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8 results on '"MESH: General practice"'

1. [Health issues of patients aged 65 years or over managed in general practice: which associations are remarkable?]

Author

Elodie Vandroz, Fabien Subtil, Laurent Letrilliart, Marc Bonnefoy, Collège Universitaire de Médecine Générale [Lyon] (CUMG), Université de Lyon, Service de Biostatistique-Bioinformatique [Lyon], Pôle de Santé Publique [Lyon], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Lyon Sud Hosp Ctr, Hospices Civils de Lyon (HCL), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Research on Healthcare Performance (RESHAPE - Inserm U1290 - UCBL1), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
medicine.medical_specialty, Lipid disorder, multimorbidity, elderly patients, therapeutic synergy, MESH: Multimorbidity, MESH: Referral and Consultation, General Practitioners, MESH: General Practice, Medicine, Humans, In patient, Referral and Consultation, Biological Psychiatry, Aged, general practice, MESH: Aged, MESH: Humans, business.industry, Ancillary Study, MESH: General Practitioners, Neuropsychology and Physiological Psychology, Family medicine, [SDV.MHEP.PSM]Life Sciences [q-bio]/Human health and pathology/Psychiatrics and mental health, General practice, [SCCO.PSYC]Cognitive science/Psychology, Neurology (clinical), Geriatrics and Gerontology, business
Abstract

International audience; Introduction: We aimed at identifying the associations of health issues managed in general practice encounters with patients aged 65 years or over, according to their sex. Methods: Ancillary study of the ECOGEN study on the consultation practice of French general practitioners. We have studied the 15 most frequent health issues managed in patients aged 65 years or over and identified the pairs most frequently and strongly associated. Results: The sample included 5,782 encounters corresponding to 17,182 health issues managed. Each encounter involved an average of 3.0 [2.9-3.0] health issues. The strongest associations mainly included cardio-metabolic conditions. The most frequent and strong pair (OR: 3.8 [3.3-4.4]) associated non-complicated arterial hypertension with lipid disorder. Some associations were specific to patient sex. Conclusion: The remarkable associations identified may enable to improve the management of elderly patients with multimorbidity by favouring synergic treatments.

Published
2021
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2. Reorganisation of GP surgeries during the COVID-19 outbreak: analysis of guidelines from 15 countries

Author

Tsopra, Rosy, Frappe, Paul, Streit, Sven, Neves, Ana Luisa, Honkoop, Persijn J., Espinosa-Gonzalez, Ana Belen, Geroğlu, Berk, Jahr, Tobias, Lingner, Heidrun, Nessler, Katarzyna, Pesolillo, Gabriella, Sivertsen, Øyvind Stople, Thulesius, Hans, Zoitanu, Raluca, Burgun, Anita, Kinouani, Shérazade, Sciences de l’information au service de la médecine personnalisée = Information Sciences to support Personalized Medicine [CRC], Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), INSERM U1059, SAINBIOSE - Santé, Ingénierie, Biologie, Saint-Etienne (SAINBIOSE-ENSMSE), Centre Ingénierie et Santé (CIS-ENSMSE), École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-École des Mines de Saint-Étienne (Mines Saint-Étienne MSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet [Saint-Étienne] (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), University of Bern, Imperial College London, Federal University of Health Sciences of Porto Alegre = Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Leiden University Medical Center (LUMC), Izmir Institute of Technology (IZTECH), Hannover Medical School [Hannover] (MHH), Uniwersytet Jagielloński w Krakowie = Jagiellonian University (UJ), Lund University [Lund], Linneaus University, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Biotechnologie et Microbiologie Appliquée (LBMA), Université Bordeaux Segalen - Bordeaux 2-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Santé Ingénierie Biologie Saint-Etienne (SAINBIOSE), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d'Investigation Clinique - Epidémiologie Clinique Saint-Etienne (CIC-EC), Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universidade do Porto = University of Porto, Universiteit Leiden, İzmir Karşıyaka District Health Directorate [İzmir, Turkey] (IKDHD), Medizinische Hochschule Hannover (MHH), German Center for Lung Research, ASL Teramo [Abruzzo, Italy] (ASLT), Torshovdalen Health Center [Oslo, Norway] (THC), National Federation of Family Medicine Employers in Romania [București, Romania] (FNPMF), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), HAL-SU, Gestionnaire, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), CIC Saint Etienne, Centre Hospitalier Universitaire de Saint-Etienne (CHU de Saint-Etienne)-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Nord (Saint Etienne), and TSOPRA, Rosy

Subjects
Medicine (General), Internationality, [SDV]Life Sciences [q-bio], General Practice, Guidelines as Topic, 1110 Nursing, 610 Medicine & health, MESH: Primary Health Care, 1117 Public Health and Health Services, Medicine, General & Internal, R5-920, 360 Social problems & social services, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, General & Internal Medicine, MESH: General Practice, SURVEILLANCE, Humans, MESH: COVID-19, General&#160, General Practitioner, Practitioner, [SDV.MHEP.ME] Life Sciences [q-bio]/Human health and pathology/Emerging diseases, [SDV.MHEP.ME]Life Sciences [q-bio]/Human health and pathology/Emerging diseases, Science & Technology, MESH: Humans, Primary Health Care, Pandemic, CLINICAL GUIDELINES, MESH: Guidelines as Topic, COVID-19, Primary care, [SDV] Life Sciences [q-bio], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Internationality, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Public Health, Clinical Practice Guidelines, Life Sciences & Biomedicine, Research Article
Abstract

Background General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries. Methods A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results. Results Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community). Conclusions We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01413-z.

Published
2021
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3. Thrombophilia assessment in presence of a venous thromboembolic disease and therapeutic consequences: Evaluation of practices in general medicine (Languedoc-Roussillon Region)

Author

Isabelle Quéré, Jean-François Schved, A. Charvier, J.-P. Laroche, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), and Université Montpellier 1 (UM1)-Université de Montpellier (UM)

Subjects
Male, medicine.medical_specialty, General Practice, 030204 cardiovascular system & hematology, Thrombophilia, MESH: Prognosis, MESH: Venous Thromboembolism, 03 medical and health sciences, MESH: Referral and Consultation, 0302 clinical medicine, Venous thromboembolic disease, General Practitioners, Predictive Value of Tests, Risk Factors, MESH: Risk Factors, MESH: General Practice, Humans, Medicine, Practice Patterns, Physicians', Intensive care medicine, Referral and Consultation, ComputingMilieux_MISCELLANEOUS, MESH: Humans, MESH: Middle Aged, business.industry, MESH: Thrombophilia, Venous Thromboembolism, Middle Aged, Prognosis, medicine.disease, MESH: Male, MESH: Predictive Value of Tests, 3. Good health, MESH: General Practitioners, MESH: France, MESH: Practice Patterns, Physicians', Female, Clinical Competence, France, MESH: Clinical Competence, Cardiology and Cardiovascular Medicine, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030215 immunology
Abstract

International audience

Published
2020
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4. AntibioGame® A serious game for teaching medical students about antibiotic use

Author

Samuel Cohen, Frédéric Méchaï, Rosy Tsopra, Manon Cabal, Olivier Bouchaud, Karima Sedki, Jean-Baptiste Lamy, Mélanie Courtine, David Eap, Laboratoire Traitement du Signal et de l'Image (LTSI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université de Paris (UP), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), UFR Santé, Médecine et Biologie Humaine (UFR SMBH), Université Sorbonne Paris Nord, Laboratoire d'Informatique Médicale et Ingénierie des Connaissances en e-Santé (LIMICS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Sorbonne Paris Nord, Université Paris 13 (UP13), Sorbonne Université (SU), Service de maladies infectieuses et tropicales [CHU Avicenne], Hôpital Avicenne [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Agence Nationale de Sécurité du Médicament et des Produits de Santé, Jonchère, Laurent, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and École Pratique des Hautes Études (EPHE)

Subjects
Male, Serious games, Students, Medical, 020205 medical informatics, [SDV]Life Sciences [q-bio], E-learning (theory), General Practice, 02 engineering and technology, Serious game, E-learning, 0302 clinical medicine, MESH: Students, Medical, Antibiotics, MESH: General Practice, 0202 electrical engineering, electronic engineering, information engineering, 030212 general & internal medicine, MESH: Teaching, media_common, Education, Medical, 4. Education, MESH: Clinical Decision-Making, Disease Management, Primary care, Anti-Bacterial Agents, MESH: Young Adult, Infectious diseases, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Psychology, Adult, media_common.quotation_subject, MESH: Education, Medical, Clinical Decision-Making, education, Health Informatics, MESH: Video Games, MESH: Disease Management, MESH: Primary Health Care, Likert scale, Education, 03 medical and health sciences, Young Adult, MESH: Anti-Bacterial Agents, Humans, Learning, [INFO]Computer Science [cs], Quality (business), Antibiotic use, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Medical education, MESH: Humans, Primary Health Care, business.industry, Teaching, ComputingMilieux_PERSONALCOMPUTING, Usability, MESH: Adult, MESH: Male, Video Games, Medical team, MESH: Learning, business, MESH: Female, human activities
Abstract

International audience; Introduction - Measures for controlling antimicrobial resistance are urgently required. We describe here AntibioGame®, a serious game for improving the training of medical students in antibiotic use in primary care. Objective - We aimed to design a serious game for antibiotics teaching and to evaluate its usability and playability by medical students. Methods - We used various gamification techniques (e.g. use of mascots, avatars, rewards, leader board) and cartoon graphics in the design of AntibioGame®. This game implements clinical case templates built from a list of learning goals defined by a medical team through an analysis of clinical practice guidelines. The game was evaluated by asking medical students to rate their satisfaction and the usability and playability of the game on an electronic form and through group discussions. The electronic form was derived from the MEEGA + scale, a five-point Likert scale including 32 items for assessing both usability and playability. Results - AntibioGame® is a case-based game in which students play the role of a doctor meeting patients in consultation and helping other health professionals to solve their problems, as in real life. The scenarios are realistic and cover situations frequently encountered in primary care. The 57 medical students enrolled found the game attractive, usable, fun, and appropriate for learning. Game quality was considered "good" (score = 60 on the MEEGA + scale). All the students said they would recommend the game, 96 % liked it and 81 % would use it for revision. Conclusion - AntibioGame® is a promising tool for improving knowledge in antibiotic prescription that could easily be included in multifaceted programs for training medical students.

Published
2020
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5. Randomized controlled trial on promoting influenza vaccination in general practice waiting rooms

Author

Jonathan Favre, Grégoire Ficheur, Lieve Peremans, Amy Willefert-Bouche, Suzanna Zgorska-Maynard-Moussa, Paul Van Royen, Christophe Berkhout, Emmanuel Chazard, Université de Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Universiteit Antwerpen [Antwerpen], CHU Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS], Universiteit Antwerpen = University of Antwerpen [Antwerpen], Public Health Sciences, Mental Health and Wellbeing research group, and Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)

Subjects
Male, Viral Diseases, Economics, Social Sciences, lcsh:Medicine, law.invention, 0302 clinical medicine, Sociology, Randomized controlled trial, Advertising, law, Medicine and Health Sciences, Public and Occupational Health, 030212 general & internal medicine, lcsh:Science, Generalized estimating equation, Marketing, general practice, Medicine(all), MESH: Aged, Vaccines, MESH: Middle Aged, Multidisciplinary, Middle Aged, Vaccination and Immunization, 3. Good health, Vaccination, MESH: Influenza Vaccines/administration & dosage, Infectious Diseases, Health Education and Awareness, Influenza Vaccines, Female, France, Engineering sciences. Technology, Research Article, MESH: General Practice, medicine.medical_specialty, Drug Research and Development, Infectious Disease Control, Patients, Influenza vaccine, Immunology, education, Pharmacy, Research and Analysis Methods, Disease cluster, 03 medical and health sciences, Health Economics, 030225 pediatrics, medicine, Humans, Influenza Vaccines/administration & dosage, Clinical Trials, Aged, Pharmacology, MESH: Humans, business.industry, lcsh:R, Biology and Life Sciences, Influenza, Randomized Controlled Trials, Communications, MESH: Male, Confidence interval, Health Care, MESH: France, Family medicine, Relative risk, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, lcsh:Q, Preventive Medicine, Clinical Medicine, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, business, MESH: Female, Health Insurance
Abstract

International audience; Background: Most of general practitioners (GPs) use advertising in their waiting rooms for patient's education purposes. Patients vaccinated against seasonal influenza have been gradually lessening. The objective of this trial was to assess the effect of an advertising campaign for influenza vaccination using posters and pamphlets in GPs' waiting rooms.Methods and findings: Registry based 2/1 cluster randomized controlled trial, a cluster gathering the enlisted patients of 75 GPs aged over 16 years. The trial, run during the 2014-2015 influenza vaccination campaign, compared patient's awareness from being in 50 GPs' standard waiting rooms (control group) versus that of waiting in 25 rooms from GPs who had received and exposed pamphlets and one poster on influenza vaccine (intervention group), in addition to standard mandatory information. The main outcome was the number of vaccination units delivered in pharmacies. Data were extracted from the SIAM-ERASME claim database of the Health Insurance Fund of Lille-Douai (France). The association between the intervention (yes/no) and the main outcome was assessed through a generalized estimating equation. Seventy-five GPs enrolled 10,597 patients over 65 years or suffering from long lasting diseases (intervention/control as of 3781/6816 patients) from October 15, 2014 to February 28, 2015. No difference was found regarding the number of influenza vaccination units delivered (Relative Risk (RR) = 1.01; 95% Confidence interval: 0.97 to 1.05; p = 0.561).Conclusion: Effects of the monothematic campaign promoting vaccination against influenza using a poster and pamphlets exposed in GPs' waiting rooms could not be demonstrated.

Published
2018
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6. Short-term effects of airborne pollens on asthma attacks as seen by general practitioners in the Greater Paris area, 2003-2007

Author

Clément Turbelin, Séverine Tual, Lorenzo Cecchi, Thierry Blanchon, Bich-Tram Huynh, Gennaro D'Amato, Isabella Annesi-Maesano, Camille Pelat, Polytech'Paris-UPMC, Université Pierre et Marie Curie - Paris 6 (UPMC), Epidémiologie des maladies infectieuses et modélisation (ESIM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Huynh BT, Tual S, Turbelin C, Pelat C, Cecchi L, D'Amato G, Blanchon T, Annesi-Maesano I., and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)

Subjects
Male, Pediatrics, MESH: Asthma, 010504 meteorology & atmospheric sciences, General Practice, medicine.disease_cause, 01 natural sciences, 0302 clinical medicine, MESH: General Practice, MESH: Child, Poisson Distribution, MESH: Weather, Child, Betula, Original Research, MESH: Fraxinus, MESH: Risk, MESH: Paris, food and beverages, Fraxinus, MESH: Young Adult, Child, Preschool, General practice, Pollen, Female, Seasons, Adult, Risk, Pulmonary and Respiratory Medicine, Paris, MESH: Air Pollution, medicine.medical_specialty, MESH: Allergens, Adolescent, Poaceae, MESH: Poisson Distribution, MESH: Betula, Young Adult, 03 medical and health sciences, MESH: Poaceae, Air Pollution, otorhinolaryngologic diseases, medicine, Humans, MESH: Cupressaceae, Weather, 0105 earth and related environmental sciences, Asthma, MESH: Adolescent, MESH: Humans, Pollen season, business.industry, MESH: Child, Preschool, Public Health, Environmental and Occupational Health, Cupressaceae, MESH: Adult, Allergens, medicine.disease, MESH: Male, 030228 respiratory system, Relative risk, MESH: Pollen, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Seasons, MESH: Female, Demography
Abstract

International audience; AIMS: To investigate for the first time the short-term effects of airborne pollen counts on general practitioner (GP) consultations for asthma attacks in the Greater Paris area between 2003-2007. METHODS: Counts were available for common pollens (Betula, Cupressa, Fraxinus and Poaceae). Weekly data on GP visits for asthma attacks were obtained from the French GP Sentinel Network. A quasi-Poisson regression with generalised additive models was implemented. Short-term effects of pollen counts were assessed using single and multi-pollen models after adjustment for air pollution and influenza. RESULTS: A mean weekly incidence rate of 25.4 cases of asthma attacks per 100,000 inhabitants was estimated during the study period. The strongest significant association between asthma attacks and pollen counts was registered for grass (Poaceae) in the same week of asthma attacks, with a slight reduction of the effect observed in the multi-pollen model. Adjusted relative risk for Poaceae was 1.54 (95% CI: 1.33-1.79) with an inter-quartile range increase of 17.6 grains/m3 during the pollen season. CONCLUSIONS: For the first time, a significant short-term association was observed between Poaceae pollen counts and consultations for asthma attacks as seen by GPs. These findings need to be confirmed by more consistent time-series and investigations on a daily basis.

Published
2010
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7. [Musculoskeletal disorders: Role of medical advisers and inter-professional relations]

Author

Bêgue, Cyril, Delaborde, Antoine, Huez, Jean-François, Tessier-Cazeneuve, Christine, Mener, Éric, Roquelaure, Yves, Huge, Sandrine, Épidémiologie en Santé au Travail et Ergonomie (IRSET-ESTER), Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université d'Angers - Faculté de médecine (UA UFR Médecine), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), and Bodin, Julie

Subjects
MESH: Occupational Diseases, Occupational Medicine, MESH: Directive Counseling, MESH: Humans, Interprofessional Relations, General Practice, Directive Counseling, MESH: Physician's Role, [STAT] Statistics [stat], Occupational Diseases, [STAT]Statistics [stat], [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: General Practice, MESH: Interprofessional Relations, MESH: Musculoskeletal Diseases, Humans, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Musculoskeletal Diseases, Physician's Role, MESH: Occupational Medicine
Abstract

Musculoskeletal disorders (MSD) were responsible for 9.7 million days of sick leave in 2010 in France. They are also a leading cause of occupational exclusion. The objective was to study the role of medical advisers (Mas) in the care of patients with MSD and their interactions with general practitioners (GPs) and occupational health physicians (OPs).We performed a qualitative study with semi-structured interviews with medical advisers from the Brittany region. Semistructured interviews were double-coded and were submitted to thematic analysis.Nine interviews were conducted with MAs from the general regime, agricultural regime, and independent workers regime. MAs described an increase in MSD, especially with complex forms. They explained that their activity was not limited to control, but that they also had an important role in limiting occupational exclusion. It is important to anticipate difficulties related to return to work in this setting. They reported contrasted but necessary relations with GPs who are at the centre of care. Return to work may require negotiation with OPs.Relations between MAs and GPs are partly based on control of prescriptions, which can create a climate of suspicion. Emphasizing the fight against occupational exclusion can provide new light on the role of MAs. Improving relations between MAs and GPs can be achieved by a better understanding of their respective roles.

Published
2016

8. What use general practitioners do they tests and scales referred to geriatric?

Author

Paolo Di Patrizio, Christine Perret-Guillaume, Athanase Benetos, Emmanuelle Blanchet, Faculté de Médecine [Nancy], Université de Lorraine (UL), Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Laboratoire de psychologie de l'interaction et des relations intersubjectives (INTERPSY), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), and Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)

Subjects
neuropsychological tests, medicine.medical_specialty, Frequency of use, 030209 endocrinology & metabolism, malnutrition, 03 medical and health sciences, MESH: Referral and Consultation, 0302 clinical medicine, General Practitioners, Surveys and Questionnaires, MESH: General Practice, cognition disorders, medicine, Humans, MESH: Surveys and Questionnaires, Set (psychology), Referral and Consultation, Biological Psychiatry, Representative sampling, Geriatrics, general practice, geriatrics, MESH: Humans, 3. Good health, Test (assessment), Multiple pathologies, MESH: General Practitioners, Neuropsychology and Physiological Psychology, Family medicine, General practice, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Neurology (clinical), Geriatrics and Gerontology, Psychology, 030217 neurology & neurosurgery
Abstract

International audience; JUSTIFICATION:the complexity of the elderly's cares justifies to set up tools of screening, diagnosis and follow-up of multiple pathologies. Numerous tests and scales were elaborated and validated, and are recommended by the Haute autorité de santé (HAS). Are these tools useful and are they adapted to the consultation of general medicine? What are the obstacles to their appropriation by the general practitioners?OBJECTIVE:to determine the frequency of use of a series of twelve tests and scales to geriatric aim by the general practitioners.SECONDARY OBJECTIVE:interests of these tests and obstacles to their use in practice.METHOD:transverse survey by mail way, with a representative sampling of general practitioners of Meurthe-et-Moselle concerning the use of 12 tests or scales validated.RESULTS:84 general practitioners on 145 requested participated in the survey (rate of answers 58%). The most used tests are the MMSE, the AGGIR, the test of the clock and the test of five words of Dubois (respectively 48, 43, 38 and 36% of regular users). Thirty five percent of the general practitioners never use tests or scales, while 37% use them at least once a month. 85.5% of the trained practitioners use it more frequently. A practitioner on two (51%) considers that these tools are unsuitable for his practice while almost totality of the general practitioners (90%) admits an interest about these tools in the screening, the diagnosis and the follow-up of the geriatric pathologies. The obstacles are essentially connected to the very time-consuming character, to the absence of specific quotation and to the lack of training.CONCLUSION:in the absence of tests and scales conceived by geriatricians and general practitioners, the existing tests although recognized useful are underused by the general practitioners of Meurthe-et-Moselle.; Justification : des outils de dépistage, de diagnostic et de suivi des polypathologies ont été élaborés et validés par les gériatres, et sont recommandés par la Haute autorité de santé. Objectif : déterminer la place, les intérêts et obstacles d’utilisation des tests et échelles à visée gériatrique en consultation de médecine générale. Méthode : enquête transversale par voie postale auprès de 84 médecins généralistes (MG) Meurthe-et-Mosellans s’intéressant à la fréquence d’utilisation de 12 instruments d’évaluation gériatrique ; l’intérêt que leur portent les MG et les obstacles à leur utilisation. Résultats : parmi les MG enquêtés, 34,5 % n’ont jamais recours à ces outils, 37 % en utilisent régulièrement. Les plus utilisés sont le MMSE, la grille Aggir, le test de l’horloge et le test de Dubois. Dans les médecins formés 85,5 % en font usage, avec une fréquence plus soutenue. Dans cet échantillon, 51 % les jugent inadaptés à leur pratique. Les principaux obstacles à leur utilisation sont le temps nécessaire, le défaut de formation, le recul du rôle du généraliste et l’absence de cotation. Conclusion : les outils à visée gériatrique sont sous-utilisés par les MG qui les jugent inadaptés à leur pratique. L’absence de cotation et le défaut de formation sont des freins à leur usage.

Published
2013
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