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Background: One of the most consistent findings reported in the paediatric cochlear implant (CI) literature is the heterogeneity of language performance observed more in grammatical morphology than in lexicon or pragmatics. As most of the corpus studies addressing these issues have been conducted in English, it is unclear whether their results can be generalized to other languages. In particular, little is known about languages known for their grammatical complexity, such as French. Aims: The aim of this corpus study was to compare the productive use of function words (FWs) and some agreement features (AGRs) in children with CIs and children with typical development (TD) matched for mean length of utterance in words (MLUwords), a general index of grammatical complexity, and auditory experience, as measured by hearing age (HA) and chronological age (CA), respectively. Methods & Procedures: Natural speech samples from 116 monolingual French‐speaking children, including 40 children with CIs followed longitudinally and 76 TD children, were collected. FWs and AGRs were analysed using a Part of Speech Tagger (POS‐T) from the Child Language Data Exchange System (CHILDES). Outcomes & Results: The two groups differed by 3 years for HA and CA. No effect of family socio‐economic status (SES) was found in the CI group. Stepwise regression analyses showed that the two groups did not share the same predictors of MLUwords: plurals and determiners predicted MLUwords in children with CIs, at 2 and 3 years of HA, whereas feminine markers and subject‐pronouns were found to best predict MLUwords in TD children at 2 and 3 years of CA. Structural equation models (SEMs), a combination of confirmatory factor analysis (CFA) and path analysis, yielded a different hierarchical structure of grammatical relations (GRs). Selective difficulties affecting verbal clitics and other pronominal forms were found specifically in the CI group (object‐pronouns, reflexive, relative and past participles). Dependency grammar analysis confirmed these contrasting developmental profiles in multiword utterances, such as preposition/nouns, subject/verbs, and verb/determiner/nouns. Conclusions & Implications: Atypical grammatical patterns in children with CIs reflect a specific architecture of syntactic dependencies of FWs underpinning morphological complexity and syntactic connectivity. Clinical implications are discussed for assessment and intervention planning. What This Paper Adds: What is already known on this subject: The productive use of FWs has been identified as a particular area of weakness in children with CIs compared with TD children. In addition, heterogenous grammatical performance has often been found after 1–3 years of CI use, regardless of demographic factors such as age at implantation, duration of deafness or SES. What this paper adds to existing knowledge: Assessing the early building of FWs and AGRs in children with CIs helps to understand the syntactic complexity and hierarchical structure of their language. Since most corpus studies on grammatical morphology have been conducted in English, it is not clear whether their difficulties can be generalized to other languages. The French language has a system of FWs and inflections that determine the morphophonological properties of nominal and verbal forms. Early grammar learning in children with CIs born with profound deafness were compared with the two groups of TD children matched both for duration of auditory experience (i.e., HA of CI children, CA of TD children) and for MLUwords. We found a similar profile between groups at 2 years but not at 3 years for HA and CA. The two groups do not share the same predictors of MLUwords: namely, plurals and determiners for CI children versus feminine markers and subject pronouns for TD children. They show a different syntactic organization of GRs. Children with CIs struggle with selective difficulties affecting verbal clitics and pronominal forms (object‐pronouns, reflexive, relative and past participles). Consistent with theories of morphophonological richness and syntactic connectivity, our results support the distributional learning hypothesis of language acquisition that infants and toddlers are sensitive to FWs and AGRs at an early age. Specific components of syntactic organization are disrupted in children with CIs. What are the potential or actual clinical implications of this work?: This work has potential clinical implications because it unravels the limitations of morphophonological processing in children with CIs. Its results highlight a specific difficulty in learning FWs and AGRs in a verbal inflectional morphology context. [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]

This paper assesses the impact of eligibility for a free means-tested complementary health insurance plan, called Couverture Maladie Universelle Complémentaire (CMUC), on doctor visits. We use information on the selection rule to qualify for the plan to identify the effect of eligibility and adopt a regression discontinuity approach. Our sample consists of low-income individuals enrolled in the Health Insurance Fund and recipients of social benefits from the Family Allowance Fund of an urban area in Northern France. Our findings do not show significant impacts of the CMUC threshold on the number of doctor visits within the full sample. Among the subsample of adults under 30 years old, however, eligible individuals are more likely to see a specialist and have, on average, significantly more specialist visits than non-eligible individuals. This specific impact of the CMUC cut-off point among young adults may be explained by the fact that young adults are less likely to be covered by a complementary health insurance plan when they are not recipients of the CMUC plan. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd. [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]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper presents a comparative critique of the 'processual temporalities' which infuse both social-scientific theorizing and selected Western cultural practices. Through study of a public-private partnership which emerged from a biotechnology project devised for producing 'self-cloning' maize for resource-poor farmers, I analyse how processual temporalities were central to re-gearing knowledge practices towards market-orientated solutions. In a study of characterizations of the 'state of flux' which affects life in a French peri-urban village, I explore how processualism is identified as a component of a metropolitan hegemony which villagers 'resist' through idealizing 'enduring temporalities' of cultural practice. Drawing on Arendt and Deleuze, I analyse processualism as a dominant contemporary chronotope, mediating and disciplining conflictive temporalities and practices, underwriting economic projects of deterritorialization and restructuring - whose idiom is also prominent in social-scientific paradigms. I substitute an 'immanent anthropology', which advocates a non-transcendental ontology of cultural practice and analysis - displacing anthropological analysis onto a polychronic temporal foundation. [ABSTRACT FROM AUTHOR]

Electoral and census data from Great Britain and France are used in a comparative analysis of the levels and determinants of local election turnout in the two countries. First, nine simple propositions about variations in turnout are tested using as similar as possible variables for each country. These variables are then used as the bases for multi-variate regression analyses. The residual cases in each country are compared in order to explore the more qualitative factors which may explain why some localities have a level of participation so much above or below that expected statistically. The paper ends with an attempt to specify an explanatory model of local electoral turnout applicable to both countries. [ABSTRACT FROM AUTHOR]

This paper discusses the emergence of management education and training in the UK, France, Germany, USA, Japan, USSR, and China. It argues that given kinds of environmental changes may lead to a wide variety of training responses, depending on the industrial and cultural contexts in which they take place. [ABSTRACT FROM AUTHOR]

Borderline Personality Disorder (BPD) is labeled as a personality disorder with impulsivity issues regarding relationships, risky behavior, and emotional dysregulation. This personality disorder is still considered to be hard‐to‐treat condition even though responses to treatment have improved significantly. In this field, Dialectical Behavioral Therapy is recognized as one of the most efficient therapeutical approaches, and some versions adapted from this gold‐standard treatment proved their effectiveness in clinical settings. We tested the 6‐month cognitive behavioral therapy (CBT) protocol ECCCLORE, composed of three modules, respectively, working on emotional regulation, distress tolerance, and relationships—in a French context to compare its effectiveness to Treatment As Usual. We recruited 56 patients with a BPD diagnosis in a day‐care unit, 34 receiving ECCCLORE and 22 receiving TAU. We assessed BPD traits, impulsivity, aggressiveness, suicidal risk, and hopelessness. Our results revealed the effectiveness of the 6‐month ECCCLORE protocol to decrease BPD symptoms and associated clinical dimensions. We also noted the persistence of its effect after a 1‐year follow‐up. Shortened CBT treatment protocols tend to prove their efficiency for symptom reduction in BPD. Further research is needed to replicate these results. [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]

The article describes the attempt to include the intensityscale technique introduced by Casati et al. 2004 into a set of standardized verifications used in operational centres. The intensityscale verification approach accounts for the spatial structure of the forecast field and allows the skill to be diagnosed as a function of the scale of the forecast error and intensity of the precipitation events. The intensityscale method has been used to verify two different resolutions of the European Centre for MediumRange Weather Forecasts ECMWF operational quantitative precipitation forecast QPF over France, and to compare the performance of the ECMWF and the Hungarian Meteorological Service operational model ALADIN forecasts, run over Hungary. Two case studies have been introduced, which show some interesting insight into the spatial scale of the error. The distribution of daily skill score for an extended period of time is also presented. The intensityscale technique shows that the forecasts in general exhibit better skill for largescale events, and lower skill for smallscale and intense events. In the paper, it is mentioned how some of the stringent assumptions on the domain over which the method can be applied, and the availability of the matched forecasts and observations, can limit its usability in an operational environment. Copyright © 2008 Royal Meteorological Society [ABSTRACT FROM AUTHOR]

Aim: Although well documented in randomised trials, the efficacy of prophylaxis against respiratory syncytial virus (RSV) in real-word conditions is less studied. The objective was to assess the impact of partial versus full RSV prophylaxis for acute respiratory infections (ARIs) and ARI-related hospital admissions in preterm children.Methods: This study included children born preterm in 2011 in France who were eligible for RSV prophylaxis and received at least one palivizumab dose from October 2011 to March 2012. Full prophylaxis was defined as receiving at least one palivizumab dose for each month of RSV exposure in the community. Children with full and partial prophylaxis were matched, and odds of ARIs and ARI-related hospital admission were compared by logistic regression.Results: Full prophylaxis concerned 861/1083 (80%) children. As compared with full prophylaxis, partial prophylaxis was not associated with ARI occurrence (odds ratio OR 1.3, 95% confidence interval CI 0.9-1.9) but was significantly associated with ARI-related hospital admission during the RSV epidemic (OR 1.9, 95% CI 1.2-2.9).Conclusion: During the 2011-2012 RSV epidemic, hospital admission rates were higher for preterm children with partial than full RSV prophylaxis. Improving compliance could help alleviate the burden of RSV on healthcare systems. [ABSTRACT FROM AUTHOR]

Aim: To describe maternal employment and the socio-economic status of the household up to 8 years after the very preterm birth of a child, according to the presence and type of motor or cognitive impairment.Method: A total of 1885 families from the French EPIPAGE cohort of children who were born very preterm between 1997 and 1998 were included. Motor and cognitive impairments were identified in children between the ages of 2 and 8 years in 770 families and were classified according to type. The 1115 families with children born very preterm without these impairments were considered the reference group.Results: Mothers of children with severe motor or cognitive impairments were less often working at 5 years after the birth than the reference mothers (21% and 30% vs 57%; p<0.001). Those working before birth returned to work less often and those not working started to work less often after the birth than did reference mothers. At 8 years, mothers of children with severe impairments reported financial difficulties more often than mothers of children without impairments.Interpretation: Despite a fairly protective regulatory framework in France, families of infants born very preterm with severe motor or cognitive impairments are socially underprivileged. Measures to maintain an acceptable standard of living for these families and their children are needed. [ABSTRACT FROM AUTHOR]

The aim of this study was to document the extent to which diabetic patients who adhered to required medical follow-ups in France experienced reduced hospital admissions over time. The main assumption was that enhanced monitoring and follow-up of diabetic patients in the primary care setting could be a substitute for hospital use. Using longitudinal claim data of diabetic patients between 2010 and 2015 from MGEN, a leading mutuelle insurance company in France, we estimated a dynamic logit model with lagged measures of the quality of adherence to eight medical follow-up recommendations. This model allowed us to disentangle follow-up care in hospitals from other forms of inpatient care that could occur simultaneously. We found that a higher adherence to medical guidance is associated with a lower probability of hospitalization and that the take-up of each of the eight recommendations may help reduce the rates of hospital admission. The reasons for the variation in patient adherence and implications for health policy are discussed. [ABSTRACT FROM AUTHOR]

Background: Blood donor selection, consisting of a pre-donation questionnaire and interview, excludes potential donors who may be at risk of transfusion-transmissible infections. Assessing the reasons for noncompliance with blood donor selection criteria is important to maintain a high level of viral safety of blood products.Study Design and Methods: An anonymous French online survey of a sample of blood donors (Complidon) was conducted from September to December 2017. Data were poststratified to be representative of all donors who donated blood between July 2016 and December 2017.Results: Of 420,190 solicited donors, 108,386 completed the survey (26%). Overall, noncompliance was estimated at 5.6%. The least respected criteria regarded sex with more than one partner during the previous 4 months for donors (1.9%) and for donors' partners (1%), travel-related criteria (1.2%) and sex between men during the previous 12 months (0.73% of men). Reasons for noncompliance differed according to criteria. Donors who were non-compliant to sexuality-based criteria mainly said they did not want to be excluded or that the questions were too personal. Conversely, donors who were exclusively non-compliant to criteria other than sexuality-based criteria more often mentioned their non-compliance during the pre-donation interview but were nevertheless authorized to donate blood.Conclusion: Despite noncompliance to blood donor criteria being relatively low in France, it still represents a threat to blood safety. Accordingly, improved communication is important to ensure that donors fully understand each selection criterion and to emphasize to health professionals the importance of listening carefully without judging during pre-donation interviews. [ABSTRACT FROM AUTHOR]

Background and Aims: Completely substituting e‐cigarettes (EC) for combustible tobacco cigarettes reduces exposure to toxicants and carcinogens. However, a large proportion of EC users (dual users) continue to smoke conventional cigarettes. This study aimed to compare estimated nicotine intake and e‐cigarette use characteristics between exclusive EC users and dual users. Design Web‐based anonymous cross‐sectional survey. Setting: France. Participants: A total of 3189 adults, current users of electronic cigarettes (EC). Data collection between 4 October 2014 and 11 November 2014. Measurements Primary outcome: estimated nicotine intake per day (mg) from participants' reports. Secondary outcomes: duration, frequency of EC use and nicotine content of e‐liquids used/day. Dual use was defined as using at least one cigarette per day while also using EC. Findings A total of 2836 respondents reported exclusive EC use and 353 reported being dual users. Backward stepwise logistic regression showed that dual users had higher estimated combined daily nicotine intake from e‐liquids and cigarettes [estimate: 2.14, standard error (SE) = 0.26, adjusted odds ratio (aOR) = 8.48, 95% confidence interval (CI) = 5.11–14.09, P < 0.001], but lower daily nicotine intake from EC (estimate: –2.14, SE = 0.26, aOR = 0.12, CI = 0.07–0.196, P < 0.001) and reported fewer months of EC use (estimate: −0.31, SE = 0.14, aOR = 0.73, CI = 0.56–0.95, P = 0.022) compared with exclusive EC users. Conclusion: Dual e‐cigarette users in France may have higher nicotine intake overall than exclusive e‐cigarette users, but they may take in less nicotine from their e‐cigarettes. [ABSTRACT FROM AUTHOR]

As other neurodegenerative diseases, Alzheimer's disease, the most frequent dementia in the elderly, is characterized by multiple progressive impairments in the brain structure and in clinical functions such as cognitive functioning and functional disability. Until recently, these components were mostly studied independently because no joint model for multivariate longitudinal data and time to event was available in the statistical community. Yet, these components are fundamentally interrelated in the degradation process toward dementia and should be analyzed together. We thus propose a joint model to simultaneously describe the dynamics of multiple correlated components. Each component, defined as a latent process, is measured by one or several continuous markers (not necessarily Gaussian). Rather than considering the associated time to diagnosis as in standard joint models, we assume diagnosis corresponds to the passing above a covariate-specific threshold (to be estimated) of a pathological process that is modeled as a combination of the component-specific latent processes. This definition captures the clinical complexity of diagnoses such as dementia diagnosis but also benefits from simplifications for the computation of maximum likelihood estimates. We show that the model and estimation procedure can also handle competing clinical endpoints. The estimation procedure, implemented in an R package, is validated by simulations and the method is illustrated on a large French population-based cohort of cerebral aging in which we focused on the dynamics of three clinical manifestations and the associated risk of dementia and death before dementia. [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: While data from USA and Canada demonstrate an opioid overdose epidemic, very little nation-wide European studies have been published on this topical subject.Methods: Using a nationally representative sample of the French Claims database (>700,000 patients), the exhaustive nationwide hospital discharge database, and national mortality registry, all patients dispensed at least one prescription opioid (PO) in 2004-2017 were identified, to describe trends in PO analgesic use, shopping behaviour, opioid-related hospitalizations and deaths. Annual prevalence of PO use and shopping behaviour (≥1 day of overlapping prescriptions from ≥2 prescribers, dispensed by ≥3 pharmacies) was estimated.Results: In 2004-2017, the annual prevalence of weak opioid use codeine, tramadol and opium rose by 150%, 123%, and 244%, respectively (p < 0.05). Strong opioid use increased from 0.54% to 1.1% (+104%, p < 0.05), significantly for oxycodone (+1950%). Strong opioid use in chronic noncancer pain rose by 88% (p < 0.05) and 1180% for oxycodone. Opioid shopping increased from 0.50% to 0.67% (+34%, p < 0.05), associated with higher mortality risk HR = 2.8 [95% confidence interval (CI): 1.2-6.4]. Opioid-related hospitalizations increased from 15 to 40 per 1,000,000 population (+167%, 2000-2017), and opioid-related deaths from 1.3 to 3.2 per 1,000,000 population (+146%, 2000-2015).Conclusions: This study provided a first European approach to a nationwide estimation with complete access to several national registries. In 2004-2017 in France, PO use excluding dextropropoxyphene more than doubled. The increase in oxycodone and fentanyl use, and nontrivial increasing trend in opioid-related morbidity-mortality should prompt authorities to closely monitor PO consumption in order to prevent alarming increases in opioid-related morbidity-mortality.Significance: In 2004-2017, prescription opioid use in France at least doubled and oxycodone use increased particularly, associated with a nontrivial increase in opioid-related morbidity-mortality. Although giving no indication for an 'opioid epidemic,' these findings call for proper monitoring of opioid use. [ABSTRACT FROM AUTHOR]

The article refers to international accounting standards and the profits-measurement behavior in France, Germany, and Great Britain. The European Method of financial analysis involves a ratio of disclosed to adjusted profit, which is called the conservatism index. Problems with the European Method--from a security-analysis perspective--include taxation, intercountry accounting harmonization, international performance comparisons, and consolidation and inflation accounting policies. Statistics show the profits-measurement behavior for the period of 1972 to 1975, chi-square test results for France/Great Britain, Germany/Great Britain, and France/Germany, and the impact of differences in international accounting on profits.

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]

This study examines whether a terrorist attack in a developed country, which does not cause major damage to its capital stocks, affects the mental health of its residents. By exploiting variations in survey dates of the European Social Survey, we use a difference-in-differences strategy to show that the attack adversely affects subjective well-being and mental health measures of French respondents. These negative effects are stronger for immigrants and low-income individuals. The impact is less dramatic for politically extreme right-wing supporters. The distance from origin has little impact on these measures. [ABSTRACT FROM AUTHOR]

The asrticle discusses the study which aims to find the differences of the computed tomography (CT) scans between small malignant tumours and respiratory epithelial adenomatoid hamartomas (REAHs)of the olfactory cleft (OC) in 46 patients in University Hospital of Nancy in France. Topics mentioned include the retrospective chart analysis of patients from 2004-2005, the investigation on the bone erosion to differentiate the malignant tumours from REAH-OCs, and the use of Osirix software.

In theory, health care providers may adapt their professional behavior to the financial incentives resulting from their remuneration. Our research question is whether the users of health care services anticipate such behavior from their general practitioner (GP) and, if they do, what consequences such anticipation has on their preferences regarding financial incentives. Our theoretical model explains users' preferences for one or another incentives scheme, disentangling the financial motives (incentives amounts, wealth) from the behavioral ones (perceived GPs' sensitivity to incentives). We empirically test our theoretical predictions using data from a survey that elicits individual preferences for either patient or provider hypothetical incentives in France. The empirical results confirm the theoretical ones: users tend to prefer incentives to patients rather than to GPs when the amount of GP incentives is high, when the amount of patient incentives is low, when they anticipate that their GP's medical decisions are affected by financial incentives or when their wealth is high. Otherwise, they prefer their GP to face financial incentives. [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]

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Developmental Medicine & Child Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Socio-economic status is related to many life style and environmental factors, some of which have been suggested to influence the risk of childhood cancer. Studies requiring subject participation are usually hampered by selection of more educated parents. To prevent such bias, we used unselected nationwide Geographical Information System (GIS)-based registry data, to investigate the influence of socio-economic disparities on the risk of childhood cancer.Methods: The Geocap study included all French residents diagnosed with cancer aged up to 15 years over the period 2002-2010 (15 111 cases) and 45 000 contemporaneous controls representative of the childhood population. Area socio-economic characteristics used to calculate the European Deprivation Index (EDI) were based on census data collected on the fine scale of the Merged Islet for Statistical Information (IRIS).Results: Overall, the risk of acute lymphoblastic leukaemia (ALL) was lower in the most deprived quintile than in the other quintiles of EDI (ORQ5vsConclusion: Living in the most deprived areas was inversely associated with the risk of ALL in childhood. There was no indication that the risk of childhood cancer of any site could be increased by deprivation. Life style or environmental factors potentially underlying the association need further investigation. [ABSTRACT FROM AUTHOR]

Objective: To assess the prevalence and associations of renal dysfunction in patients with rheumatoid arthritis (RA).Methods: COMEDRA is a French nationwide cross-sectional multicenter study on comorbidities in RA. Renal function was assessed from the estimated glomerular filtration rate (eGFR), using the Modification of Diet in Renal Disease equation. RA characteristics and risk factors for renal impairment were collected. Two logistic regression models, 1 with and 1 without the Framingham Risk Score, were constructed from variables that were significantly associated with an eGFR of <60 ml/minute/1.73 m(2) or were clinically relevant.Results: Of the 970 recruited patients, 931 were analyzed (women 79.6%, mean age 57.8 years, disease duration 11.1 years, Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28-ESR] 3.1). A total of 82 patients (8.8%) had an eGFR <60 ml/minute/1.73 m(2) and 9% had proteinuria. In univariate analysis, renal impairment was associated with age (P < 0.001), history of hypertension (P < 0.001), high systolic blood pressure (P = 0.03), and the Systematic Coronary Risk Evaluation (SCORE) equation (P = 0.002), but not with sex, disease duration, disease activity (as assessed by DAS28-ESR), nonsteroidal antiinflammatory drug use, disease severity (erosions, joint replacement), or RA medications. Multivariate analysis models showed that age (odds ratio [OR] 1.05 [95% confidence interval (95% CI) 1.03-1.09]) and hypertension (OR 2.5 [95% CI 1.5-4.3]) were associated with renal impairment. A second model showed that the SCORE equation (OR 1.33 [95% CI 1.06-1.67]) was associated with renal impairment.Conclusion: Renal impairment is relatively common in RA and is associated with cardiovascular risk factors such as age, hypertension, and the SCORE equation but not with disease activity or severity. [ABSTRACT FROM AUTHOR]

Background: Red blood cell (RBC) storage lesions and RBCs from females transfused into male recipients may have adverse effects on transfusion recipients' survival. We hypothesized that the effect of donor sex and the effect of age of blood on mortality would be most apparent in cardiac surgery patients.Study Design and Methods: Using data from French Blood Services and two university hospitals, we conducted a retrospective cohort study on cardiac surgery patients whose first transfusion occurred between 2007 and 2011. The age of blood and donor sex effects on 1-year survival were studied using Cox regression modeling, with time-dependent stratification on the number of RBCs and adjustments for the type of surgery and other products transfused.Results: Among the 2715 cardiac surgery patients, 85.1% were alive after 1 year. Age of blood and donor sex were associated with survival before adjustments (p < 0.0001). However, the adjusted hazard ratios (HRs) for patients transfused with blood stored for 29 days or more versus 14 days or less were 0.97 (95% confidence interval [95% CI], 0.69-1.35; p = 0.98) and 1.22 (95% CI, 0.81-1.82) for patients who received only sex-mismatched RBCs versus all matched units (p = 0.27). For males transfused solely with female RBCs, the HR was 0.96 (95% CI, 0.57-1.61; p = 0.69); in females transfused only with male RBCs, it was 2.03 (95% CI, 0.87-4.73; p = 0.17).Conclusions: In this first study of survival after transfusion in France, there was no significant effect for age of blood or donor sex. Contrary to previously reported data, female RBCs appear to be safe for male recipients. [ABSTRACT FROM AUTHOR]

As nationally mixed people have parents born in different countries, they can potentially identify with multiple national reference groups, allowing the researcher to study national identification processes. The analysis of approximately one hundred people of nationally mixed background living in France, Germany, and the United Kingdom highlights different registers of identification. There are important differences in how nationally mixed people articulate them, which leads to the identification of different national repertoires of identification. In France, a strong French national identity was emphasized, whereas German national identity seems more fragile because it depends mainly on cultural socialization. In the United Kingdom, non-national identities are developed in a context where the national community is not clearly defined, while ethnicity is publicly recognized. The register and repertoire of identification concepts thus allow the researcher to analyse identity discourses and then explain national differences through international comparison. [ABSTRACT FROM AUTHOR]

This article aims to study consumer behaviour towards the paradoxes of Sustainable Food (SF). Consumers may perceive various paradoxes today affecting the sustainable marketing offer, e.g. the concept of the sustainable product, its environment and actors offering these products. Consequently, they cope with these perceptions through different strategies. By adapting Mick and Fournier's (1998) model to SF we investigate two main classes of coping mechanism: avoidance strategies and problem-solving strategies. In order to understand what consumers perceive and how they act in everyday life, we conducted semistructured interviews in two specific countries (France and Italy) using two different consumer profiles: 84 non-engaged individuals and 18 consumers who had already engaged in networks supporting local food purchases, such as members of the Association for the Preservation of Local Farming (AMAP) in France and the Solidarity Purchasing Groups (GAS) in Italy. Findings show different combinations of paradoxes and strategies between non-engaged French and Italian consumers. Their discourses highlight the influence of the context and cultural conditions of each country, whereas participants in AMAP and GAS seem to be similar when they evoke paradoxes and the way they act on the basis of a common culture. In conclusion, the article presents contributions to the conceptual framework, the model adaptation and discusses barriers to Sustainable Consumption (SC) in France and Italy. [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]

Context An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States' long-term care financing reform efforts. Methods We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. Findings France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income adjusted and amounts are low. Nevertheless, expenditures have exceeded projections, burdening local governments. Private supplemental insurance covers 11% of French, mostly middle-income adults (versus 3% of Americans 18 and older). Whether policyholders will maintain employer-sponsored coverage after retirement is not known. The government's interest in pursuing an explicit public/private partnership has waned under President François Hollande, a centrist socialist, in contrast to the previous center-right leader, President Nicolas Sarkozy, thereby reducing the prospects of a coordinated public/private strategy. Conclusions American private insurers are showing increasing interest in long-term care financing approaches that combine public and private elements. The French example shows how a simple, cheap, cash-based product can gain traction among middle-income individuals when offered by employers and combined with a steeply income-adjusted universal public program. The adequacy of such coverage, however, is a concern. [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]

Education is one major public service in which quasi-markets and other choice-based mechanisms are now established methods of delivery. The types of school people choose, and the extent to which their choices are realized, have a fundamental impact on the outcomes of any mechanism of school choice. In this article, we provide a comparative analysis of the school choice strategies of middle-class families in London and Paris. We draw on approximately 200 in-depth interviews carried out across the two cities. This enables us to investigate the extent to which middle-class school choice strategies transcend the institutional context provided by both the local (state and private) schools market and national education policy in England and France. We discuss these findings in the context of current school choice policy and consider their implications for future policy design. [ABSTRACT FROM AUTHOR]

Muslim immigrants to Europe display distinctive attitudes toward women in a wide range of survey data. This study investigates whether this translates into distinctive behavior. Relying on a dictator game in France and an identification strategy that isolates the effect of religion from typical confounds such as race, we compare the donations of matched Christian and Muslim immigrants and rooted French to in-group and out-group men vs. women. Our results indicate that Muslim immigrant participants deviate from Christian immigrant and rooted French participants in their behavior toward women: while the latter favor women over men, Muslim immigrants favor men over women. [ABSTRACT FROM AUTHOR]

The issue of identity spatialisation lies at the interface between classic theories of social identity in social psychology and the environmental psychology approach in terms of sociospatial identity. This study of adolescents and young adults aimed to identify the influence of belonging to a place on self-construction according to place of residence in France. Two regions were compared: (a) the French Basque region, where there is high cultural specificity; and (b) Bordeaux region, which is less culture-specific. Data were collected from 229 adolescents and young adults from these two regions. The feeling of belonging to a region, sociospatial identity, and social identity were estimated using self-report questionnaires. Results demonstrate the existence of several forms of sociospatial identity. Basques tended to overinvest on the regional level-especially when they spoke the Basque language (Euskara)-whereas the sociospatial identity of Bordeaux inhabitants was multi-level. Furthermore, the expression of sociospatial identity was age-dependent. These findings help to define, measure, and interpret the processes and dynamics of identity associated with belonging to different territories. [ABSTRACT FROM AUTHOR]

Background The present study was aimed at investigating the selection of landmarks by individuals with intellectual disability (ID). The hypothesis was that they would be less efficient than individuals without IDs in the selection of landmarks when learning a new route. Methods The experiment took place in a natural setting with a group of participants with ID and a group of control participants matched by chronological age. The participants were first guided along a route situated in an unfamiliar district. Then, they had to guide the experimenter along the route while pointing to all the objects and features they found useful for wayfinding. Results The designated objects were categorised as a function of their landmarks properties. There were significant differences between the two groups for non-permanent landmarks, distant landmarks and non-unique landmarks. The two groups selected landmarks near intersections in the same proportions. However, the individuals with ID selected more non-unique landmarks and less textual signage than the control group at these decision points. Conclusion Individuals with ID seem to be less efficient than individuals without disability in landmark selection. This may limit their wayfinding abilities in their day-to-day travelling. This may also account for their difficulties in obtaining the kind of spatial knowledge which relates to the configural structure of their environment. [ABSTRACT FROM AUTHOR]

Objectives To compare the prevalence of periodontal disease between two randomly selected population-based studies (the Oral Infections and Vascular Disease Epidemiology Study ( INVEST) and the Study of Health in Pomerania ( SHIP)) and address relevant methodological issues. Methods Comparison was restricted to 55- to 81-year olds. Attachment loss ( AL), probing depth ( PD) and tooth count were assessed in INVEST (full-mouth, six sites) and SHIP (half-mouth, four sites). Subjects were classified according to the CDC/ AAP case definition. Recording protocols were standardized. Mixed linear or logistic models were used to compare INVEST with SHIP. Results Mean half-mouth AL was lower in INVEST versus SHIP ( INVEST: 2.9 mm versus SHIP: 4.0 mm, p < 0.05). Findings were similar across multiple periodontal disease definitions. After equalization of recording protocols and adjustment for periodontal risk factors, mean AL and PD were 1.2 and 0.3 mm lower in INVEST versus SHIP ( p < 0.001). The odds for severe periodontitis ( CDC/ AAP) was 0.2-fold in INVEST versus SHIP ( p < 0.001). Confounding effects of age, gender, race/ethnicity, education and use of interdental care devices were highest as indicated by change-in-estimate for study. Conclusion Implementation of the proposed method for comparison of epidemiological studies revealed that periodontitis was less prevalent in INVEST compared with SHIP, even after extensive risk-factor adjustment. [ABSTRACT FROM AUTHOR]

Iron raw materials provide a privileged source of information for the reconstruction of metallurgical techniques and the circulation of iron products. An interdisciplinary approach, combining archaeological and archaeometrical studies of the exemplars known from the French Iron Age, has been undertaken. This enables a new typological classification to be produced that demonstrates a correlation between morphological and structural properties. Through comparison with chronological data, it is possible to propose a reconstruction of the organization of production according to three main periods, which are characterized by the circulation of different qualities of iron and by diverse levels of artisanal specialization. [ABSTRACT FROM AUTHOR]

Menard C., Dumas C., Gillot N., Laurent L., Labarbe B., Ireland J. & Volatier J.-L. (2012) The French OQALI survey on dairy products: comparison of nutrient contents and other nutrition information on labels among types of brands. J Hum Nutr Diet. 25, 323-333 Abstract Background: Depending on their spending power, consumers may choose foodstuffs from more or less expensive types of brands (national, retailer, economy-line retailer or discount brands). The present study, on dairy products, assesses the nutritional composition and the frequencies of labelled nutrition parameters, according to types of brands. Methods: The 1646 most consumed dairy products were collected. Nutrient contents and other labelled nutrition parameters provided on the packaging (i.e. nutrition and health claims, nutrition guidelines such as guideline daily amounts, consumption advice and information on added vitamins and minerals) were captured in the French branded product composition database (OQALI). Results: Significant differences between brands were found for energy, protein, fat, saturates, carbohydrate, sugars, dietary fibre, calcium and sodium, in four of six dairy groups studied, but not systematically. National brands and retailer brands provided more detailed nutrition labelling and more frequent nutrition claims than cheaper brands. More retailer brand products provided nutrition guidelines and consumption advice than the other branded products. National brand products more frequently contained added vitamins and minerals and more frequently bore health claims. Conclusions: Nutrient contents of the cheaper brands of dairy products did not vary systematically from more expensive ones. However, national brands and retailer brands products provided more nutrition information on labels than the cheaper ones. There should be more detailed studies comparing different types of brands regarding labelling practices for nutrient contents and other nutrition information about foodstuffs to help prepare public health recommendations, adapted to all consumers, regardless of their income. [ABSTRACT FROM AUTHOR]

ABSTRACT Climate change is a major current affair for which recent United Nations climate conferences aim to build consensus and develop international solutions. The objective of this article is to compare, through the theoretical lens of social representations, the way in which French and German media, specifically newspapers, represent the Bali climate conference. We use the triangulation of data analysis to take both the pragmatic and the semantic aspects of media discourse into account. Results show that German media adopt both a local and a global vision of climate change and of the conference. Religious metaphors highlight a moral dimension of the conference, suggesting anchoring in human and political categories. In contrast, in French media, we identify that conflicts between countries render the stakes of climate change concrete by war metaphors. The French discourses examined are shown to be organised through the anchoring of political and financial categories. Results are discussed in relation to the history of green movements in the two countries and in relation to practical implications. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Two glacial deposits in the Gesso valley ( Maritime, Alps) have been 10 Be-dated at 20 140±1080 (weighted mean± SD) and 16 590±970 years, respectively, thus constraining the Last Glacial Maximum ( LGM) and Gschnitz stadials in the southwestern part of the Alps. The LGM age is chronologically coherent with MIS 2 and synchronous with most other LGM moraines in the Alps. The Gschnitz stadial also appears to be in agreement with the ages obtained from other Alpine sites and with Heinrich Event I. This suggests that the Alpine glaciers reacted simultaneously and essentially synchronously with the climate change associated with Heinrich Event 1. The Equilibrium Line Altitudes ( ELAs) of the LGM and Gschnitz reconstructed palaeoglaciers are 1850 and 1910 m a.s.l., respectively. The ELA comparison across the Alps indicates that the palaeoclimate of the Maritime Alps during the LGM was rather different from that of other Alpine sectors. However, the similar Gschnitz ELA value between the Gesso valley and other sites across the mountain chain indicates that Alpine glaciers responded with the same intensity to the climate change associated with Heinrich Event I. Overall, these results suggest that the interaction between the atmospheric circulation of air masses and local Alpine orography was more complex than has previously been argued. [ABSTRACT FROM AUTHOR]

In a field setting, students (N = 1800) on different campus locations were asked by a young female confederate for a donation during a health fundraising solicitation (French Téléthon). The solicitor wore a white tee-shirt with different inscriptions: no inscription, 'Loving = Helping', and 'Donating = Helping'. Results found that, compared with the no inscription condition, the number of donators increased when the tee-shirt 'Loving = Helping' was worn by the solicitor-confederate and decreased when wearing the tee-shirt 'Donating = Helping'. The activation spreading theory is used to explain these results. Practical interest for health fundraising organizations is developed. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

ACADEMIC EMERGENCY MEDICINE 2010; 17:970–978 © 2010 by the Society for Academic Emergency Medicine Objectives: This study investigated whether mathematical models using calendar variables could identify the determinants of emergency department (ED) census over time in geographically close EDs and assessed the performance of long-term forecasts. Methods: Daily visits in four EDs at academic hospitals in the Paris area were collected from 2004 to 2007. First, a general linear model (GLM) based on calendar variables was used to assess two consecutive periods of 2 years each to create and test the mathematical models. Second, 2007 ED attendance was forecasted, based on a training set of data from 2004 to 2006. These analyses were performed on data sets from each individual ED and in a virtual mega ED, grouping all of the visits. Models and forecast accuracy were evaluated by mean absolute percentage error (MAPE). Results: The authors recorded 299,743 and 322,510 ED visits for the two periods, 2004–2005 and 2006–2007, respectively. The models accounted for up to 50% of the variations with a MAPE less than 10%. Visit patterns according to weekdays and holidays were different from one hospital to another, without seasonality. Influential factors changed over time within one ED, reducing the accuracy of forecasts. Forecasts led to a MAPE of 5.3% for the four EDs together and from 8.1% to 17.0% for each hospital. Conclusions: Unexpectedly, in geographically close EDs over short periods of time, calendar determinants of attendance were different. In our setting, models and forecasts are more valuable to predict the combined ED attendance of several hospitals. In similar settings where resources are shared between facilities, these mathematical models could be a valuable tool to anticipate staff needs and site allocation. [ABSTRACT FROM AUTHOR]