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International audience; PURPOSE: We conducted a population-based study of epilepsy in Prey Veng (Cambodia) to explore self-esteem, fear, discrimination, knowledge-attitude-practice (KAP), social-support, stigma, coping strategies, seizure-provoking factors, and patient-derived factors associated with quality of life (QOL). METHODS: The results are based on a cohort of 96 cases and matched controls (n = 192), randomly selected from the same source population. Various questionnaires were developed and validated for internal consistency (by split-half, Spearman-Brown prophecy, Kuder-Richardson 20), content clarity and soundness. Summary, descriptive statistics, classical tests of hypothesis were conducted. Uncorrected chi-square was used. Group comparison was done to determine statistically significant factors, for each domain, by conducting logistic regression; 95% confidence interval (CI) with 5% (two-sided) statistical significance was used. KEY FINDINGS: All questionnaires had high internal consistency. Stress was relevant in 14.0% cases, concealment in 6.2%, denial in 8.3%, negative feelings in public in 3.0%. Mean self-esteem was 7.5, range 0-8, related to seizure frequency. Mean discrimination was least during social interactions. Coping strategies were positive (e.g. look for treatment). Postictal headache, anger, no nearby health facility, etc. were associated with QOL. SIGNIFICANCE: The reliability of our questionnaires was high. A positive social environment was noted with many infrequent social and personal prejudices. Not all populations should (by default) be considered as stigmatized or equipped with poor KAP. We addressed themes that have been incompletely evaluated, and our approach could therefore become a model for other projects.

International audience; Investigating career motivations and intentions of dental students provides a better understanding of their role in society and contributes to the debate on dental education and practices. This study describes the profile, career choice motivations, and career intentions of Brazilian dental students and evaluates factors related to these choices. A cross-sectional study was carried out among dental students from three Brazilian public universities (N=915), with a response rate of 83.7 percent. Students (N=766) responded to a self-administered questionnaire about sociodemographic factors, reasons for choosing dentistry as a career, and future career intentions. Job conception was found to be the main reason for choosing dentistry as a profession. Most students intended to become specialists and work in both the public and private sectors simultaneously. Female students (OR 2.23, 95 percent CI=1.62-3.08), low-income students (OR 1.86, 95 percent CI=1.10-3.13), and students beginning their program (OR 1.87, 95 percent CI=1.22-2.85) were more likely to work in the public and private sectors simultaneously than other types of students. This study suggests that choice of career and career plans are influenced by factors related to the students' characteristics and their conception of the profession. The opportunity to combine private and public dental practice may be viewed as a way to achieve income and job security.

Background In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico-social care. Method The study included 100 subjects—50 cases of mesothelioma and 50 controls—randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six-expert panel using two methods: “by job” rating, where all the jobs in were assessed regardless of the subjects; and “by subject” rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the “by subject” rating. Kappa coefficients were used to measure agreement between the ratings. Results Agreement between “by job” and “by subject” ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six-expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68). Conclusion This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the “by subject” rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation. Am. J. Ind. Med. 55:440–449, 2012. © 2012 Wiley Periodicals, Inc.

International audience; Social anhedonia is a more promising indicator of vulnerability to schizophrenia than physical anhedonia, both as assessed by Chapman scales. More broadly, the populations identified by these scales would have a propensity to different psychiatric disorders. This cross-sectional study examined the respective profiles of schizotypy, anxiety, and depression in French students with physical and social anhedonia, using psychometric and interview-based measures. Compared to controls (n=46), subjects with social anhedonia (n=19) reported higher schizotypal scores for interpersonal, paranoid, disorganization, and cognitive/perceptual dimensions, whereas subjects with physical anhedonia (n=35) had more extensive interpersonal deficits and paranoia. Both groups had more depressive and anxiety symptoms than controls, in particular subjects with social anhedonia.

International audience; Excess dietary proteins and "acid ash" diets have been suspected to increase the risk of osteoporosis, but experimental and epidemiological evidence is mixed. We aimed to determine whether the association between protein intake and the overall acid-base equilibrium of the diet (as renal net acid excretion [RNAE] estimate) and fracture risk vary according to calcium intake. During an average of 8.37 +/- 1.73 yr of follow-up, 2408 women reported a fracture (excluding high-impact trauma) among 36,217 postmenopausal women from the E3N prospective study. We used Cox regression models to study the interaction between calcium and, respectively, proteins and RNAE, from the 1993 dietary questionnaire for fracture risk determination, adjusting for potential confounders. There was no overall association between fracture risk and total protein or RNAE. However, in the lowest quartile of calcium (

International audience; Previous studies evaluating the association between arterial blood pressure and venous thromboembolism (VTE) reported conflicting results. The relationship between antihypertensive therapy and VTE has never been specifically evaluated. This report from a hospital-based case-control study included 785 cases with confirmed unprovoked VTE and their 785 age- and sex-matched controls. Cases and controls were asked for drug exposure in a one-to-one standardized interview using the same questionnaire. Drug exposure was defined as current use of drugs at admission with onset at least 1 week ago. Three hundred and eighty-four out of 785 cases (48.9%) and 379 out 785 controls (48.3%) reported that they were currently using at least one antihypertensive drug. Among all antihypertensive therapies, only angiotensin II receptor blockers were significantly associated with a reduced risk for VTE: adjusted conditional odds ratio (OR) 0.45 (95% CI, 0.29-0.70). In this hospital-based case-control study, a preventive role for angiotensin II receptor blockers as regards VTE risk was suggested. More studies are needed in order to further elucidate the biological mechanisms involved.

First delivery at an older age is not an uncommon event in modern obstetric practice. The present study was undertaken to compare the prevalence of postpartum stress urinary incontinence (SUI) according to maternal age and mode of delivery.Fifty two consecutive elderly primiparae (mean age 40.0 +/- 1.8) who underwent spontaneous vaginal delivery, 42 consecutive elderly primiparae (mean age 40.7 +/- 3.6) who underwent elective cesarean section, and 92 consecutive young primiparae (mean age 26.2 +/- 2.5) who underwent spontaneous vaginal delivery were interviewed 1-2 years postpartum about the symptom of SUI. Women who had SUI before pregnancy were not enrolled. Obstetric data were collected from computerized hospital records.The prevalence of SUI 1-2 years after spontaneous vaginal delivery was significantly higher in elderly compared with younger primiparae (38.5% vs. 9.8%, respectively). Elderly primiparae who underwent elective cesarean section had a significantly lower prevalence of postpartum SUI than those delivered vaginally (16.7% vs. 38.5%, respectively). Further comparison of stress-incontinent versus continent elderly primiparae failed to reveal significant demographic or obstetric differences, except for increased prevalence of SUI during pregnancy among incontinent patients (45% vs. 19%, respectively).First vaginal delivery at an older age carries an increased risk for postpartum SUI. Stress-incontinent women also had higher prevalence of SUI during pregnancy. This finding implies that the pathophysiologic process of SUI begins during pregnancy, prior to active labor and delivery. Nonetheless, elective cesarean section in these women has a protective effect and lowers the risk of developing postpartum SUI.