FATSEIN study comprised 466 breast cancer patients followed over a 2-year period. Fatigue was measured with the Multidimensional Fatigue Inventory questionnaire ( MFI-20) during 10 visits. A novel combination of Mixed Models, Growth Mixture Modeling, and Structural Equation Modeling was used to assess the occurrence of RS in fatigue changes to identify subgroups displaying different RS patterns over time. An increase in fatigue was evidenced over the 8-month follow-up, followed by a decrease between the 8- and 24-month. Four latent classes of patients were identified. Different RS patterns were detected in all latent classes between the inclusion and 8 months (last cycle of chemotherapy). No RS was evidenced between 8- and 24-month. Several RS effects were evidenced in different groups of patients. Women seemed to adapt differently to their treatment and breast cancer experience possibly indicating differing needs for medical/psychological support. [ABSTRACT FROM AUTHOR]

Introduction: Multimorbid chronic diseases are usually considered separately in trials. Here, we aimed to describe overall multimorbidity patterns in adults aged 55 years or older and assess their effect on health-related quality of life (HRQoL). Methods: We used data for 5,647 participants included in the SUpplémentation en VItamines et Minéraux AntioXydants 2 (SU.VI.MAX 2) population-based trial. HRQoL was assessed by the French versions of the Medical Outcome Study Short Form 36 and the Duke Health Profile. An exploratory factor analysis was used to determine multimorbidity patterns, and a multimorbidity score for each resulting pattern was calculated. Adjusted multiple linear regression was used to examine the association between the identified multimorbidity and HRQoL scores by gender and for each age group (55–59, 60–64, 65–69, ≥ 70 years). Results: More than 63% of the sample reported two or more chronic conditions (from 55.8% for those 55–59 years to 74.4% for those ≥ 70 years). Multimorbidity was more common among women than men (67.3% vs 60%). Two different multimorbidity patterns were identified. Pattern A was represented mainly by mental illness and bone impairments. Pattern B was represented mainly by cardiovascular and metabolic disorders. After adjusting for covariates, a high pattern A score was associated with reduced HRQoL for the physical and mental components of each HRQoL questionnaire, and a high pattern B score was associated with reduced HRQoL for only the physical component of each questionnaire. These multimorbidity scores affected HRQoL differently by age group. Conclusion: Our study used a novel methodological approach to account for multimorbidity patterns in determining the link with chronic conditions. These multimorbidity scores (counted and weighted) can be used in clinical research to control for the effect of multimorbidity on patients’ HRQoL and may be useful for clinical practice. Clinical Trial Registration: Clinicaltrial.gov (number ). [ABSTRACT FROM AUTHOR]

This randomized controlled trial study aims to investigate the efficacy of an early psychological intervention called EMDR-RE compared to Critical Incident Stress Debriefing on 60 victims of workplace violence, which were divided into three groups: ‘EMDR-RE’ (n = 19), ‘CISD’ (n = 23), and ‘delayed EMDR-RE’ (n = 18). EMDR-RE and CISD took place 48 hours after the event, whilst third intervention was delayed by an additional 48 hours. Results showed that after 3 months PCLS and SUDS scores were significantly lower with EMDR-RE and delayed EMDR-RE compared to CISD. After 48 hours and 3 months, none of the EMDR-RE-treated victims showed PTSD symptoms. [ABSTRACT FROM AUTHOR]

Background: This study describes the effect of TG4010 vaccine on Health related Quality of Life (HRQOL) in patients with stage IIIb and IV non–small-cell lung cancer (NSCLC). Methods: 148 patients with advanced NSCLC expressing MUC1 were randomly assigned to receive TG4010 plus chemotherapy or chemotherapy alone. HRQOL was assessed with the Functional Assessment of Cancer Therapy-Lung (FACT-L) at baseline and every 6 weeks until disease progression. Time until definitive deterioration (TUDD) of the four well-being dimensions of the FACT-L physical (PWB), functional (FWB), emotional (EWB) and social well-being (SWB) and the Lung Cancer Subscale (LCS) domains were analyzed for a 5-point minimal clinically important difference. Results: No difference of TUDD of HRQOL has been found between treatment arms. No prognostic factors have been found to have a significant impact on the TUDD of PWB, SWB and LCS domains. The gender, the performance status and the smoking habits seemed to be associated with a shorter TUDD of EWB domain. The smokers and the former smokers seemed to present a shorter TUDD of FWB domain. Conclusion: This study suggests that adding therapeutic vaccination with TG4010 to standard chemotherapy in patients with advanced NSCLC is associated with a similar evolution in HRQOL compared to chemotherapy alone. [ABSTRACT FROM AUTHOR]

Purpose. Fatigue is one of the most frequent symptoms in patients with cancer. However, the precise determinants of fatigue are still unknown. This study was conducted to investigate factors correlated with cancer-related fatigue before surgery and just before subsequent adjuvant therapy. Methods. Patients completed the Multidimensional Fatigue Inventory (MFI-20), the European Organization for Research and Treatment of Cancer 30-item quality-of-life questionnaire before and after surgery, the Trait Anxiety Inventory and the Life Orientation Test before surgery, and the State Anxiety Inventory before the start of adjuvant therapy. Multiple regression analysis of determinants of change in MFI-20 total score after surgery was conducted. Results. A series of 466 eligible patients with stage I-III breast cancer with planned surgery were recruited. An increase in MFI-20 total score after surgery was significantly correlated with higher preoperative fatigue and lower role functioning before surgery; a decrease in role functioning, physical functioning, and cognitive functioning after surgery; an increase in insomnia after surgery; and a higher state anxiety after surgery. Disease stage, lymph node metastases, surgical procedure, and demographic characteristics (e.g., age, marital status, having children, educational level) were not correlated with fatigue in multivariate analysis. Conclusion. These results suggest that worsening fatigue after surgery for breast cancer is associated with a decrease in physical functioning and an increase in psychological distress rather than with the cancer characteristics. Therefore, screening measures should be implemented at the time of diagnosis--before starting treatment--to identify psychologically vulnerable patients and to offer them professional support. [ABSTRACT FROM AUTHOR]

Le vécu d'ACEs (Adverse Childhood Experiences) est à ce jour considéré comme un déterminant majeur dans la survenue à l'âge adulte de problématiques de santé physiques et psychologiques. Malgré le caractère prolifique de ce domaine de recherche, un certain nombre de flous conceptuels subsistent, dont témoignent notamment l'absence de définition claire des ACEs ou encore leur appellation dans la littérature. Cette faiblesse conceptuelle a des conséquences pour l'étude, non seulement de la gamme d'adversités à considérer et les paramètres à prendre compte (i.e., gravité, temporalité, durée), mais aussi en ce qui concerne les dysfonctionnements qui découlent de cette adversité. Au-delà de l'impact sur la compréhension de ce qu'est ou n'est pas un vécu d'adversité, ces flous rendent particulièrement délicats son évaluation, le recueil de données sur la base de critères suffisamment homogènes, ainsi que l'espoir d'une prévention efficiente. En effet, si l'on veut agir sur les maux de l'adversité, il convient de circonscrire l'objet pour mieux comprendre ses modalités d'expression, ses déterminants et ses conséquences sur la santé. L'objectif de cet article sera de proposer un état des lieux des différentes compréhensions de l'adversité pour clarifier ce concept. Dans le cadre de ce travail, nous avons souhaité nous focaliser sur deux axes principaux, le premier relatif à l'identification du contexte d'émergence des travaux sur les ACEs et le second qui concernera la question au combien crucial de leur conceptualisation. Adverse childhood experiences (ACEs) have been consistently linked with negative physical and mental health outcomes in adulthood. Despite decades of research dedicated this phenomenon, certain inconsistency exists in the literature regarding how ACEs are conceptually defined. This lack of clarification can impact study outcomes, not only in terms of the range of adversities to be considered and parameters to account for (i.e., severity, temporality, duration), but also with regard to the nature of dysfunctions that result from ACEs. Beyond impacting our overall understanding of what adverse experiences encompass, this obscurity concerning their operational definition complicates how they are assessed, the process of collecting data based on homogeneous criteria and ultimately can hinder effective prevention. Indeed, any meaningful advancement towards treating illness associated with ACEs will require more rigorous definition of ACEs to better understand how they manifest and their specific impact on health outcomes. Our objective in this article is to propose a comprehensive inventory of existing definitions of adversity with a view to clarifying this concept. Within the framework of that objective, we focused on two principal axes: the context of the emerging work on ACEs and the critical question of how ACEs are conceptually defined. [ABSTRACT FROM AUTHOR]

Introduction: Even if indications for mastectomy have been progressively reduced in loco-regional breast cancer (BC) treatment, the harmful effects of surgery are still numerous and can impact physical and psychological wellbeing of women. The RIPOSTE (Reconstruction, self-Image, Posture, Oncology, "Santé"-Health, Therapy, "Escrime"-Fencing) program aimed to propose adapted fencing to patients with BC. This study aims to investigate the effect and conditions of effectiveness of the RIPOSTE program., Methods and Analysis: This is a prospective randomized controlled trial including 24 patients with invasive BC who have just undergone surgery. The study will be proposed to the patient and if interested, the patient will be referred to a sports physician for a medico-sportive evaluation. At the end the evaluation, if the patient meets the inclusion criteria, she will be randomly assigned to one of the 2 groups based on a 1:1 principle: Early RIPOSTE group (receive one fencing session per week for 3 months immediately after their inclusion), Delayed RIPOSTE group (receive one fencing session per week for 3 months but within the 3 months following their inclusion). Patients will be included for 6 months with 3 follow-up times (0, 3, and 6 months) by a sport physician. The primary outcome is the evolution of quality of life score. Secondary outcomes are disability score, fatigue, anxiety-depression, cost-effectiveness and process evaluation., Ethics and Dissemination: The study protocol has been approved by a French ethics committee (CPP Sud Méditerranée IV, N°ID-RCB: 2020-A01916-33). Results will be submitted for publication, at scientific conferences and through press releases., Trial Registration: NCT04627714., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Omorou, Peiffert, Rotonda, Van Hoye, Allado, Hily, Temperelli, Chenuel, Hornus-Dragne and Poussel.)

Objectives: The aims of this study were to identify homogeneous subgroups of knee and/or hip OA patients with distinct trajectories of the combination of pain and physical function (PF) over time and to determine the baseline factors associated with these trajectories., Methods: We used data from the Knee and Hip Osteoarthritis Long-term Assessment (KHOALA) cohort, a French population-based cohort of 878 patients with symptomatic knee and/or hip OA. Pain and PF were measured annually over 5 years with the Medical Outcomes Study Short Form 36 questionnaire. First, trajectory models were estimated with varying numbers of groups for each of the outcomes separately then fitted into a multi-trajectory model. We used multinomial logistic regression to determine the baseline characteristics associated with each trajectory., Results: Univariate four-class models were identified as most appropriate for pain and PF. Comparison of separate trajectories showed that 41% of patients included in the severe functional limitations trajectory did not belong to the more severe pain trajectory (Cramér's V statistic = 0.45). Group-based multi-trajectory modelling revealed four distinct trajectories of pain and PF. On multivariate analyses, female sex, older age, high Kellgren grade, low physical activity intensity, low psychosocial distress score (high distress) and low vitality score were associated with the more severe symptoms trajectory., Conclusion: Over 5 years, we identified four distinct trajectories combining pain and PF. Management of weight, fatigue and psychosocial distress and the practice of physical activity seem important to maintain function and limit pain in patients with lower-limb OA., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: The aim of this study was to compare the responsiveness of the European Organization for Research and Treatment (EORTC) quality of life questionnaires (QLQ-C30, QLQ-CR38) and the Functional Assessment of Cancer Therapy-colorectal version 4 questionnaire (FACT-C)., Method: This prospective study included 127 patients with colorectal cancer: 71 undergoing chemotherapy and 56 radiation therapy. Responsiveness statistics included the Standardized Response Mean (SRM) and the Effect Size (ES). The patient's overall assessment of his/her change in state of health status was the reference criterion to evaluate the responsiveness of the QoL questionnaires., Results: 34 patients perceived their health as stable and 17 as improved between the first and the fourth courses of chemotherapy. 21 patients perceived their health as stable and 22 as improved between before and the last week of radiotherapy.The responsiveness of the 3 questionnaires differed according to treatments. The EORTC QLQ-C30 questionnaire was more responsive in patients receiving chemotherapy, particulary functional scales (SRM > 0.55). The QLQ-CR38 and the FACT-C questionnaires provided little clinically relevant information during chemotherapy or radiotherapy., Conclusion: The EORTC QLQ-C30 questionnaire appears to be more responsive in patients receiving chemotherapy.