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Resume Contexte La problematique des troubles vocaux chez les enseignants a ete documentee dans des etudes preliminaires internationales, justifiant la pertinence et l’importance de la realisation d’actions de prevention dans cette population. Objectif L’objectif principal de cette etude est d’evaluer la facon dont les enseignants ayant beneficie d’une intervention sur l’hygiene vocale et la prevention des troubles de la voix la percoivent et si les resultats dependent de l’âge de l’enseignant et de son experience. Pour cela, l’analyse critique de deux parametres, l’insatisfaction et l’apprentissage, a ete menee. Materiel et methodes Depuis plus de quinze ans, la Mutuelle generale de l’Education nationale (MGEN), en partenariat avec le ministere de l’Education nationale, propose une formation a la voix et a l’hygiene vocale aux enseignants en formation initiale et continue. A l’issue de chaque formation, un questionnaire d’evaluation est remis aux participants. Les donnees sont analysees statistiquement. Resultats En 2014, 1144 questionnaires ont ete recueillis. La population retenue pour l’analyse (n = 1012) est constituee de 81 % de femmes, 52 % des repondants ont plus de 30 ans, 52 % sont en formation initiale, 59 % affirment avoir deja ete confrontes a un probleme vocal, dont 22 % ayant ete dans l’impossibilite de faire cours a cause d’un probleme de voix. Quarante-trois pour cent declarent avoir des difficultes vocales. Ils sont 91 % a etre satisfaits a l’issue de la formation. Le fait d’avoir moins de 30 ans est associe a la fois a un risque plus eleve d’etre insatisfait (OR = 2,54 ; IC 95 % = [1,09–5,92]) et a un apprentissage plus faible (OR = 0,62 ; IC 95 % = [0,41–0,92]). Le fait de declarer avoir deja ete confronte a des problemes vocaux avec impossibilite de faire cours est aussi associe au moindre risque d’etre insatisfait et a l’apprentissage fort, mais a la limite de la significativite pour l’insatisfaction. Conclusions Les enseignants sont globalement tres satisfaits des interventions proposees. Elles permettent l’acquisition de connaissances theoriques et pratiques et meriteraient de s’inscrire sur le long terme. La satisfaction a l’issue de cette formation et la capacite de protection vocale acquise augmentent significativement avec l’âge des participants. Le manque d’informations et de connaissance sur les exigences vocales de la profession pourrait expliquer les differences observees.

Objectif de l’etude Les enseignants seraient particulierement a risque de souffrir de troubles vocaux, mais en France peu de donnees existent. Notre objectif a ete d’evaluer la prevalence des troubles vocaux chez les enseignants francais, d’en determiner les facteurs associes et d’explorer le retentissement de ces troubles sur le bien-etre. Methodes Dans l’enquete postale nationale « Qualite de vie des enseignants » (Fondation MGEN/Education nationale, n = 2653), les troubles vocaux ont ete evalues au moyen de trois indicateurs : handicap vocal (Voice Handicap Index-10 items), impossibilite de faire cours a cause d’un probleme de voix depuis le debut de l’annee scolaire, au moins une consultation d’un professionnel de sante pour un probleme vocal. Dans des modeles multivaries, nous avons investigue differents facteurs de risque personnels, professionnels et environnementaux et explore le retentissement potentiel des troubles vocaux sur le bien-etre au travail ( burnout , absenteisme, satisfaction professionnelle) et la qualite de vie globale (questionnaire World Health Organisation-Quality of life-Bref). Resultats Treize pourcent des enseignants presentaient un handicap vocal modere a severe, 16 % avaient ete dans l’impossibilite de faire cours a cause d’un probleme de voix depuis le debut de l’annee scolaire et 23 % avaient deja consulte pour un probleme de voix. Apres ajustement, les facteurs significativement associes aux trois indicateurs de troubles vocaux etaient : le sexe feminin, une demande psychologique elevee, avoir ete victime de violence psychologique au travail et a deux indicateurs sur trois : l’âge, la pollution ressentie de l’environnement de vie et une origine sociale des eleves defavorisee. Les enseignants souffrant de troubles vocaux etaient moins satisfaits de leur vecu professionnel et de leur qualite de vie. Conclusion Notre etude permet d’objectiver la problematique des troubles vocaux chez les enseignants francais et appuie l’interet de realiser des actions de prevention et de promotion de la sante dans cette population.

Publication Inra prise en compte dans l'analyse bibliométrique des publications scientifiques mondiales sur les Fruits, les Légumes et la Pomme de terre. Période 2000-2012. http://prodinra.inra.fr/record/256699; International audience; Background: Current hypotheses suggest that intake of fruit and vegetables (FVs) protects against age-related cognitive impairment. Objective: We examined the 13-y association between FV intake and cognitive performance in a sample of French adults. Design: A total of 2533 subjects aged 45–60 y at baseline, who were part of the Supplementation with Antioxidant Vitamins and Minerals 2 (SU.VI.MAX 2) cohort, were selected. FV intake was estimated at baseline in participants who had completed at least six 24-h dietary records. Cognitive performance was assessed 13 y after baseline and included an evaluation of verbal memory (RI-48 cued recall, semantic, and phonemic fluency tests) and executive function (trail-making and forward and backward digit span tests). Principal components analysis was performed to account for correlations in test scores. The relation between cognitive performance and quartiles of FV intake was assessed by multivariate linear regression analyses. Results: Intakes of FVs (P-trend = 0.02), fruit alone (P-trend = 0.04), vitamin C–rich FVs (P-trend = 0.03), vitamin C (P-trend = 0.005), and vitamin E (P-trend = 0.04) were positively associated with verbal memory scores. In contrast, intakes of FVs (P-trend = 0.006), vegetables alone (P-trend = 0.03), and β-carotene–rich FVs (P-trend = 0.02) were negatively associated with executive functioning scores. Conclusions: FVs might have a differential effect on cognition according to groups of FVs and type of cognitive function. Further research using sensitive and reliable measures of various types of cognitive function is needed to clarify the effect of individual FV groups and nutrients. This trial is registered at clinicaltrials.gov as NCT00272428.

International audience; BACKGROUND: General practitioners (GPs) play a key role in identifying and managing patients with suicidal tendencies. Few studies, however, examine both GP and patient characteristics and GP practices associated with suicide assessment. This article aims to evaluate 1) GPs' success in early identification of suicidal ideation (SI) in patients starting antidepressant or anxiolytic treatment, and 2) patient- and GP-related factors associated with this success. METHODS: Survey of 144 GPs practising in southeastern France and of consecutive adults consulting them during June-October 2004 and prescribed antidepressant or anxiolytic treatment. Data were collected from GPs (consultation-questionnaires focusing on their prescription, diagnosis and detection of SI) and patients (self-administered questionnaires including the Hospital Anxiety and Depression scale and social and demographic characteristics). We used multilevel logistic regression to analyse factors associated with SI detection. RESULTS: GPs completed consultation-questionnaires for 713 patients, 405 of whom completed self-administered questionnaires. Eighty-nine patients (22%) reported SI; in 43 cases (48%) SI had not been detected by the GP. GPs detected SI more frequently when they had completed continuing medical education about depression, when patients had higher depressive symptom scores, and when consultations were relatively long. LIMITATIONS: Study limited to patients receiving initial prescriptions for antidepressants or anxiolytics. CONCLUSIONS: The percentage of undetected SI in this study population was high. Additional training of GPs increases the chances of detecting SI. Medical training and continuing medical education should include better instruction about SI risk factors and diagnosis, including non-major depressions, and stress that screening requires sufficient consultation time.

Funding European Commission (DG-SANCO) , the International Agency for Research on Cancer (IARC) , MRC Early Career Fellowship (MR/M501669/1) ., Background Unhealthy diets, the rise of non-communicable diseases, and the declining health of the planet are highly intertwined, where food production and consumption are major drivers of increases in greenhouse gas emissions, substantial land use, and adverse health such as cancer and mortality. To assess the potential co-benefits from shifting to more sustainable diets, we aimed to investigate the associations of dietary greenhouse gas emissions and land use with all-cause and cause-specific mortality and cancer incidence rates. Methods Using data from 443 991 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, a multicentre prospective cohort, we estimated associations between dietary contributions to greenhouse gas emissions and land use and all-cause and cause-specific mortality and incident cancers using Cox proportional hazards regression models. The main exposures were modelled as quartiles. Co-benefits, encompassing the potential effects of alternative diets on all-cause mortality and cancer and potential reductions in greenhouse gas emissions and land use, were estimated with counterfactual attributable fraction intervention models, simulating potential effects of dietary shifts based on the EAT–Lancet reference diet. Findings In the pooled analysis, there was an association between levels of dietary greenhouse gas emissions and allcause mortality (adjusted hazard ratio [HR] 1·13 [95% CI 1·10–1·16]) and between land use and all-cause mortality (1·18 [1·15–1·21]) when comparing the fourth quartile to the first quartile. Similar associations were observed for cause-specific mortality. Associations were also observed between all-cause cancer incidence rates and greenhouse gas emissions, when comparing the fourth quartile to the first quartile (adjusted HR 1·11 [95% CI 1·09–1·14]) and between all-cause cancer incidence rates and land use (1·13 [1·10–1·15]); however, estimates differed by cancer type. Through counterfactual attributable fraction modelling of shifts in levels of adherence to the EAT–Lancet diet, we estimated that up to 19–63% of deaths and up to 10–39% of cancers could be prevented, in a 20-year risk period, by different levels of adherence to the EAT–Lancet reference diet. Additionally, switching from lower adherence to the EAT–Lancet reference diet to higher adherence could potentially reduce food-associated greenhouse gas emissions up to 50% and land use up to 62%. Interpretation Our results indicate that shifts towards universally sustainable diets could lead to co-benefits, such as minimising diet-related greenhouse gas emissions and land use, reducing the environmental footprint, aiding in climate change mitigation, and improving population health., European Commission European Commission Joint Research Centre, World Health Organization, UK Research & Innovation (UKRI) Medical Research Council UK (MRC) MR/M501669/1

Introduction En France, pres d’un million de personnes exercent la profession d’enseignant. Si la finalite du metier reste immuable, le contexte et les pratiques pedagogiques se transforment au fil des evolutions societales, des reformes et des reajustements du systeme educatif. Qu’en est-il de l’evolution du bien-etre des enseignants ? Objectif Quantifier l’evolution d’indicateurs de qualite de vie professionnelle et globale des enseignants au cours des 15 dernieres annees. Examiner l’homogeneite des variations au sein meme de la population enseignante, selon le sexe et le degre d’enseignement. Methodes Trois enquetes nationales postales, a caractere representatif, realisees aupres d’enseignants du secteur public (premier degre, second degre et superieur) en 2000 (n = 3482), 2005 (n = 3842) et 2013 (n = 2343) ont ete mobilisees. Les reponses aux items equivalents ont ete comparees apres standardisation sur le sexe, l’âge et le niveau d’enseignement. Les indicateurs etudies concernaient les conditions de travail (temps de trajet, risques psychosociaux selon le modele de Karasek), le bien-etre professionnel (« Maslach Burnout Inventory », desir de changer de profession) et la qualite de vie (sante ressentie). Resultats La comparaison synoptique des chiffres obtenus pour les trois enquetes suggere, pour les enseignants sur 15 ans, une intensification des sources de stress lie au travail (augmentation de la demande psychologique et du temps de travail hors enseignement), un affaiblissement du bien-etre professionnel (augmentation du desir de changement et de la symptomatologie d’epuisement emotionnel) et une degradation de la sante ressentie. Cependant, certains indicateurs restent stables comme le soutien social ou l’accomplissement personnel au travail. Par ailleurs, les evolutions observees ne sont pas homogenes selon le sexe ou le degre d’enseignement. Conclusion Ce constat d’un affaiblissement du bien-etre des enseignants appelle de nouvelles etudes pour elucider les mecanismes sous-jacents et mettre en lumiere des leviers permettant d’enrayer le phenomene.

Objectifs Face a l’augmentation du nombre d’enseignants non-titulaires en France, notre objectif a ete, dans le second degre, d’evaluer leurs conditions de travail et leur bien-etre professionnel et general par comparaison aux titulaires. Methodes Dans l’enquete postale nationale « Qualite de Vie des Enseignants » (Fondation MGEN/Education nationale), 118 enseignants non-titulaires et 1298 enseignants titulaires du second degre ont ete interroges sur leur bien-etre professionnel (satisfaction professionnelle, souhait de changer de profession, trois dimensions du Maslach Burnout Inventory) et general (questionnaire de qualite de vie WHOQOL-BREF). Apres stratification sur le secteur d’enseignement (public/prive), ces indicateurs de bien-etre ont ete modelises en fonction du statut d’emploi dans des modeles de regression ajustes sur de nombreux facteurs de confusion potentiels (âge, conditions d’exercice, etc.). Resultats Les non-titulaires exercaient dans des conditions globalement moins favorables que les titulaires dans les deux secteurs. Pourtant, dans le secteur public, les non-titulaires (n = 70) presentaient de meilleurs indicateurs de bien-etre professionnel que les titulaires (n = 1051). Notamment, ils souhaitaient moins changer de profession (OR [95 %IC] = 0,36 [0,20 ; 0,66]) et presentaient un epuisement emotionnel plus faible (0,37 [0,18 ; 0,78]). Par contraste, les enseignants non-titulaires du prive (n = 48) tendaient a etre moins satisfaits de leur experience professionnelle et a avoir plus de symptomes d’epuisement emotionnel que leurs homologues titulaires (n = 247). Concernant le bien-etre general, les enseignants non-titulaires du prive etaient moins satisfaits de leur qualite de vie (0,29 [0,12 ; 0,66]) que les titulaires. Enfin, les non-titulaires etaient significativement moins satisfaits de leur environnement de vie, que ce soit dans le public (β[95 %IC] = −4,94 points [−8,17 ; −1,71]) ou dans le prive (−6,33 points [−10,97 ; −1,69]). Conclusions Les enseignants non-titulaires du prive presentaient de moins bons indicateurs de bien-etre professionnel et general. Dans le public, les resultats etaient plus contrastes, mais on retrouvait une moindre satisfaction vis-a-vis de l’environnement de vie. Cette etude appuie l’importance d’integrer les enseignants non-titulaires aux actions de promotion de la sante en direction des personnels enseignants.

Exposure to air pollution influences children's health, however, the biological mechanisms underlying these effects are not completely elucidated. We investigated the association between short- and medium-term outdoor air pollution exposure with protein profiles and their link with blood pressure in 1170 HELIX children aged 6-11 years. Different air pollutants (NO2, PM10, PM2.5, and PM2.5abs) were estimated based on residential and school addresses at three different windows of exposure (1-day, 1-week, and 1-year before clinical and molecular assessment). Thirty-six proteins, including adipokines, cytokines, or apolipoproteins, were measured in children's plasma using Luminex. Systolic and diastolic blood pressure (SBP and DBP) were measured following a standardized protocol. We performed an association study for each air pollutant at each location and time window and each outcome, adjusting for potential confounders. After correcting for multiple-testing, hepatocyte growth factor (HGF) and interleukin 8 (IL8) levels were positively associated with 1-week home exposure to some of the pollutants (NO2, PM10, or PM2.5). NO2 1-week home exposure was also related to higher SBP. The mediation study suggested that HGF could explain 19% of the short-term effect of NO2 on blood pressure, but other study designs are needed to prove the causal directionality between HGF and blood pressure. The study received funding from the European Community’s Seventh Framework Programme (FP7/2007–206) (grant agreement no 308333) (HELIX project), the H2020-EU.3.1.2. - Preventing Disease Programme (grant agreement no 874583) (ATHLETE project) and from the European Union’s Horizon 2020 research and innovation programme (grant Agreement number: 733206) (Early Life stressors and Lifecycle Health (LIFECYCLE)). BiB received funding from the Welcome Trust (WT101597MA), from the UK Medical Research Council (MRC) and Economic and Social Science Research Council (ESRC) (MR/N024397/ 1). The study was supported by the European Union FP7 programmes (FP7/ 2007–2013, HELIX, ESCAPE, ENRIECO, Medall projects). INMA was supported by grants from the Instituto de Salud Carlos III, CIBERESP, and the Generalitat de Catalunya-CIRIT. KANC was funded by the grant of the Lithuanian Agency for Science Innovation and Technology (6-04-2014_31V-66). The Rhea project was financially supported by European projects (EU FP6-2003-Food-3-NewGeneris, EU FP6. STREP Hiwate, EU FP7 ENV. 2007.1.2.2.2. Project No 211250 Escape, EU FP7- 2008-ENV-1.2.1.4 Envirogenomarkers, EU FP7-HEALTH-2009- single stage CHICOS, EU FP7 ENV. 2008.1.2.1.6. Proposal No 226285 ENRIECO, EU- FP7- HEALTH-2012 Proposal No 308333 HELIX). MC received funding from Instituto Carlos III (Ministry of Economy and Competitiveness) (CD12/00563 and MS16/00128). JU is supported by Spanish regional program PERIS (Ref.: SLT017/20/ 000119) Granted by Departament de Salut de la Generalitat de Catalunya. The CRG/UPF Proteomics Unit is part of the Spanish Infrastructure for Omics Technologies (ICTS OmicsTech) and it is member of the ProteoRed PRB3 consortium which is supported by grant PT17/0019 of the PE I + D + i 2013–2016 from the Instituto de Salud Carlos III (ISCIII)

International audience; BACKGROUND: The established relationship between vision impairment and depression is limited by the examination of depression only as a unidimensional construct. The present study explores the vision-depression relationship using a dimensional approach.METHODS: 9036 participants aged 65 years and above enrolled in the Three-City study were included. Relationships between baseline near Vision Impairment (VI) or self-reported distance Visual Function (VF) loss with trajectory of four dimensions of depression - depressed affect, positive affect, somatic symptoms and interpersonal problems - over 12 years were examined using mixed-effects models. Depression dimensions were determined using the four-factor structure of the Centre for Epidemiology Studies-Depression Scale (CESD).RESULTS: In the fully adjustment models, mild near VI predicted poorer depressed affect (b = 0.04, p = .002) and positive affect (b = -0.06, p

International audience; Few studies have examined the associations between parents' own eating behaviors and their feeding practices. We aimed to study the associations between maternal eating behaviors and feeding practices in toddlerhood. In this cross-sectional analysis, maternal eating behaviors and feeding practices were assessed at 2-year follow-up by using the Three-Factor Eating Questionnaire (TFEQ-R21) and the Comprehensive Feeding Practices Questionnaire (CFPQ), respectively, among mothers of 1322 children from the EDEN mother-child cohort. Depending on their distributions, scores from the two questionnaires were considered continuous or binary variables, according to the median. Linear or logistic regression models were used as appropriate to assess the associations between maternal eating behaviors, considered simultaneously in a combined model, and their feeding practices. Maternal cognitive restraint was positively associated with maternal restriction for health and restriction for weight. Maternal uncontrolled eating was positively associated with pressure to eat and use of food to regulate the child's emotions. Maternal uncontrolled eating was also negatively associated with restriction for weight, but only among boys. This study supports that mothers' own eating behaviors are associated with their feeding practices in toddlerhood. Further studies are needed to understand the role of parental feeding practices in the familial transmission of eating behavior.

International audience; Epidemiological studies on statin use in relation to skin cancer risk are scarce and yielded conflicting results. We explored this association in Etude Epidémiologique auprès de femmes de l'Education Nationale, a prospective cohort of French women born in 1925–1950. Health and lifestyle data were self-reported biennially and matched with drug reimbursement data, allowing the identification of participants’ statin use since 2004. Multivariable cause-specific hazards regression models adjusted for skin cancer risk factors estimated hazard ratios with 95% confidence intervals. Over 2004–2014, 455 cutaneous melanoma, 1,741 basal cell carcinoma, and 268 squamous cell carcinoma cases were ascertained among 62,473 women. Compared with never use, there were no associations between ever use of statins and melanoma (hazard ratio = 1.16, 95% confidence interval = 0.94–1.44) or squamous cell carcinoma (hazard ratio = 0.89, 95% confidence interval = 0.66–1.19) risks and a decrease in basal cell carcinoma risk with ever use of statins (hazard ratio = 0.89, 95% confidence interval = 0.79–0.996). We found no trend of increasing or decreasing risks with dose, duration of use, time since first use, or age at first use and no statistically significant effect modification by pigmentary traits or residential UVR exposure. Because of the limited number of studies evaluating the associations between the use of statins and the risks of melanoma, basal cell carcinoma, and squamous cell carcinoma, these findings would deserve further investigation in other settings.

International audience; Bisphenol A (BPA) is used in a wide variety of products and objects for consumers use (digital media such as CD's and DVD's, sport equipment, food and beverage containers, medical equipment). For humans, the main route of exposure to BPA is food. Based on previous estimates, almost 20% of the dietary exposure to BPA in the French population would be from food of animal origin. However, due to the use of composite samples, the source of the contamination had not been identified. Therefore, 322 individual samples of non-canned foods of animal origin were collected with the objectives of first updating the estimation of the exposure of the French population and second identifying the source of contamination of these foodstuffs using a specific analytical method. Compared to previous estimates in France, a decline in the contamination of the samples was observed, in particular with regard to meat. The estimated mean dietary exposures ranged from 0.048 to 0.050 μg (kg bw)(-1) d(-1) for 3-17 year children and adolescents, from 0.034 to 0.035 μg (kg bw)(-1) d(-1) for adults and from 0.047 to 0.049 μg (kg bw)(-1) d(-1) for pregnant women. The contribution of meat to total dietary exposure of pregnant women, adults and children was up to three times lower than the previous estimates. Despite this downward trend in contamination, the toxicological values were observed to have been exceeded for the population of pregnant women. With the aim of acquiring more knowledge about the origin the potential source(s) of contamination of non-canned foods of animal origin, a specific analytical method was developed to directly identify and quantify the presence of conjugated BPA (BPA-monoglucuronide, BPA-diglucuronide and sulphate forms) in 50 samples. No conjugated forms of BPAs were detected in the analysed samples, indicating clearly that BPA content in animal food was not due to metabolism but arise post mortem in food. This contamination may occur during food production. However, despite extensive sampling performed in several different shops (butcheries, supermarkets ....) and in different conditions (fresh, prepared, frozen ...), the source(s) of the contamination could not be specifically identified.

International audience; The distinction between effort and other factors, such as family background, matters for correcting policies and normative reasons when we appeal to inequality of opportunity. We take advantage of a purposefully designed survey on secondary schools in rural Bangladesh to offer a comprehensive view of the importance of overall effort when measuring inequalities of opportunity in education. The analysis comprises decomposition exercises of the predicted variance of student performance in mathematics and English by source (effort, circumstances, etc.) and subgroup (within- and between-schools) based on parametric estimates of educational production functions. Pupils’ effort, preferences, and talents contribute between 31% and 40% of the total predicted variances in performance scores. The contribution of overall effort falls by 10% when the correlation between effort and circumstances is taken into account. These findings are robust to the choice of estimation strategy (i.e. combined within- and between-schools variation models versus multilevel random-effect models). All in all, these results advocate that social determinism in education can be mitigated by individual effort at school.

Background In the elderly, little attention has been paid to anxiety both on a symptom dimension and as a disorder, as an independent risk factor for the incidence of activity limitations. Methods In a community-dwelling cohort of 1581 persons aged 65+, the association between trait anxiety symptoms (Spielberger Trait, third highest tertile) and baseline DSM-IV anxiety disorder, and 7-year incident activity limitations was determined using mixed logistic regression models. Repeated measures of activity limitations included, by increased severity level: social restriction (neighbourhood and house confined), mobility (Rosow and Breslau scale) and limitations in instrumental activities of daily living (IADL). Results Of the sample, 14.2% had an anxiety disorder at baseline. Adjusting for baseline socio-demographic and health variables, depression (past and current), antidepressant and anxiolytic drugs, baseline anxiety disorder was associated with an increased risk of incident IADL limitation (OR (95% CI): 1.84 (1.01–3.39), p = 0.048) and trait anxiety with increased incidence of social restriction (OR (95% CI): 2.41 (1.42–4.09), p = 0.001). Associations remained significant in participants free of depressive symptoms at baseline (OR (95% CI): 2.92 (1.41–6.05), p = 0.004; OR (95% CI): 3.21 (1.31–7.89), p = 0.011, respectively). Limitations Activity limitations were self-reported and may have been over-reported in participants with anxiety. Conclusion Both trait anxiety symptomatology and anxiety disorder were independently associated with increased incidence of activity limitations with a gradient of severity: trait anxiety associated with incident social restriction and anxiety disorder with more severe IADL limitations, suggesting that anxiety is a predictor of activity limitations in the elderly independently of depression comorbidity.

International audience; OBJECTIVES:Using register-based insurance data, we aimed to evaluate health-related differences between respondents and nonrespondents in a mailed epidemiologic survey, with a particular focus on mental health.STUDY DESIGN AND SETTING:In 2005, 19,406 adults covered by the national education system health insurance plan were sent a general health questionnaire including a significant part devoted to mental health. Of them, 52% responded. Using multivariable logistic regression models, we compared participants and nonparticipants on various sociodemographic characteristics, morbidity variables, and health care utilization indicators derived from the routine health insurance databases, regardless of response status. Mental health was appraised through the reimbursement of psychiatric services and the volume of psychotropic prescriptions received in 2004-05.RESULTS:In addition to traditional sociodemographic covariates of participation, we observed that respondents used more medical services than nonrespondents (visits to general practitioners, dentists, and specialists other than psychiatrists) but essentially for somatic disorders, as they also were prescribed significantly fewer psychotropic drugs.CONCLUSION:Response bias may impact estimation quality even in apparently sociodemographically homogeneous populations. Our results confirmed that persons with mental complaints are less likely to respond to a survey focused on their troubles and illustrate the risk of underestimation of psychiatric disease in population-based surveys.

International audience; Cough is a common symptom that affects a large proportion of the general population, but has been somewhat neglected in the epidemiological literature in the recent years. Various types of coughs are described based on life-long epidemiological surveys. Using published and unpublished data from three epidemiological studies (the European Community Respiratory Health survey, the French Epidemiological study on the Genetics and environment of asthma (EGEA) and the French E3N study), some specific aspects are discussed in detail. Phenotypic heterogeneity according to chronicity, or its productive nature, or its daytime or nocturnal characteristics are discussed. The association of cough with asthma and gender is described, together with its evolution over a 12-year period. The potential for genetic studies of cough is discussed.

International audience; OBJECTIVES: Mild cognitive impairment (MCI) case-finding criteria have low specificity in general population studies. This study retrospectively identifies cases of MCI and determines baseline criteria giving the highest discriminability. The ability of these criteria to increase current case detection specificity is estimated. DESIGN: A population-based cohort was recruited from electoral rolls from three French cities. Clinical and environmental characteristics were evaluated at baseline and at 2- and 4-year follow-up. The clinical characteristics of incident cases of dementia were examined retrospectively. PARTICIPANTS: Eight thousand nine hundred nineteen persons aged 65 years and older without dementia (60.8% women) were included in this study. The mean age (SD) of the participants was 74.2 (5.6) years for men and 74.4 (5.6) years for women. RESULTS: Three hundred twenty persons (3.6%) were retrospectively classified as MCI at baseline. This MCI group had poorer performance on all cognitive tests compared with the rest of the cohort, and a subsample undergoing MRI were found to have more white matter hyperintensities. The group were also characterized by the presence of an ApoE ε4 genotype (odds ratio [OR]: 2.17, confidence interval [CI]: 1.44-3.29 for men; OR: 2.27, CI: 1.59-3.24 for women) and instrumental activities of daily living loss (OR: 1.72, CI: 1.01-3.0 for men; OR: 1.49; CI: 0.97-2.3 for women). Women with MCI also had high depressive symptomatology (OR: 1.96; CI: 1.34-2.87), anticholinergic drug use (OR: 1.59; CI: 1.05-2.28), and low body mass index (OR: 1.54, CI: 1.05-2.28) and for men a history of stroke (OR: 2.17, CI: 1.16-4.05) and glycemia (OR: 1.72, CI: 1.13-2.71). Addition of these characteristics to conventional MCI definitions increases their specificity. CONCLUSIONS: This general population study using a retrospective method for classifying persons with MCI identified gender-specific noncognitive clinical variables that may increase specificity.