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Background: Electronic death certification was established in France in 2007. A methodology based on intrinsic characteristics of death certificates was designed to compare the quality of electronic versus paper death certificates. Methods: All death certificates from the 2010 French mortality database were included. Three specific quality indicators were considered: (i) amount of information, measured by the number of causes of death coded on the death certificate; (ii) intrinsic consistency, explored by application of the International Classification of Disease (ICD) General Principle, using an international automatic coding system (Iris); (iii) imprecision, measured by proportion of death certificates where the selected underlying cause of death was imprecise. Multivariate models were considered: a truncated Poisson model for indicator (i) and binomial models for indicators (ii) and (iii). Adjustment variables were age, gender, and cause, place, and region of death. Results: 533,977death certificates were analyzed. After adjustment, electronic death certificates contained 19% [17%-20%] more codes than paper death certificates for people deceased under 65 years, and 12% [11%-13%] more codes for people deceased over 65 years. Regarding deceased under and over 65 respectively, the ICD General Principle could be applied 2% [0%-4%] and 6% [5%-7%] more to electronic than to paper death certificates. The proportion of imprecise death certificates was 51% [46%-56%] lower for electronic than for paper death certificates. Conclusion: The method proposed to evaluate the quality of death certificates is easily reproducible in countries using an automatic coding system. According to our criteria, electronic death certificates are better completed than paper death certificates. The transition to electronic death certificates is positive in many aspects and should be promoted. [ABSTRACT FROM AUTHOR]

Introduction: Obtaining vascular access is crucial in critically ill patients. The EZ‐IO® device is easy to use and has a high insertion success rate. Therefore, the use of intraosseous vascular access (IOVA) has gradually increased. Aim: We aim to determine how IOVA was integrated into management of vascular access during out‐of‐hospital cardiac arrest (OHCA) resuscitation. Methods: Analysing the data from the OHCA French registry for events occurring between 1 January 2013 and 15 March 2021, we studied: demography, circumstances of occurrence and management including vascular access, delays and evolution. The primary outcome was the rate of IOVA implantation. Results: Among the 7156 OHCA included in the registry, we analysed the 3964 (55%) who received cardiopulmonary resuscitation. The vascular access was peripheral in 3122 (79%) cases, intraosseous in 775 (20%) cases and central in 12 (<1%) cases. The use of IOVA has increased linearly (R2 = 0.61) during the 33 successive trimesters studied representing 7% of all vascular access in 2013 and 33% in 2021 (p = 0.001). It was significantly more frequent in traumatic cardiac arrest: 12% versus 5%; p < 0.0001. The first epinephrine bolus occurred significantly later in the IOVA group, at 6 (4–10) versus 5 (3–8) min; p < 0.0001. Survival rate in the IOVA group was significantly lower, at 1% versus 7%; p < 0.0001. Conclusion: The insertion rate of IOVA significantly increased over the studied period, to reach 30% of all vascular access in the management OHCA patients. The place of the intraosseous route in the strategy of venous access during the management of prehospital cardiac arrest has yet to be determined. Summary statement: What is already known about this topic? How the intraosseous vascular access was integrated into the vascular approach during the medical resuscitation of out‐of‐hospital cardiac arrest remains unknown What this paper adds? The use of intraosseous access strongly increased (more than 400%) between 2013 and 2021, exceeding 30% of all vascular access in OHCA in 2021.The outcome of OHCA patients treated with intraosseous access was less favourable. The implications of this paper: The use of intraosseous venous access increased despite the lack of evidence supporting this practice.More studies are required to precisely determine the place of the intraosseous route and its impact on the prognosis of cardiac arrest. [ABSTRACT FROM AUTHOR]

Background: Changing the food environment is an important public health lever for encouraging sustainable food choices. Targeting the availability of vegetarian main meals served in cafeterias substantially affects food choice, but acceptability has never been assessed. We examined the effects of an availability intervention at a French university cafeteria on students' main meal choices, meal offer satisfaction and liking. Methods: A four-week controlled trial was conducted in a university cafeteria in Dijon, France. During the two-week control period, vegetarian main meals constituted 24% of the offer. In the subsequent two-week intervention period, this proportion increased to 48%, while all the other menu items remained unchanged. Students were not informed of the change. Student choices were tracked using production data, and daily paper ballots were used to assess student satisfaction with the meal offer and liking of the main meal they chose (score range [1;5]). Nutritional quality, environmental impact, and cost of production of meal choices were calculated for each lunchtime. Food waste was measured over 4 lunchtimes during control and intervention periods. An online questionnaire collected student feedback at the end of the study. Results: Doubling availability of vegetarian main meals significantly increased the likelihood of choosing vegetarian options (OR = 2.57, 95% CI = [2.41; 2.74]). Responses of the paper ballots (n = 18,342) indicated slight improvements in meal offer satisfaction from 4.05 ± 0.92 to 4.07 ± 0.93 (p = 0.028) and in liking from 4.09 ± 0.90 to 4.13 ± 0.92 (p < 0.001) during control and intervention periods, respectively. The end-of-study questionnaire (n = 510) revealed that only 6% of students noticed a change the availability of vegetarian main meals. The intervention led to a decrease in the environmental impact of the main meals chosen, a slight decrease in nutritional quality, a slight increase in meal costs and no change in food waste. Conclusions: Doubling availability of vegetarian main meals in a university cafeteria resulted in a twofold increase in their selection, with students reporting being more satisfied and liking the main meals more during the intervention period. These results suggest that serving an equal proportion of vegetarian and nonvegetarian main meals could be considered in French university cafeterias to tackle environmental issues. Trial registration: Study protocol and analysis plan were pre-registered on the Open Science Framework (https://osf.io/pf3x7/). [ABSTRACT FROM AUTHOR]

Background: Digital game‐based learning is gaining increased attention from both researchers and educators for improving mathematics instruction. However, the evidence for game‐based learning is mixed and research with rigorous research design and analyses are limited. Objective: Here, in a pre‐registered randomized controlled study, we investigated whether a fraction game designed collaboratively by educational experts and professional game developers may serve as a useful tool to enhance students' fraction knowledge. Methods: We assigned French fifth graders to either an experimental group who used the game (n = 110) or a control group (n = 78) who received traditional instruction on fractions. Fraction knowledge was assessed pre‐ and post‐intervention. Results: Results show that students in the active control group had superior overall fraction performance than students in the experimental group at the end of intervention. However, the game had a positive effect on decimal learning. We also found a positive relation between game performance and overall fraction knowledge scores at post‐test. Contribution: The study highlights the importance of game metrics as indicators of personalized assessment tools. Given the increased usage of games in learning mathematics and the equivocal results on the effectiveness of these games, our study also highlights the importance of pre‐registration and randomized controlled studies. Lay Description: What is already known about this topic: Digital game‐based learning (DGBL) is gaining popularity in mathematics teaching.DGBL shows potential for teaching difficult abstract concepts such as fractions.However, research evaluating DGBL for fractions is limited. What this paper adds: The study examines a fraction game designed by education experts and game designers.Students fraction knowledge is assessed using paper‐based test.Challenges associated with DGBL in the classroom are discussed in the paper. Implications for practice: The results will guide educators in designing effective fraction instruction in classroom.The study highlights the critical role of instructional support in DGBL for fractions.Game based metrics can be used to individualize instruction in the classroom. [ABSTRACT FROM AUTHOR]

Background: Many instructors transitioned their courses from face‐to‐face environments to computer‐mediated learning environments (CMLEs) following the onset of the coronavirus disease 2019 (COVID‐19) pandemic. However, little was known about how teleconferencing platforms and their corresponding functions affect student learning when the COVID‐19 pandemic began. Objectives: The aim of this study was to provide more clarity on the conditions through which online teleconferencing platforms influence student achievement. More specifically, this study investigated how displaying lecture‐relevant and lecture‐irrelevant messages in a chat box during a video lecture delivered via the Zoom teleconferencing platform affected student learning and note taking. Methods: Participants viewed the video lecture either with (relevant or irrelevant) or without messages appearing in the chat box of the Zoom window. Participants completed a learning test immediately following the lecture. Results and Conclusions: No difference regarding student achievement was observed between the three groups. However, results revealed that students in the relevant‐lecture messages group reported a higher extraneous cognitive load than the other groups even if they reported positive attitudes about the messages appearing on the chat box. Students in the lecture‐relevant group also recorded more notes during the lecture compared to the two other groups, but this result did not reach significance. This study extends previous research that investigated how messaging influences learning in classroom settings. Findings suggest that allowing relevant discussions is not the best strategy to promote learning in CMLEs as this information seems to compete with the other relevant information being presented during the ongoing lecture. Lay Description: What is already known about this topic: In video lectures, the chat box has been identified as the function most often used to support students' learning.Responding to lecture‐relevant messages can enhance students' learning.However, it remains unknown how simply reading, but not responding to, lecture‐relevant and lecture‐irrelevant messages can affect learning and note taking. What this paper adds: In previous studies, researchers examined how messaging affects learning in a classroom setting, but not within a computer‐mediated lecture environment.The present study extends previous research that investigated how messaging influences learning in classroom settings.This study provides more clarity on the conditions through which online teleconferencing platforms affect student learning and note taking.Findings suggest that allowing relevant discussions is not the best strategy to promote learning in CMLEs as this information seems to compete with the other relevant information being presented during the ongoing lecture. Implications for practitioners: The features of video lectures are critical factors, as they influence students' learning and should therefore be taken into account when designing educational materials.Instructors should not allow students to engage in lecture‐relevant and irrelevant messaging and discussion during video lectures as it competes with the other relevant information being presented. [ABSTRACT FROM AUTHOR]

This paper presents data from a Québec French-speaking child with protracted phonological development (PPD) who received phonological intervention based on a nonlinear phonological framework. At 5;3, he showed relative strengths in word structure compared with consonants (e.g., /s, f, v, k, ɡ/). Addressing segmental constraints in intervention led to higher overall accuracy and more consistent production of singleton consonants and word-medial consonant sequences and further gains in word structure. As part of a special cross-linguistic issue on individual profiles in PPD, the current paper provides an in-depth pre/post-treatment phonological analysis and contributes to emerging normative French-Canadian data on assessment and treatment. [ABSTRACT FROM AUTHOR]

Emergency departments (EDs) have a key role in the public health system. They are facing a constant growth of their volume. Forecasting the daily volume is a major tool to adapt the allocation of resources. In this paper, we focus on pediatric EDs. They are specific by their strong seasonal variation, determined by the academic pace. The main contribution of this paper is to integrate the effects of this pace to the annual seasonality. We also tried out to improve the daily forecasting by forecasting the week means of the flow first. We trained and tested these models specifically on the pediatric EDs of Paris university hospital trust. For the eight pediatric EDs gathered, on average for the years 2016 to 2019, we forecasted the daily volume with a Mean Absolute Percentage Error (MAPE) of 6.6% for a 7-days forecasting, 7.1% for a 14-days forecasting and 7.6% for a 28-days forecasting. Account of rhythm allows a performance increase, with results respectively 7%, 10.1% and 8.4% better relatively to a baseline model based on a periodic regression on the weeks. [ABSTRACT FROM AUTHOR]

Phenomenon: The urgency of having fair and trustworthy competency-based assessment in medical training is growing. Simulation is increasingly recognized as a potent method for building and assessing applied competencies. The growing use of simulation and its application in summative assessment calls for comprehensive and rigorously designed programs. Defining the current baseline of what is available and feasible is a crucial first step. This paper uses anesthesia and intensive care (AIC) in France as a case study in how to document this baseline. Approach: An IRB-approved, online anonymous closed survey was submitted to AIC residency program directors and AIC simulation program directors in France from January to February 2021. The researcher-developed survey consisted of 65 questions across five sections: centers' characteristics, curricular characteristics, courses' characteristics, instructors' characteristics, and simulation perceptions and perspectives. Findings: The participation rate was 31/31 (100%) with 29 centers affiliated with a university hospital. All centers had AIC simulation activities. Resident training was structured in 94% of centers. Simulation uses were training (100%), research and development (61%), procedural or organizational testing (42%), and summative assessment (13%). Interprofessional full-scale simulation training existed in 90% of centers. Procedural training on simulators prior to clinical patients' care was performed "always" in 16%, "most often" in 45%, "sometimes" in 29% and "rarely" or "not" in 10% of centers. Simulated patients were used in 61% of centers. Main themes were identified for procedural skills, full-scale and simulated patient simulation training. Simulation activity was perceived as increasing in 68% of centers. Centers expressed a desire to participate in developing and using a national common AIC simulation program. Insights: Based on our findings in AIC, we demonstrated a baseline description of nationwide simulation activities. We now have a clearer perspective on a decentralized approach in which individual institutions or regional consortia conduct simulation for a discipline in a relatively homogeneous way, suggesting the feasibility for national guidelines. This approach provides useful clues for AIC and other disciplines to develop a comprehensive and meaningful program matching existing expectations and closing the identified gaps. [ABSTRACT FROM AUTHOR]

Research to date has shown that HIV infection is a highly stressful experience for individuals, and one of the key adaptive resources after such painful experiences may be forgiveness. The aim of the present study was to examine the associations between dispositional forgiveness (assessed using Mullet's Forgivingness Questionnaire and Toussaint's Forgiveness Scale), perceived stress (single-item measure of stress symptoms), health perception (EuroQol visual analogue version of the scale) and life satisfaction (Satisfaction With Life Scale) in people living with HIV (PLWH) in France. Paper surveys were completed by 222 PLWH aged 18–78 (57% male). Multiple regression analysis revealed that sensitivity to circumstances, unconditional forgiveness, self-forgiveness, and forgiveness of others were significant predictors of health and happiness. Mediation analysis showed that these relationships are completely mediated by perceived stress. The present findings suggest that forgiveness and perceived stress may be important variables for healing in PLWH. Interventions designed to improve forgiveness and self-forgiveness may result in improved health and life satisfaction in PLWH. [ABSTRACT FROM AUTHOR]

Background: Computer‐based assessment allows for the monitoring of reader behaviour. The identification of patterns in this behaviour can provide insights that may be useful in informing educational interventions. Objectives: Our study aims to explore what different patterns of reading activity exist, and investigates their interpretation and consistency across different task sets (units), countries, and languages. Three patterns were expected: on‐task, exploring and disengaged. Methods: Using log data from the PISA 2012 digital reading assessment (9226 students from seven countries), we conducted hierarchical cluster analyses with typical process indicators of digital reading assessments. We identified different patterns and explored whether they remained consistent across different units. To validate the interpretation of the identified patterns, we examined their relationship to performance and student characteristics (gender, socio‐economic status, print reading skills). Results and Conclusions: The results indicate a small number of transnational clusters, with unit‐specific differences. Cluster interpretation is supported by associations with student characteristics—for example, students with low print reading skills were more likely to show a disengaged pattern than proficient readers. Exploring behaviour tended to be exhibited only once across the three units: It occurred in the first unit for proficient readers and in later units for less skilled readers. Major Takeaways: Behavioural patterns can be identified in digital reading tasks that may prove useful for educational monitoring and intervention. Although task situations are designed to evoke certain behaviours, the interpretation of observed behavioural patterns requires validation based on task requirements, assessment context and relationships to other available information. Lay Description: What is already known about the subject matter?: Students differ in how they read, comprehend and use digital information.Indicators from process data provide insight about how students engage with digital reading tasks. What does this paper add to the subject matter?: Based on multiple process indicators, a small number of clusters indicating different behavioural activity can be distinguished.These clusters can be described as on‐task, passive, hasty, exploring, disengaged, persistent and lost interest.A meaningful interpretation of the clusters must consider the requirements of the underlying tasks. Implications for practice and/or policy: Knowledge of how students engage with digital resources may provide useful feedback for teachers to guide students' learning or intervene when they struggle.Educational monitoring: The high comparability of country‐specific results suggests an invariant set of solution strategies in the digital reading assessment. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to present the results of a study that draws upon a collaborative research strategy and has two main objectives: 1) Translating and adapting into French the Measure of Victim Empowerment Related to Safety (MOVERS scale) (Goodman et al. Psychology of Violence, 5(4), 355-366, 2015a); 2) Validating the French version of the MOVERS scale in a population of French-Canadian women receiving shelter services. The French-Canadian MOVERS (FCM) was administered to 189 women receiving shelter services in the province of Québec (Canada). The factorial structure, reliability and validity of the FCM were tested. This paper highlights that the FCM replicates the three dimensions found in the original version (Goodman et al. Psychology of Violence, 5(4), 355-366, 2015a), displays significant correlations with measures of depression, anxiety and stress, self-esteem, perceived social support, satisfaction with life and self-efficacy, and has overall good reliability estimates. The FCM is a valid and reliable scale to assess safety-related empowerment among women receiving shelter services. Furthermore, the scale provides interesting opportunities to shelter workers, which will be discussed in the paper. [ABSTRACT FROM AUTHOR]

Conspiracy Beliefs (CB) are a key vector of violent extremism, radicalism and unconventional political events. So far, social‐psychological research has extensively documented how cognitive, emotional and intergroup factors can promote CB. Evidence also suggests that adherence to CB moves along social class lines: low‐income and low‐education are among the most robust predictors of CB. Yet, the potential role of precarity—the subjective experience of permanent insecurity stemming from objective material strain—in shaping CB remains largely unexplored. In this paper, we propose for the first time a socio‐functional model of CB. We test the hypothesis that precarity could foster increased CB because it undermines trust in government and the broader political 'elites'. Data from the World Value Survey (n = 21,650; Study 1, electoral CB) and from representative samples from polls conducted in France (n = 1760, Study 2a, conspiracy mentality) and Italy (n = 2196, Study 2b, COVID‐19 CB), corroborate a mediation model whereby precarity is directly and indirectly associated with lower trust in authorities and higher CB. In addition, these links are robust to adjustment on income, self‐reported SES and education. Considering precarity allows for a truly social‐psychological understanding of CB as the by‐product of structural issues (e.g. growing inequalities). Results from our socio‐functional model suggest that implementing solutions at the socio‐economic level could prove efficient in fighting CB. [ABSTRACT FROM AUTHOR]

Background and aims: Among European countries, France is particularly concerned by adolescent tobacco smoking, especially in disadvantaged socio‐economic backgrounds (SES). We measured the respective contributions of parental smoking and family living arrangement to social disparities in smoking during adolescence. Design: Secondary analysis of survey data. Setting: A cross‐sectional nation‐wide exhaustive 12‐day survey in March 2017 of French youth aged 17–18.5 years participating in the national mandatory civic information day. Participants: A total of 13 314 adolescents answering a pen‐and‐paper questionnaire about their own tobacco consumption and the smoking of their parents. Measurements Risk ratios (RRs) were computed using modified Poisson regressions, and population‐attributable fraction (PAF) was used as a measure of the explanatory roles of the different factors as mediators of SES. Findings Adolescents living within very privileged and privileged SES were significantly less likely to report daily tobacco smoking (20.4 and 22.7%, respectively) than those within modest and disadvantaged ones (26.0 and 28.6%, respectively). Parental smoking and family living arrangement independently explained the smoking inequalities among adolescents. After adjusting for schooling factors, the risks associated with parental smoking ranged between RR = 1.64 [95% confidence interval (CI) = 1.50–1.79] when the father only smoked and RR = 2.17 (95% CI = 1.99–2.36) when both parents smoked, compared with non‐smoking parents; the risk associated with living in a non‐intact family was 1.35 (95% CI = 1.26–1.43) and that of living outside the parental home was 1.20 (95% CI = 1.10–1.30). Apprentices and adolescents out of school had higher risks than those at school (RR = 1.82, 95% CI = 1.68–1.98) and RR = 2.10, 95% CI = 1.92–2.29). The contribution of parental smoking to adolescent smoking (PAF = 32%) was greater than that of SES (PAF = 9%), family living arrangement (PAF = 17%) or schooling factors (14%). The share of SES decreased from 18 to 9% when considering these mediating factors. Conclusion: In France, parental smoking appears to be the factor that most influences adolescent smoking, followed by family living arrangement; the role of family socio‐economic status is small in comparison. [ABSTRACT FROM AUTHOR]

The objective of this paper is to describe gestational weight gain (GWG), to assess the applicability of the 2009 Institute of Medicine (IOM) guidelines, and to derive a GWG adequacy classification within a French cohort. We included twins from the national, prospective, population‐based JUmeaux MODe d'Accouchement (JUMODA) cohort study (2014–2015). Following the IOM approach, we selected a 'standard' population of term pregnancies with 'optimal' birthweight (≥2500 g; n = 2562). GWG adequacy (insufficient; adequate; excessive) was defined using IOM recommendations (normal body mass index [BMI]: 16.8–24.5 kg [also utilized for underweight BMI]; overweight: 14.1–22.7 kg; obese: 11.4–19.1 kg). Additionally, using the IOM approach, we determined the 25th and 75th percentiles of GWG in our standard population to create a JUMODA‐derived GWG adequacy classification. GWG and GWG adequacy were described, overall and by BMI and parity. In the JUMODA standard population of term twin livebirths with optimal birthweight, mean GWG was 16.1 kg (standard deviation 6.3). Using IOM recommendations, almost half (46.5%) of the women had insufficient and few (10.0%) had excessive GWG, with similar results regardless of BMI or parity. The 25th and 75th percentiles of GWG in the JUMODA standard population (underweight: 13–21 kg; normal weight: 13–20 kg; overweight: 11–19 kg; obese: 7–16 kg) were lower than the IOM recommendations. The IOM recommendations classified a relatively high percentage of French women as having insufficient and a low percentage as having excessive GWG. Additional research to evaluate recommendations in relation to adverse perinatal outcomes is needed to determine whether the IOM recommendations or the JUMODA‐derived classification is more appropriate for French twin gestations. Key messages: Using the 2009 Institute of Medicine (IOM) recommendations to define gestational weight gain (GWG) adequacy in our French cohort classified almost half of women as having insufficient GWG and a relatively low percentage as having excessive GWG.The USA‐derived IOM definition for adequate GWG may not apply in France or in other non‐USA, contemporary obstetric populations.Additional research in large, population‐based contemporary cohorts with prospective GWG ascertainment and assessment of GWG adequacy classifications in relation to adverse outcomes is needed to inform evidence‐based GWG recommendations for twin pregnancies. [ABSTRACT FROM AUTHOR]

There is some indication that discrimination as well as low levels of life satisfaction render young people at risk of cyberhate victimization. Adopting a socio-ecological perspective, this paper examines whether supportive family, peer and school environments may buffer against the effects of perceived discrimination and low life satisfaction on cyberhate victimization. Data from four countries (N = 3396) of the EU Kids Online IV survey on children aged 11–17 (51% girls) revealed a positive association between perceived discrimination and cyberhate victimization, but this impact was moderated by supportive family and peer environments. A negative association between life satisfaction and cyberhate victimization was mitigated by peer support. However, no associations with the school context were found. The current study provides new insights on how social support on different levels of the social environment may buffer against potential risk factors for cyberhate victimization and can inform decision-makers towards intervention and prevention strategies. [ABSTRACT FROM AUTHOR]

Attachment disorganization is a significant high-risk factor for infant mental health. Its association with high-risk psychosocial contexts has been clearly identified, but the link between these difficult social contexts and maternal disruptive communication has been poorly explored. The CAPEDP (Compétences Parentales et Attachement dans la Petite Enfance; Parental competences and attachment in early childhood) study assessed the effects of a manualized home-intervention on the mental health of children and its major determinants. In this controlled trial, 440 young, first-time mothers belonging to socially vulnerable populations were recruited. Mothers in the intervention group received psychological support from the 27th week of pregnancy through to their child's second birthday, while both groups received assessment visits at the 3rd, 6th, 9th, 18th, and 24th months of age of the child and benefited from assistance by the research team. When the children reached 12 months of age, an ancillary study, the CAPEDP-Attachment (n = 119) evaluated the effects of this intervention on attachment. The current paper describes the program's impact on this subsample concerning maternal disruptive behavior, while exploring the role of socioeconomic risk factors. Our results showed that: (a) mothers in the intervention (IG) group presented significantly less disruptive communication than those in the control group (CG), even though the CG received a significant level of care over and above that which is available to the public in the French health system as 'care as usual'; (b) having a "low income" and "having given birth prematurely" was associated with maternal disruptive communication; and (c) the intervention impact increased when the model was adjusted for these two variables. Results suggest that attachment focused intervention programs should invest both maternal interactional skills and social and economic vulnerability. [ABSTRACT FROM AUTHOR]

Background: Articulatory excursion and vocal intensity are reduced in many children with dysarthria due to cerebral palsy (CP), contributing to the children's intelligibility deficits and negatively affecting their social participation. However, the effects of speech‐treatment strategies for improving intelligibility in this population are understudied, especially for children who speak languages other than English. In a cueing study on English‐speaking children with dysarthria, acoustic variables and intelligibility improved when the children were provided with cues aimed to increase articulatory excursion and vocal intensity. While French is among the top 20 most spoken languages in the world, dysarthria and its management in French‐speaking children are virtually unexplored areas of research. Information gleaned from such research is critical for providing an evidence base on which to provide treatment. Aims: To examine acoustic and perceptual changes in the speech of French‐speaking children with dysarthria, who are provided with speech cues targeting greater articulatory excursion (French translation of 'speak with your big mouth') and vocal intensity (French translation of 'speak with your strong voice'). This study investigated whether, in response to the cues, the children would make acoustic changes and listeners would perceive the children's speech as more intelligible. Methods & Procedures: Eleven children with dysarthria due to CP (six girls, five boys; ages 4;11–17;0 years; eight with spastic CP, three with dyskinetic CP) repeated pre‐recorded speech stimuli across three speaking conditions (habitual, 'big mouth' and 'strong voice'). Stimuli were sentences and contrastive words in phrases. Acoustic analyses were conducted. A total of 66 Belgian‐French listeners transcribed the children's utterances orthographically and rated their ease of understanding on a visual analogue scale at sentence and word levels. Outcomes & Results: Acoustic analyses revealed significantly longer duration in response to the big mouth cue at sentence level and in response to both the big mouth and strong voice cues at word level. Significantly higher vocal sound‐pressure levels were found following both cues at sentence and word levels. Both cues elicited significantly higher first‐formant vowel frequencies and listeners' greater ease‐of‐understanding ratings at word level. Increases in the percentage of words transcribed correctly and in sentence ease‐of‐understanding ratings, however, did not reach statistical significance. Considerable variability between children was observed. Conclusions & Implications: Speech cues targeting greater articulatory excursion and vocal intensity yield significant acoustic changes in French‐speaking children with dysarthria. However, the changes may only aid listeners' ease of understanding at word level. The significant findings and great inter‐speaker variability are generally consistent with studies on English‐speaking children with dysarthria, although changes appear more constrained in these French‐speaking children. What this paper addsWhat is already known on the subjectAccording to the only study comparing effects of speech‐cueing strategies on English‐speaking children with dysarthria, intelligibility increases when the children are provided with cues aimed to increase articulatory excursion and vocal intensity. Little is known about speech characteristics in French‐speaking children with dysarthria and no published research has explored effects of cueing strategies in this population.What this paper adds to existing knowledgeThis paper is the first study to examine the effects of speech cues on the acoustics and intelligibility of French‐speaking children with CP. It provides evidence that the children can make use of cues to modify their speech, although the changes may only aid listeners' ease of understanding at word level.What are the potential or actual clinical implications of this work?For clinicians, the findings suggest that speech cues emphasizing increasing articulatory excursion and vocal intensity show promise for improving the ease of understanding of words produced by francophone children with dysarthria, although improvements may be modest. The variability in the responses also suggests that this population may benefit from a combination of such cues to produce words that are easier to understand. [ABSTRACT FROM AUTHOR]

Policy PointsPrivate health insurance (PHI) in France has been facing critical changes over the past 30 years. A complementary and voluntary scheme, it has been historically dominated by nonprofit entities. However, the share of for‐profit insurance companies in the sector has significantly increased. Nonprofit firms also changed their strategies and mimicked some for‐profit behaviors.The present paper argues that this process is a result of the conflict‐provoking coevolution of the insurance and health care sectors. Trying to improve the regulation of the insurance industry as whole, two European directives first jeopardized the business model of nonprofit entities. Then, two national reforms designed to improve health coverage significantly increased competition among insurers, notably in the area of corporate‐level contracts.Decoupling the insurance and health care sectors has become a major source of policy feedback and unexpected outcomes of reforms affecting the very organization of PHI. Context: In France, private health insurance (PHI) has an exceptionally high level of coverage and accounts for 13.7% of health expenditures. A complementary and voluntary scheme, it has been historically dominated by nonprofit, mutual benefit societies. Over the past 20 years, however, the market share of for‐profit insurance companies has increased by 47%. Financialization of the field developed, and competition based on new risk management strategies also increased. The broad aim of this paper is to characterize and to elucidate the causes of this trend. More specifically, we are interested in how and to what extent a series of supranational and national policies contributed to this situation. Method: Our data come from three sources. We first reviewed documents published by health insurers, government reports, and newspaper articles. We then conducted two semistructured interview campaigns between September 2017 and May 2018. The first mostly covered private and public actors and their involvement in European Union (EU) policymaking (n = 21). The second series of interviews was conducted with another group of actors directly involved at the French level (n = 16). Findings: Our findings support preliminary observations. PHI in France, we argue, is indeed facing a development of competition and marketlike instruments. Four major policies (two EU directives and two national reforms) played a significant role in this outcome. Surprisingly, however, it has never been the purpose of legislators and policymakers: while EU directives created a regulatory framework for insurance activities within the Single Market, policies adopted at the national level initially aimed at improving health coverage. We show that it is the interactions and the noncoordination among all of these policies that explain their unexpected outcome. Conclusions: The trend described in this paper is twofold. The first is Europeanization, as PHI in France is increasingly affected by EU legislation. Since this framework tends to favor larger firms and for‐profit companies, a reduction in statutory coverage can no longer be considered a quasi‐neutral transfer from (publicly owned) social security to nonprofit providers. At the same time, PHI is shifting toward collectivization: as competition increases, complementary health coverage is becoming gradually standardized and based at the corporate level. Together, these changes are likely to reduce freedom of choice and individual welfare, an assumption supported by studies published on the most recent period. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tax increases are the most effective but still the least-used tobacco control measure. The tobacco industry (TI) employs lobbying strategies to oppose the implementation of tax policies on its products. Over the past two decades, French tobacco tax policies have been characterized by a relative inconsistency. This research aims to understand why, by analyzing the arguments of French policymakers (MPs and government) between 2000 and 2020 in favor or against tax increases. METHODS To capture parliamentary debates, we performed an advanced term search on the French National Assembly website, using the keyword 'tobacco'. The search returned 5126 available documents out of which 1106 (12.6%, 645 questions, 461 responses) covered price and taxation and were included. They were analyzed using descriptive statistics and thematic content analysis (NVivo) and were compared, when relevant, to arguments raised in the international literature on TI lobbying against taxation increases. RESULTS We found 3176 arguments on tobacco taxation: 77.2% were against tobacco tax increases and 22.7% were in favor of tax policies. Arguments varied depending on the source: 92.4% of MPs' arguments were against tax increases, while 52.1% of arguments from government responses were in favor. The anti-tax arguments were similar to those identified in the international literature that singled out negative economic and social consequences (illicit trade, penalizing tobacconists). Other arguments that were more specific to the French context, highlighted the key economic and social role played by tobacconists in France. Pro-tax arguments highlighted the health, economic and social benefits of tax policies. CONCLUSIONS This is the first French tobacco research on parliamentary documents, although Parliament is a place of direct TI lobbying. It will enable public health actors to better understand the arguments used by the TI in order to counter them in front of MPs, and to better monitor debates in Parliament. [ABSTRACT FROM AUTHOR]

Background: As educational digital technologies are increasingly being used in schools, past research left unanswered the question of these technologies' impact on the socioeconomic achievement gap even when equal access is guaranteed. Objectives: The objectives of the present study are to examine whether and how the socioeconomic achievement gap can be reduced through the use of computer‐assisted instruction (CAI). Methods: We addressed this issue experimentally by comparing CAI to conventional teacher‐led classroom instruction with more than 800 middle and high school students from disadvantaged and highly privileged socioeconomic backgrounds in a range of topics. Results and Conclusions: Both disadvantaged and highly privileged students taught with CAI outperformed those taught with conventional instruction, thus maintaining the socioeconomic achievement gap constant. However, we also found that disadvantaged students receiving CAI performed as well as highly privileged students receiving conventional teacher‐led instruction. Takeaways: The positive effects associated with CAI may therefore help compensate the difficulties of students with a disadvantaged background, a still neglected possibility. Lay Description: What is already known about this topic?: Socioeconomic status affects academic achievement especially in students from disadvantaged backgrounds.Inequal access to digital learning is a by‐product of socioeconomic status.Computer‐assisted instruction is known to yield positive effects on learning. What this paper adds?: It examines the effectiveness of computer‐assisted instruction on reducing the socioeconomic achievement gap when equal access to digital education is guaranteed at the school level.It shows that computer‐assisted instruction (relative to teacher‐led conventional instruction) benefited disadvantaged students and their highly privileged counterparts equally, shifting the socioeconomic achievement gap upward.However, disadvantaged students receiving CAI may reach similar performance level as their highly privileged counterparts receiving conventional instruction, thus compensating the socioeconomic achievement gap. Implications for practice and/or policy: This finding strengthens the importance of targeting teaching methods depending on students' socioeconomic characteristics to allow disadvantaged students to maximize their learning potential and chances to access to higher education. [ABSTRACT FROM AUTHOR]

To explain that students with intellectual disabilities are not fully included in mainstream education, the present paper investigates public attitudes towards inclusive education and notably examines how these vary according to students' type of disability (i.e., an intellectual, a communicational, a sensory, a motor, or a specific learning one). Data were extracted from an opinion poll on inclusive education conducted on a representative sample of the French population (N = 1001). The analyses indicated that the public are less favourably inclined towards the inclusion of students with an intellectual disability in comparison to students with autism spectrum disorder, a sensory disability, specific learning disabilities or a motor disability. Participants who are familiar with disability seem to express more favourable attitudes than those who are not. The present study contributes to a better understanding of public attitudes towards inclusive education and opens perspectives to develop more inclusive societies. [ABSTRACT FROM AUTHOR]

Many studies have demonstrated the crucial role of vocabulary in predicting reading performance in general. More recent work has indicated that one particular facet of vocabulary (its depth) is more closely related to language comprehension, especially inferential comprehension. On this basis, we developed a training application to specifically improve vocabulary depth. The objective of this study was to test the effectiveness of a mobile application designed to improve vocabulary depth. The effectiveness of this training was examined on 3rd and 4th grade children's vocabulary (breadth and depth), decoding and comprehension performances. A randomized waiting‐list control paradigm was used in which an experimental group first received the intervention during the first 4 weeks (between pretest and post‐test1), thereafter, a waiting control group received the training for the next 4 weeks (between postest1 and posttest2). Results showed that the developed application led to significant improvements in terms of vocabulary depth performance, as well as a significant transfer effect to reading comprehension. However, we did not observe such a beneficial effect on either vocabulary breadth or written word identification. These results are discussed in terms of the links between vocabulary depth and comprehension, and the opportunities the app presents for remedying language comprehension deficits in children. Lay Description: What is already known about this topic:Vocabulary is a powerful predictor of both word identification and text comprehensionVocabulary depth rather than breadth is more closely related to language comprehensionDepth of vocabulary is particularly predictive of inferencing skills What this paper adds:We develop a new training application specifically targeting vocabulary depthThe training led to significant gain in children's knowledge for the taught wordsWe also observe a transfer effect with significant improvements in reading comprehension Implications for practice and/or policy:Vocabulary depth trainings represent a good way for remedying language comprehension deficits [ABSTRACT FROM AUTHOR]

Background/objectives: Sedentary behavior (SB), defined as sitting (nonexercising), reclining, and lying down (posture), or by low energy expenditure, is a public health risk independent to physical activity. The objective of this systematic literature review was to synthesize the available evidence on amount of SB reported by and measured in older adults. Data source: Studies published between 1981 and 2014 were identified from electronic databases and manual searching. Large-scale population studies/surveys reporting the amount of SB (objective/ subjective) in older adults aged ≥ 60 years of age were included. Appraisal and synthesis was completed using MOOSE guidelines. Results: 349,698 adults aged ≥ 60 within 22 studies (10 countries and 1 EU-wide) were included. Objective measurement of SB shows that older adults spend an average of 9.4 hr a day sedentary, equating to 65-80% of their waking day. Self-report of SB is lower, with average weighted self-reports being 5.3 hr daily. Within specific domains of SB, older adults report 3.3 hr in leisure sitting time and 3.3 hr watching TV. There is an association with more time spent in SB as age advances and a trend for older men to spend more time in SB than women. Conclusion/ implications: Time spent sedentary ranges from 5.3-9.4 hr per waking day in older adults. With recent studies suggesting a link between SB, health, and well-being, independent of physical activity, this is an area important for successful aging. Limitations: Different methodologies of measurement and different reporting methods of SB made synthesis difficult. Estimated SB time from self-report is half of that measured objectively; suggesting that most self-report surveys of SB will vastly underestimate the actual time spent in SB. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd 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.)

Purpose: This study aims to investigate the relationship between a positive leadership style [i.e. authentic leadership (AL)] and nurses' psychological health (i.e. nurses' flourishing and satisfaction with work–family balance), including psychological capital (PsyCap) as a mediational variable. Design/methodology/approach: A cross-sectional study was conducted with a self-report questionnaire including 1,076 nurses from public and private hospitals in France. Findings: Structural equation modeling results revealed that AL is related to nurses' flourishing and satisfaction with work–family balance and that PsyCap acted as a partial mediator between this leadership style and positive outcomes. Practical implications: This research indicated that hospitals can enhance nurses' psychological health not only in their work but also in their lives in general by improving leaders' authentic management style and developing PsyCap (e.g. staffing, training and development). Originality/value: An original feature of this paper concerns its focus on the mediating role of PsyCap in the relationship between AL and these positive outcomes. Moreover, this study underlined the influence of leadership style on nurses' psychological health beyond occupational health. The research makes a valuable contribution to the existing AL literature by establishing a new explanatory model of AL and nurses' psychological health in the French context. It also highlights the interest in developing this leadership style in health-care settings. [ABSTRACT FROM AUTHOR]

Background This paper studies the evolution of transitions from first cigarette use to daily use by socioeconomic status (SES) among French adolescents over the course of 17 years, in a context of decreasing prevalence of tobacco use. Methods A total of 182 266 adolescents participated in the nationally representative ESCAPAD survey at nine different time points between 2000 and 2017. Discrete time-event analysis was used to model the transition to daily cigarette use as a function of SES, gender, age at onset and the use of other psychoactive substances. Results Although lifetime cigarette smoking and daily cigarette smoking decreased significantly over the studied time span, suggesting a positive impact of prevention policies, disadvantaged adolescents were consistently more prone to engage in daily cigarette smoking, more so in 2017 than 15 years earlier. In the same time span, transitions from initiation to daily cigarette smoking have shortened, with an accelerated pace among underprivileged adolescents. Conclusions Accelerated transitions from initiation to daily cigarette use are a prevalent trend among disadvantaged adolescents in France. Efforts to mitigate the impact of marketing strategies and to promote health literacy should be pursued to reduce social inequalities in health. [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]

Purpose: France, once a pioneer in psychiatry, is now sinking as its population faces major mental health challenges. This includes the 12 Million French individuals with psychiatric conditions, the lack of appropriate structures and the shortage of skilled mental health professionals, but it also leaves families in critical situations. The purpose of this study is to explore the carers' caregiving experiences and to suggest ways to organise educational programmes to support mental health carers in France. Design/methodology/approach: The research was conducted from January 2018 to November 2019. It included French carers of patients with mental conditions. Recorded semi-structured interviews were used and findings were analysed through an inductive thematic analysis and regrouped into key themes. Findings: Participants had overwhelming negative representations of "mental illness". The fact that they were excluded from participating in the patient's health management further added to their misconceptions around mental disability, it limited their communication with their family and amplified their burdens. Research limitations/implications: There is an urgent need for carer empowerment; carers should be included in educational programmes, they should benefit from French Government subsidies and social-network assistance and receive quality assistance by trained mental health professionals. The critical situation of carers can only be addressed by combining these three steps and through the action of appropriate actors in the field of mental health, thus alleviating the current paradigm of psychiatric care in France. Originality/value: Thousands of research papers regarding carers have been published in other countries. In addition yet, to the knowledge, only a few investigations on French mental health carers have been conducted to this day. The singularity of this research lies in the rare individual interviews, which provided us with first-hand testimonies of mental health carers in France. This data could be of vital aid for professionals and for policymakers when advocating for better support of carers in mental health. [ABSTRACT FROM AUTHOR]

Aims: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden. Methods: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression. Results: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4–6.4) and VPA recommendation (OR 2.8–5.0) than non-participants. Conclusions: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. 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 The emergence of COVID-19 triggered the massive implementation of non-pharmaceutical interventions (NPI) which impacted the circulation of respiratory syncytial virus (RSV) during the 2020/2021 season. Methods A time-series susceptible-infected-recovered (TSIR) model was used early September 2021 to forecast the implications of this disruption on the future 2021/2022 RSV epidemic in Lyon urban population. Results When compared to observed hospital-confirmed cases, the model successfully captured the early start, peak timing, and end of the 2021/2022 RSV epidemic. These simulations, added to other streams of surveillance data, shared and discussed among the local field experts were of great value to mitigate the consequences of this atypical RSV outbreak on our hospital paediatric department. Conclusions TSIR model, fitted to local hospital data covering large urban areas, can produce plausible post-COVID-19 RSV simulations. Collaborations between modellers and hospital management (who are both model users and data providers) should be encouraged in order to validate the use of dynamical models to timely allocate hospital resources to the future RSV epidemics. [ABSTRACT FROM AUTHOR]

Using cross-sectional data from a representative sample of the French population (the 2008 Disability Health survey), this paper examines whether the SF-6D, a widely used preference-based measure of health-related quality of life in economic evaluations, fully captures the variation in subjective well-being (SWB) due to chronic illnesses. We conduct a mediation analysis to disentangle the direct and indirect, through the SF-6D, effects of various chronic conditions on SWB (happiness). Our results show that the SF-6D reflects changes in happiness due to most illnesses except mental illness. Changes in SWB mediated by the SF-6D account for 74% of the total effect. The variation unexplained by the SF-6D is significant and increases substantially in the presence of multimorbidity when a chronic illness is combined with anxiety or depression. Overall, our results suggest that the SF-6D incompletely captures the subjective experience of chronically ill patients, especially those with comorbid conditions. • 74% of the effect of chronic illness on happiness is captured by the SF-6D. • The SF-6D does not fully capture the effect of mental illness on happiness. • The effect not captured by the SF-6D increases significantly with multimorbidity. [ABSTRACT FROM AUTHOR]

Study Objective: The present study is aimed at providing an assessment of the changes in burnout, job strain, isostrain, sleepiness, and fatigue levels over time and identifying factors associated with these symptoms among healthcare workers in French emergency departments (EDs). Method: We conducted a prospective, multicenter study in four EDs and an emergency medical service. Participants completed questionnaires at inclusion and at 90 days to assess burnout, job strain, isostrain, sleepiness, and fatigue. Results: A total of 211 respondents (43.5%) completed the questionnaires at inclusion. At the beginning of the study, 84 (40.8%) participants presented symptoms of burnout, 86 (43.2%) had symptoms of job strain, and 58 (29.4%) of isostrain. Forty‐two (20.1%) healthcare workers presented symptoms of sleepiness, and 8 (3.8%) had symptoms of fatigue. We found that symptoms of burnout were more frequent for healthcare workers with a previous psychiatric history (55.3% vs. 39.1%, p = 0.02) and were lower among participants who had at least one dependent child (33.1% vs. 48.3%, p = 0.013). Symptoms of job strain were higher among administrative staff compared to physicians (55.6% vs. 28.7%, p = 0.01) and among healthcare workers with managerial responsibilities compared to those without (45.6% vs. 28.8%, p = 0.015). Symptoms of isostrain were higher among administrative staff (42.3%) compared to paramedics (34.1%) and physicians (19.8%, p = 0.026). Conclusion: We identified that potential factors associated with the emergence of symptoms of burnout and job strain are suggested, underlining several areas of improvement for the prevention against mental health disorders in the specific population of ED healthcare workers. Trial Registration: ClinicalTrials.gov identifier: NCT04383886. [ABSTRACT FROM AUTHOR]

Background: French laws governing end-of-life medical practices forbid euthanasia and affirm patients' right to deep and continuous sedation until death. Cultural traditions and disparities in health care provision, as in overseas France, could limit the enforcement of such laws and modify end-of-life medical practices. Aim: This research aims to describe end-of-life medical decisions in overseas France and to compare with those described in mainland France. Methods: A retrospective study of a random sample of adult patients who died between March 2020 and February 2021 was conducted in four overseas French departments. Physicians who certified the deaths were asked to describe end-of-life care and medical decisions in a questionnaire. Results: A total of 1815 deaths were analysed over 8730 questionnaires sent. Withholding treatments was the most frequent decision (41%), treatment for pain or symptoms was intensified for a third of patients, Deep and continuous sedation until death was implemented in 13.3% cases. The use of drugs to deliberately end life was mentioned in 1.3% deaths. At least one decision was made in 61.6% deaths. More decisions that may hasten death were made before predictable deaths. Intensification of pain and symptoms treatment was more frequent in 2022 than in 2010. Deep and continuous sedation was introduced by law in 2016 without prejudice to other decisions. Conclusion: Physicians in overseas France have implemented recent changes in end-of-life laws, including deep and continuous sedation. Comparisons with 2010 mainland France survey show a better implementation of palliative medicine in 2022, with higher proportions of treatment withholding. [ABSTRACT FROM AUTHOR]

Purpose: Cross-language studies suggest more similarities than differences in how dysarthria affects the speech of people with Parkinson's disease (PwPD) who speak different languages. In this study, we aimed to identify the relative contribution of acoustic variables to distinguish PwPD from controls who spoke varieties of two Romance languages, French and Portuguese. Method: This bi-national, cross-sectional, and case-controlled study included 129 PwPD and 124 healthy controls who spoke French or Portuguese. All participants underwent the same clinical examinations, voice/speech recordings, and self-assessment questionnaires. PwPD were evaluated off and on optimal medication. Inferential analyses included Disease (controls vs. PwPD) and Language (French vs. Portuguese) as factors, and random decision forest algorithms identified relevant acoustic variables able to distinguish participants: (a) by language (French vs. Portuguese) and (b) by clinical status (PwPD on and off medication vs. controls). Results: French-speaking and Portuguese-speaking individuals were distinguished from each other with over 90% accuracy by five acoustic variables (the mean fundamental frequency and the shimmer of the sustained vowel /a/ production, the oral diadochokinesis performance index, the relative sound level pressure and the relative sound pressure level standard deviation of the text reading). A distinct set of parameters discriminated between controls and PwPD: for men, maximum phonation time and the oral diadochokinesis speech proportion were the most significant variables; for women, variables calculated from the oral diadochokinesis were the most discriminative. Conclusions: Acoustic variables related to phonation and voice quality distinguished between speakers of the two languages. Variables related to pneumophonic coordination and articulation rate were the more effective in distinguishing PwPD from controls. Thus, our research findings support that respiration and diadochokinesis tasks appear to be the most appropriate to pinpoint signs of dysarthria, which are largely homogeneous and language-universal. In contrast, identifying language-specific variables with the speech tasks and acoustic variables studied was less conclusive. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are very common bacterial infections in children. Early detection of renal parenchymal involvement in this setting can help clinicians make more effective treatment choices. The aim of this pilot study was to assess the ability of plasma and urinary neutrophil gelatinase-associated lipocalin (pNGAL and uNGAL) levels, measured using an automated system, to accurately predict renal parenchymal involvement in children with febrile UTIs. Methods: This prospective single-center study included 28 children aged ≥ 4 years with a first episode of febrile UTIs. All patients underwent magnetic resonance imaging. pNGAL, uNGAL, procalcitonin, C-reactive protein (CRP), and white blood cells were measured before antibiotic therapy. Results: The receiver operating characteristic (ROC) area under the curve for predicting acute pyelonephritis was 0.6 for pNGAL, 0.8 for CRP, 0.4 for PCT, and 0.4 for uNGAL. The ROC analyses showed an optimal cutoff of 141.0 ng/mL for pNGAL (sensitivity, 54.2%; specificity, 75.0%; positive predictive value, 92.9%; and negative predictive value, 21.4%). Conclusion: pNGAL and uNGAL did not effectively aid the early prediction of renal parenchymal involvement in children ≥ 4 years with febrile UTIs. The novelties of this study were the use of MRI as the gold standard and an automated biochemical method to measure NGAL. [ABSTRACT FROM AUTHOR]

Objective: To assess rates of traversing barriers to care to access optimal clinical outcomes in people with migraine internationally. Background: People in need of medical care for migraine should consult a health care professional knowledgeable in migraine management, obtain an accurate diagnosis, and receive an individualized treatment plan, which includes scientific society guideline-recommended treatments where appropriate. Methods: The Chronic Migraine Epidemiology and Outcomes-International (CaMEO-I) Study was a cross-sectional, web-based survey conducted from July 2021 through March 2022 in Canada, France, Germany, Japan, the United Kingdom, and the United States (US). Respondents who met modified International Classification of Headache Disorders, 3rd edition, criteria for migraine and had Migraine Disability Assessment Scale (MIDAS) scores of ≥ 6 (i.e., mild, moderate, or severe disability) were deemed to need medical care and were included in this analysis. Minimally effective treatment required that participants were currently consulting a health care professional for headache (barrier 1), reported an accurate diagnosis (barrier 2), and reported use of minimally appropriate pharmacologic treatment (barrier 3; based on American Headache Society 2021 Consensus Statement recommendations). Proportions of respondents who successfully traversed each barrier were calculated, and chi-square tests were used to assess overall difference among countries. Results: Among 14,492 respondents with migraine, 8,330 had MIDAS scores of ≥ 6, were deemed in need of medical care, and were included in this analysis. Current headache consultation was reported by 35.1% (2926/8330) of respondents. Compared with the US, consultation rates and diagnosis rates were statistically significantly lower in all other countries except France where they were statistically significantly higher. Total appropriate treatment rates were also statistically significantly lower in all other countries compared with the US except France, which did not differ from the US. All 3 barriers were traversed by only 11.5% (955/8330) of respondents, with differences among countries (P < 0.001). Conclusions: Of people with migraine in need of medical care for migraine, less than 15% traverse all 3 barriers to care. Although rates of consultation, diagnosis, and treatment differed among countries, improvements are needed in all countries studied to reduce the global burden of migraine. Trial registration: NA. [ABSTRACT FROM AUTHOR]

Introduction: Lung cancer is a significant cause of mortality, especially among smokers. Lung cancer and smoking are strongly associated, according to numerous studies. Methods: Publications related to smoking and lung cancer were retrieved from the Science Citation Index Expanded (SCIE) database of the Web of Science Core Collection for the period 1994–2023. Descriptive and visual analyses were performed on the topics, journals, countries, institutions, authors, and citations of the publications. Results: A total of 728 articles were retrieved from the Web of Science (WOS) SCIE database for the period January 1994 to December 2023, and the number of publications in the relevant literature demonstrated a progressive increase with time. A total of 647 articles were classified as experimental, while 81 were classified as reviews. The studies were published in 200 journals. The three journals that published the most articles were the American Journal of Epidemiology with 82 articles, Lung Cancer with 34 articles, and Cancer Causes and Control with 26 articles. The three most prolific countries were the United States (286 articles, 38.3%; 15879 citations), China (116 articles, 15.9%; 2911 citations), and France (75 articles, 10.3%; 3694 citations). The four most popular keywords in this field are 'early cancer detection', 'experimental', 'CT', and 'survival rate'. Conclusions: The findings of our study revealed key areas for focus in smoking and lung cancer research, having a view of supplying important data and motivation for further investigations. [ABSTRACT FROM AUTHOR]

Objective In studies of concomitant arterial–venous umbilical cord blood gases (CAV-UBGs), approximately 10% of technically valid samples have very similar pH and/or pCO 2 values and were probably drawn from the same type of blood vessel. Without a way to objectively determine the source in these cases, it has been argued that most of these same-source CAV-UBGs are venous because the vein is larger and more easily sampled than the artery. This study aimed to calculate the probability of an arterial (ProbAS) or venous source (ProbVS) of same-source CAV-UBGs in the clinically and medicolegally important pH range of 6.70 to 7.25 using a statistical predictive model based on the cord blood gas values. Study Design Starting with a dataset of 56,703 CAV-UBGs, the ProbAS, ProbVS, and respective 95% confidence intervals (CIs) were calculated for the 241 sample pairs with near-identical pH, pCO 2 , and pO 2 values and a pH of 6.70 to 7.25. Using a previously validated generalized additive model, the source was categorized as: Probable Arterial or Highly Probable Arterial if the ProbAS and CIs were >0.5 or >0.8, respectively; Probable Venous or Highly Probable Venous if the ProbVS and CIs were >0.5 or >0.8, respectively; or Indeterminant if the CIs encompassed ProbAS/VS = 0.5. Results A total of 39% of the same-source CAV-UBGs were Probable Arterial, 56% were Probable Venous, and 5% were Indeterminant. However, considering samples with a pH ≤7.19, 80% were Probable Arterial and 16% were Probable Venous. Considering the Highly Probable categories, the more acidemic specimens were 9 times more likely to be arterial than venous. Similarly, CAV-UBGs with pCO 2 > 8.2 kPa (62 mm Hg) or pO 2 ≤ 1.9 kPa (14 mm Hg) were more likely to be in the arterial rather than the venous categories. Conclusion Same-source CAV-UBGs in the more acidemic, hypercarbic, or hypoxemic ranges are more likely to be arterial than venous. Key Points Umbilical cord arterial/venous gases (CAV-UBGs) with similar values are thought to be mainly venous. A validated statistical model was used to predict the probability an arterial or venous source. CAV-UBGs with very similar values and pH > 7.19 are likely venous; however, those with pH ≤ 7.19 and/or pCO 2 > 8.2 kPa and/or pO 2 ≤1.9 kPa are more likely arterial. [ABSTRACT FROM AUTHOR]

Recent research suggests that inducing fixed (rather than malleable) beliefs about groups leads to more negative attitudes toward out-groups. The present paper identifies the underlying mechanism of this effect. We show that individuals with a fixed belief about groups tend to construe intergroup settings as threatening situations that might reveal shortcomings of their in-group (perceived threat). In the present research, we measured (Study 1) and manipulated (Study 2) participants' lay theories about group malleability. We found that the extent to which individuals had an entity (versus an incremental) group theory influenced the level of threat they felt when interacting with out-group members, and that perceived threat in turn affected their level of ethnocentrism and prejudice. These findings shed new light on the role of lay theories in intergroup attitudes and suggest new ways to reduce prejudice. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Information seeking (IS) has become a critical activity in video‐based environments. Up to now, the effects of support on information seeking (i.e., scaffolding) have seldom been assessed. The twofold aim of the current study was to (a) assess the effects of scaffolding on IS in videos and (b) determine the characteristics of the users' mental models after an IS activity with or without scaffolding. We divided 50 participants into two groups that either did or did not benefit from initial scaffolding during an IS task. Both groups then had to perform a localization task without any further access to scaffolding. Results showed that scaffolding the video by providing a table of contents and markers on a timeline helped students to engage in highly efficient IS, but they had less accurate mental representations of the video than those without scaffolding. The hypothesis that scaffolding provides a usable but external model was therefore supported. Lay Description: What is already known about this topic: Videos are increasingly used in learning.Searching for information in videos may be a complex activity.So far, very few studies have been conducted on the potential effect of scaffolding videos during an information‐seeking (IS) task. What this paper adds: In this study, we put in place the scaffolding of the video by adding a table of contents and markers on the timeline.Structuration and segmentation have positive effects on the performance in IS, in terms of response success, time spent on each search, relevance, and perceived difficulty.Scaffolding has a negative impact on the users' internal representations of the video. Implications for practice: Incorporating a table of contents and a structured timeline into a video facilitates the search activity.Without scaffolding, the search activity is longer and cognitively more costly.Paradoxically, users have a poorer representation of the video (i.e., poorer mental model) after the IS task when they were given scaffolding.Future studies should focus on the benefits of providing structuring and segmentation in learning tasks. [ABSTRACT FROM AUTHOR]

Background The symmetrical Lyon brace is a brace, usually used to maintain correction after a plaster cast reduction in the Cotrel's EDF (Elongation-Derotation-Flexion) frame. The new Lyon brace or ARTbrace is an immediate corrective brace based on some of the principles of the plaster cast which are improved due to advances in CAD/CAM technology. The aim of this paper is to describe concepts of this new brace to be not only a replacement of the plaster cast, but also a definitive brace. Methods Instead of a plaster cast, three segmental CAD/CAM moulds are made with the instantaneous full 3D raster stereography digitizer (Orten): 1. In self axial elongation 2. In shift and lumbar lordosis 3. In shift and thoracic kyphosis A specific software (OrtenShape) makes up the overlay of the three moulds. Mould 1 is used for the pelvis and the shoulders mould 2 for the lumbar segment and mould 3 for the thoracic segment. The mathematical basis of the ARTbrace is the torso column which is a circled helicoid with horizontal circle generator. A torso column is reproduced in the opposite direction of the scoliosis. Like the plaster cast, the ARTbrace is worn for a "total time" of 24 hours 7 days a week without modifying the standard protocol of the Lyon brace reduction. The prospective controlled cohort observational study of the 225 first patients treated since May 2013 is reported below. Results The in-brace immediate reduction is: 0.7, i.e. 40% better with the ARTbrace than with a plaster cast. The correction of flat back is 9° (from 18°.4 to 28°.5 kyphosis Cobb angle). The improved aesthetic appearance is equal for rib hump and ATR. Conclusion This first paper is an introduction with very short results and does not prejudge the final outcome. The ARTbrace can be used not only to replace the plaster cast, but also as a definitive brace. The new segmental moulding with final detorsion is even more efficient and to this day the ARTbrace is the most effective to reduce the Cobb angle of scoliosis. [ABSTRACT FROM AUTHOR]

The objectives of this work were (a) to adopt the Active Healthy Kids Global Alliance Report Card methodology to evaluate the state of physical activity (PA) for French children and adolescents with disabilities (CAWD) and (b) to identify the strengths, weaknesses, opportunities, and threats (SWOT) perceived by French PA experts for promoting PA among CAWD. The harmonized Active Healthy Kids Global Alliance Report Card development process was used to assign a grade to the 10 common PA indicators. SWOT templates were completed by PA experts and then collapsed in a summary figure. Despite increasing efforts to provide active opportunities to CAWD, concerning low grades were assigned to behavioral indicators. SWOT analysis provided important insights for the promotion of PA in CAWD. This work highlighted the need for the inclusion of CAWD in a comprehensive national PA surveillance system and for more efficient strategies promoting PA specifically targeting CAWD in France. [ABSTRACT FROM AUTHOR]

introduction We aimed to estimate the prevalence and incidence of specific symptoms and predictors of post-acute COVID-19 syndrome using data collected from an anonymous online survey. methods We included adult participants with symptoms ≥60 days (D60+), fulfilling the World Health Organization COVID-19 cases definition, and/or hospitalized for COVID-19 at the time of infection (D0). Self-reported symptoms were collected at D0 and D60+. Logistic regression was performed to identify factors associated with self-reported cutaneous signs prevalence and self-reported tachycardia and/ or HBP incidence on D60+. results From April to June 2020, 956 members of a Twitter long-term COVID-19 community were included in the study population: 81% were women, 81% were aged <50 year, 22% were smokers, and 95% have never been hospitalized. At D60+, the 956 participants reported a broad spectrum of symptoms which were also present at D0+. At D60+, 16% and 39% of participants reported cutaneous signs and tachycardia and/or hypertension, respectively. The incidence of self-reported tachycardia and/or hypertension at D60+ was 12%. Female gender (AOR=2.56; 95% CI: 1.22-6.1) and smoking (AOR=2.34; 95% CI: 1.39-3.92) were associated with prevalence of cutaneous signs at D60+. Smoking (AOR=2.05; 95% CI: 1.23.47) was the main correlate of tachycardia and/or HBP incidence at D60+. conclusions The incidence of self-reported tachycardia and/or hypertension is not negligible and suggests an interaction between COVID-19 and smoking. Reinforcing symptoms monitoring of people after acute COVID-19, mainly women and smokers, and expanding the promotion of smoking cessation strategies are novel priorities in this COVID-19 era. [ABSTRACT FROM AUTHOR]

ABSTRACT Research on ideological attitudes has identified two main dimensions that refer to two fundamental features of group organization: social solidarity and social control. In response to prior research that has studied their relationship mainly from a correlational perspective, this paper introduces a social reality model based on psychological functionality of ideological attitudes. Social position variables (education, income and material vulnerability) and insecurity variables (fear of crime and distrust) are used to predict the interplay between ideological attitudes towards social solidarity and social control. Using K-means cluster analysis, a typology with four patterns of support for solidarity and control ('socials', 'repressives', 'minimalists' and 'social-repressives') was created, on the basis of representative survey data for the UK, France and Germany ( N = 7034). Results from logistic regression analyses show that the proposed social reality model explains membership in typology categories, with similar results across the three countries. Overall, the model underscores the social origins of ideological attitudes as functional responses to perceived social reality. The paper illustrates how the social psychological study of ideological attitudes may be enriched by a typological approach that examines patterns of attitudes rather than single dimensions. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Breastfeeding is recommended until 6 months of age, but a wide range of infant formula is available for nonbreastfed or partially breastfed infants. Our aim was to describe infant formula selection and to examine social- and health-related factors associated with this selection. Analyses were based on 13,291 infants from the French national birth cohort Etude Longitudinale Française depuis l'Enfance. Infant diet was assessed at Month 2 by phone interview and monthly from Months 3 to 10 via internet/paper questionnaires. Infant formulas were categorized in 6 groups: extensively or partially hydrolysed, regular with or without prebiotics/probiotics, and thickened with or without prebiotics/probiotics. Associations between type of infant formula used at 2 months and family or infant characteristics were assessed by multinomial logistic regressions. At Month 2, 58.1% of formula-fed infants were fed with formula enriched in prebiotics/probiotics, 31.5% with thickened formula, and 1.4% with extensively hydrolysed formula. The proportion of formula-fed infants increased regularly, but the type of infant formula used was fairly stable between 2 and 10 months. At Month 2, extensively hydrolysed formulas were more likely to be used in infants with diarrhoea or regurgitation problems. Partially hydrolysed formulas were more often used in families with high income, with a history of allergy, or with infants with regurgitation issues. Thickened formulas were used more with boys, preterm infants, infants with regurgitation issues, or in cases of early maternal return to work. The main factors related to the selection of infant formula were family and infant health-related ones. [ABSTRACT FROM AUTHOR]

Background: Evidence for the management of pregnant women with acute hypoxaemic respiratory failure (AHRF) is currently lacking. The likelihood of avoiding intubation and the risks of continuing the pregnancy under invasive ventilation remain undetermined. We report the management and outcome of pregnant women with pneumonia related to SARS-CoV-2 admitted to the ICU of tertiary maternity hospitals of the Paris area. Methods: We studied a retrospective cohort of pregnant women admitted to 15 ICUs with AHRF related to SARS-CoV-2 defined by the need for O2 ≥ 6 L/min, high-flow nasal oxygen (HFNO), non-invasive or invasive ventilation. Trajectories were assessed to determine the need for intubation and the possibility of continuing the pregnancy on invasive ventilation. Results: One hundred and seven pregnant women, 34 (IQR: 30–38) years old, at a gestational age of 27 (IQR: 25–30) weeks were included. Obesity was present in 37/107. Intubation was required in 47/107 (44%). Intubation rate according to respiratory support was 14/19 (74%) for standard O2, 17/36 (47%) for non-invasive ventilation and 16/52 (31%) for HFNO. Factors significantly associated with intubation were pulmonary co-infection: adjusted OR: 3.38 (95% CI 1.31–9.21), HFNO: 0.11 (0.02–0.41) and non-invasive ventilation: 0.20 (0.04–0.80). Forty-six (43%) women were delivered during ICU stay, 39/46 (85%) for maternal pulmonary worsening, 41/46 (89%) at a preterm stage. Fourteen non-intubated women were delivered under regional anaesthesia; 9/14 ultimately required emergency intubation. Four different trajectories were identified: 19 women were delivered within 2 days after ICU admission while not intubated (12 required prolonged intubation), 23 women were delivered within 2 days after intubation, in 11 intubated women pregnancy was continued allowing delivery after ICU discharge in 8/11, 54 women were never intubated (53 were delivered after discharge). Timing of delivery after intubation was mainly dictated by gestational age. One maternal death and one foetal death were recorded. Conclusion: In pregnant women with AHRF related to SARS-CoV-2, HFNO and non-invasive mechanical ventilation were associated with a reduced rate of intubation, while pulmonary co-infection was associated with an increased rate. Pregnancy was continued on invasive mechanical ventilation in one-third of intubated women. Study registration retrospectively registered in ClinicalTrials (NCT05193526). [ABSTRACT FROM AUTHOR]

Background: Both enhancing life expectancy and decreasing inequalities in lifespan between social groups are significant goals for public policy. To date, however, methodological tools to study progress in both dimensions simultaneously have been lacking. There is also a consensus that absolute and relative inequalities in lifespan must be studied together. Methods: We introduce a novel graphical representation that combines national mortality rates with both absolute and relative measures of social inequality in mortality. To illustrate our approach, we analyze French and German data stratified by place of residence. Results: For all-age mortality, in France we find a steady pace of decline in both mortality and in regional inequalities in mortality over recent decades. In Germany, substantial progress was made in the 1990s, mostly driven by convergence between eastern and western Germany, followed by a period of slower progress. Age-specific analyses for Germany reveal a worrying divergence in regional trends at ages 35–74 in recent years, which is particularly pronounced among women. Conclusion: Our novel visual approach offers a way to simultaneously examine two dimensions of progress in longevity, and facilitates meaningful comparisons between populations, even when their current mortality rates differ. The applied methods can be easily reproduced in any country for which long-term mortality series stratified by region, or any relevant socioeconomic characteristic, are available. It is useful for both scientific analysis and policy advice. [ABSTRACT FROM AUTHOR]

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To develop and validate the Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire, a new specific instrument with the goal of sensitively measuring vulnerability to sport‐specific stressful situations among elite athletes. Five hundred and thirty‐one competitive elite athletes (mean age = 17.6 ± 4.4 years) completed the Ford Insomnia Response to Stress Test (FIRST) questionnaire and the IRSST, a six‐item questionnaire developed to assess the level of sleep disturbance in response to the commonly experienced sport‐specific stressful situations. A development and validation process including substantive, structural, and external stages was used in the present study. One eigenvalue of the exploratory factor analyses was greater than 1.0 (i.e., 2.91, 48.52% of explained variance) whereas the scree test provided evidence for a one‐factor solution, with all the six items achieving a loading of 0.40 or higher on the factor. Cronbach alpha was 0.77 and provided evidence for the reliability of the IRSST score. The correlation between IRSST and FIRST scores was 0.47 (p < 0.001, moderate effect size). These results provide strong evidence for construct validity, indicating that the IRSST is a promising scale for assessing the likelihood of sleep disruption due to sports‐related stressful situations. The results of reliability and correlational analyses provided further evidence of the promising psychometric properties of the IRSST. We believe that the IRSST could provide to the sport and sleep science communities a sleep screening tool for use in this unique population. Highlights: The Insomnia in Response to Sports‐related Stress Test (IRSST) questionnaire is a promising new specific instrument for assessing the likelihood of sleep disruption due to sports‐related stressful situationsThe IRSST could provide to the sport and sleep science communities a sleep screening tool for use in the unique population of competitive elite athletesThe IRSST can be used to identify athletes with sleep difficulties related to sports‐specific stressful situations (e.g., training, competition, injury) [ABSTRACT FROM AUTHOR]