Search

Introduction: Risk factors and cardiovascular diseases are overrepresented in people with severe and persistent mental disorders. A person diagnosed with schizophrenia or bipolar disorder is two to three times more likely to die of cardiovascular disease than the general population., Purpose of Research: An empowerment program has been co-created to reduce these health inequalities. It is one part of the COPsyCAT project. The people-centered approach has been used. The participation of the patients, caregivers, and health professionals was decisive., Results: Stakeholders redefined the objectives of the program. The aim is to improve quality of life, rather than reducing cardiovascular risk. Existing tools -that have been evaluated for their usability - were selected to allow for self-directed patient orientation, so that the constraints between psychiatry and primary care could be circumvented. The program is based on the pooling of existing resources in a territory. The individual power of action and the organization of healthy offers are thus designed to reinforce each other., Conclusions: This article concretely describes the steps through to which the COPsyCAT empowerment program was designed, in co-construction by the researchers of the study, the users and user associations and healthcare professionals at based on their experiential knowledge. The feasibility of the program and the appropriation of tools in real situations will soon be evaluated. The measure of the program’s effectiveness on cardiovascular risk will come in second time.

Introduction: The environment and living conditions of parents during the "first 1000 days" period influence the short- and long-term health trajectories of children. Professionals following pregnancies play an important role in advising future parents to adopt health-promoting behaviors. It appeared necessary to describe the prevention messages transmitted by professionals early in pregnancy., Objectives: To identify the prevention messages systematically delivered during the first trimester of pregnancy and determine the degree of priority that professionals (midwives, obstetricians, general practitioners) of Bourgogne-Franche-Comté give to them., Results: Prevention messages on infectious risk were addressed by 96.5% of respondents, and those on risk behaviors and addictions by 93.7%. Dietary balance and sports activities (78.5%), as well as risks in the daily life (47.1%) were less delivered. The messages that professionals declared to be delivered systematically to pregnant women during the first trimester were generally those that they considered to be priorities. There were some differences depending on the professional. Regarding information media, the majority of respondents did not use any. They agreed on the importance of a paper-based information medium and wished to be able to rely on a digital medium (62.6%)., Conclusion: The co-construction of support that meets the needs of both women and professionals and that is validated by health authorities would contribute to better consideration and promotion of health-promoting behaviors by parents, by promoting empowerment of women and couples from the beginning of pregnancy.

Introduction: Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study., Patients and Method: The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia., Results: Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one’s health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant., Conclusion: An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.

The aim of this paper is to carry out a survey and comparative analysis of social representations of physical activity and fruit and vegetables in a sample of young, adult and elderly subjects. Four "urban" areas and four "rural" areas were selected for the purposes of the investigation. The samples used to assess social representations of fruit and vegetables and physical activity included 132 and 153 participants respectively. Verbal association was used and a factorial correspondence analysis was applied to the data. The prevention messages delivered as part of the second national program of nutrition and health were integrated by adult participants. A very limited awareness of the benefits of eating fruit and vegetable was observed in the young population. This study underlines the importance of implementing regular measures for the purposes of qualitative local evaluations that consider the specific characteristics of every age group in order to assess the psychological impact of prevention campaigns.

The aim of this study was to evaluate the working conditions of employees in a local council as well as their possible relationships to health, particularly to psychosocial risks--an emerging occupational risk which causes physical and mental illness. Between November 2004 and October 2005, 919 employees were asked to fill out a self-administered questionnaire about their working conditions, their self-perceived health status, and sociodemographic characteristics. The exposure to psychosocial risk (job strain) was evaluated using the Job Content Questionnaire developed by Karasek. A total of 625 employees responded to the survey (participation rate = 68%). Their self-perceived health status was good overall, but the prevalence of job strain reached 22%, and was associated with an accrued frequency of work dissatisfaction, strong perception of stressful work and the desire and intent to change job positions.

The evaluation of needs and means concerning the care of patients in palliative treatment is among the problems seen as priority by the High Committee for Public Health. We have thus tried to characterise, in a specific health sector, the patients receiving palliative care in short-stay establishments in order to evaluate their care needs. We carried out an exhaustive descriptive survey among all public and private short-stay establishments in the Côte d'Or region. Of the 2116 patients in the hospital on the day of the survey, roughly 30% were considered as eligible for palliative care (patients suffering from serious, chronic and progressive illnesses). The average age of these patients is 63.9 years (standard deviation 19.7). They mainly suffer from tumours (50%), circulatory pathologies (15%), mental illness (7%), or neurological illnesses (6%). Among the patients that may need palliative care, 38% say they feel pain despite treatment with pain-killers among 25.3% of them. The personnel providing care is insufficiently trained in palliative care or in pain, as only a maximum of 18% of nurses and 5% of doctors in short-stay establishments have been trained in these areas.

The law, edicted on the 27th june 1990, has introduced in France the without consent hospitalization, to replace the law of 30th june 1838 which was composed of confinements or psychiatric placings. On of the both new types of a without consent admission, called "by a third person request" hospitalization (HDT) containing a procedure called "usual" and another one called "situation emergency", appeared to us more and more used in our practice, particularly the "situation emergency" HDT. Therefore we compared on three periods, one before the law, the two others ones 3 and 6 years after it, the different types of psychiatric admissions in all of the seven psychiatric sectors of a french department. All the hospitalization's forms increase with the chronologic time in Côte d'Or. We notice too in this department an important increase of the HDT, but especially in the "situation emergency" ones, and this, with a statistically revealing way compared to the other types of admission. If this phenomena wasn't purely localized, which only the departmental commissions of psychiatric hospitalization, created by the 1990's law, can reveal by proceeding to an expected assessment of the law consequences, the legislator should fastly take this evolution into account.

Background: Unbiased and reliable data are presently required for health planning concerning end stage renal diseases (ESRD) in Languedoc-Roussillon region of France., Methods: A comprehensive retrospective study has been carried out on patients with ESRD in 1994 in this area. Information was collected from medical and social documents by physicians. The present report describes the management of patients and their demographic and epidemiologic characteristics. Multiple correspondence analysis was carried out to estimate to what extent mode of renal replacement therapy is determined by patient characteristics., Results: An incidence of 11.4 for new cases of renal replacement therapy was found per 100,000 inhabitants. This represents an increase of 4.8% in the total number of patients. The patients were found to be elderly (25% being over 72 years) and to present with multiple pathologies (32.5% severe cardiac pathology; 20.7% arteritis of the lower limbs; 15.1% diabetes; 11.2% manifesting malignant tumors). Only 57.5% received dialysis within a hospital setting; 30.1% received dialysis at home; 13% perform autodialysis; 1.2% were being trained for home dialysis in December. The renal transplantation rate was 5.5%. No significant relationship was found between choice of therapy and age, renal disease, comorbidities and place of dwelling., Conclusions: This study demonstrates the great variety in the modes of treatment used, the facilities provided and the evolutive trend, which together make programming planning difficult.

Two cross-sectional studies were performed on probabilistic samples in the Hérault "département"--respectively in 1987-1988 on children born in 1983 and in 1992-1993 on children born in 1988--to measure the evolution of the prevalence of obesity. A greater proportion of high weight for height (Z score of 1.0 and more, international reference population) has been observed in comparison with the first year. A major increase in the prevalence of obesity (setting a Z score of 2 as limit) has been recorded between the two periods (odds ratio = 2.51 (1.57 to 4.02)). It cannot be explained by structural changes of the population as regards factors known to be associated with obesity (urbanization, mother's occupation, family composition, social status, unemployment, distribution according to the country of origin). The possible influence of changes in the way of life is discussed in relation with the literature. This first representative sample study confirms--at least for the district studied--the findings in various populations, suggesting that the prevalence of obesity is increasing in France. The causes of this phenomenon remain to be defined.