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The purpose of this study is to investigate the seismic ambient noise spectral anomalies that occur near gas reservoirs. These anomalies involve a significant spectral amplification of the vertical component for frequencies generally between 1.5 and 4 Hz and have been reported at various hydrocarbon sites worldwide. There are differing views on the mechanisms responsible for these anomalies. The guideline for this study is that many hydrocarbon reservoirs share a common geological feature: an anticline structure. It appears to cause site effects that influence the amplitude of the ambient noise wavefield. This research examines a dense real data set of ambient noise recorded at the Chémery underground gas storage site in France. The analysis identifies stable spectral anomalies between 1.2 and 2.4 Hz that are correlated to the position of the anticline structure, which also corresponds to the position of the gas bubble. We use a beamforming technique to study the composition and the origin of the ambient noise, and show that the variations of the spectral anomalies over time are correlated to changes in the source wavefield. Finally, we perform numerical simulations of Rayleigh wave propagation within a realistic 3-D velocity model of the Chémery site, while using source distributions directly extracted from real data analysis. The comparison of the simulated anomalies with real data yields a satisfactory qualitative fit. We conclude that the fundamental-mode Rayleigh wave site effect on the anticline is the main mechanism of the spectral anomaly. [ABSTRACT FROM AUTHOR]

Introduction: There is limited understanding of different predictors of smoking cessation success (SCS) among women and men, despite well-documented differences in smoking behavior. Methods: Using data from DePICT (Description des Perceptions, Images, et Comportements liés au Tabagisme), a national survey of French adults which recruited 2377 regular and former smokers we investigated whether major determinants of SCS differed by sex. Factors associated with unsuccessful vs. No successful quit attempt; vs. SCS were studied using multivariate multinomial logistic regression analyses stratified by sex. Results: Women and men share some determinants of SCS including no cannabis use, living in a nonsmoker household and importance giving to being a nonsmoker. However, no e-cigarette use, low-to-moderate alcohol consumption, early smoking initiation, and higher education were associated with SCS only among women. No use of nicotine replacement, having family members who smoke, family opinion on smoking and current employment, were associated with SCS only among men. Neutral or negative friends' opinion on smoking or living with a smoker were associated with unsuccessful smoking attempts among men. Conclusions: Our results show differences between determinants of SCS according to sex, which highlights the importance of developing tailored interventions that account for sex/gender differences in smoking cessation. [ABSTRACT FROM AUTHOR]

Background: The return-to-sport rate at 2 years after multiple-revision anterior cruciate ligament (ACL) reconstructions has not been evaluated. Hypothesis: It was hypothesized that patients who undergo multiple-revision ACL reconstructions would have a lower return-to-sport rate at 2 years after surgery than those who undergo a single-revision reconstruction. Furthermore, it was hypothesized that the multiple-revision group would have lower functional scores. Study Design: Cohort study; Level of evidence, 3. Methods: A single-center cohort study in patients who underwent revision ACL reconstruction was begun in 2012. This study included 2 groups: Patients who underwent a single revision, and those who underwent multiple revisions. The main evaluation criterion was the return to sport at the 2-year follow-up. The secondary criteria were the International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, and ACL–Return to Sport after Injury (ACL-RSI) functional knee scores at the 1- and 2-year follow-ups. Results: A total of 322 patients (single-revision group: n = 302; multiple-revision group: n = 20) were included. A significant difference in the percentage of patients who stopped all sports activity was found between the 2 groups at 2 years (single-revision group: 19.4%; multiple-revision group: 50%). The return-to-sport rate at the same or lower level of performance was higher in the single-revision group as well (17% vs 14.3% for return at the same level; 45.6% vs 14.3% for return at a lower level; P =.03). At the 2-year follow-up, the functional scores of the single-revision group were significantly higher those than in the multiple-revision group: IKDC (77.7 ± 13.82 vs 64.79 ± 15.22; P <.001), KOOS (72.66 ± 17.63 vs 52.5 ± 15.64; P <.001), Lysholm (84.05 ± 11.88 vs 72.5 ± 13.49; P <.001), and ACL-RSI (52.34 ± 21.83 vs 46.43 ± 14.8; P =.0036). Conclusion: Only a small percentage of patients returned to the same level of sport after single- revision and multiple-revision ACL reconstruction, yet significantly more in the former. More patients who underwent multiple revisions gave up their sport. Functional scores were higher for single-revision than multiple-revision surgeries. [ABSTRACT FROM AUTHOR]

What Is Known and Objective: The dispensing of clotting factor concentrates in hospital pharmacies imposes accessibility constraints on patients and their caregivers, thereby increasing the disease burden. Very few studies have addressed these issues so far in terms of individual perceptions and actual difficulties. The PHAREO study aims to report patient's perception of treatment accessibility and evaluate spatial accessibility. Methods: The PHAREO study is an observational survey based on a questionnaire specifically designed for the study purpose in collaboration with patients' representatives in the second demographic and economic French region. Results and Discussion: We collected 293 responses (participation rate of 64.1%) which show that 89.8% of respondents were either very or rather satisfied with regard to access to treatment. However, respondents reported difficulties in accessing the hospital pharmacy. The data also showed that 79.2% of respondents tended to over‐estimate travel time which was reported above their acceptable threshold for 39.2% of them. The main determinants of dissatisfaction were parental burden (OR 2.5 [1.3; 4.8], p = 0.008) and waiting time at the hospital pharmacy (OR 1.5 [1.1;2.0], p = 0.016, per 10 min increase). What Is New and Conclusion: The PHAREO study provides subjective and objective data regarding satisfaction levels of persons with haemophilia and other coagulation deficiencies, with a high representativeness rate for patients on prophylaxis (87.5%). Both respondents and hospital pharmacists pled for an evolution of the current dispensing circuit to improve access to treatment and reduce the burden for patients. Currently, the community pharmacists are apart from the dispensing circuit. The authors propose improvements in the pathway of care for patients and their caregivers by including the community pharmacists alongside the hospital pharmacists in a centralized coordination scheme. [ABSTRACT FROM AUTHOR]

Among 1428 children participating in the French EDEN cohort study, we examined the relationship between childcare from 0 to 3 years(childminder, center-based, informal) and later trajectories of behavioral difficulties (ascertained via the Strengths and Difficulty Questionnaire at 3, 5.5 and 8 years) established using group-based trajectory modeling. Family and child characteristics were controlled for using Inverse Probability Weights. Children who were in center-based childcare had lower levels of emotional and behavioral difficulties in bivariate analyses, however these associations were no longer statistically significant after controlling for covariates. Compared to children who spent at least 1 year in center-based childcare, those who spent less than 1 year with a childminder as well as those who were in informal care had higher levels of emotional and behavioral difficulties in multivariate analyses. Early life childcare may have long-term benefits for children's behavioral and emotional development, particularly if it is of high quality and lasts at least 1 year [ABSTRACT FROM AUTHOR]

Sexual victimisation has been associated with suicidal ideation, especially among women; however data on this association from a large sample of general population is surprisingly limited. Also, no study quantifies sex differences in the effect of sexual victimisation on suicide risk. We used data from the French Health Barometer, a general population phone survey, which recruited 25,319 adults aged 18 to 75 years in 2017. Data were weighted to be representative of the French adult population. Three outcomes were examined: (a) suicidal ideation in the preceding year, (b) suicidal imagery (having thought about how to commit suicide), and (c) suicide attempt in the preceding year. We conducted adjusted mediation analyses, using the counterfactual approach, to evaluate the contribution that lifetime sexual victimisation has in the association between sex and suicide risk. Women were around five times more likely to report lifetime sexual violence (9.1% vs 1.9%) and were more at risk of any suicidal ideation (Ora = 1.20 (95%CI: 1.07–1.36)) and suicidal imagery (Ora = 1.39 (95%CI: 1.20–1.61)), but not suicide attempt compared to men in adjusted analysis. In mediation analysis, sexual victimisation explained 49 and 40% of the increased risk women have compared to men in suicidal ideation and suicidal imagery, respectively. Sexual violence is more prevalent among women and explains a substantial share of sex difference in suicide risk. Our findings reiterate the importance of the prevention of sexual violence and an adequate care for victims, especially women, in public health and mental health policies and initiatives. [ABSTRACT FROM AUTHOR]

Purpose: Our study estimates rates of depressive symptoms and suicide risk according to sexual minority status, and examines the mediating effect of verbal victimisation in the association between sexual minority status and mental health outcomes. Method: Analysis is based on data from the 2017 French Health Barometer, a general population phone survey, which recruited 25,198 adults aged 18–75 years. Data were weighted to be representative of the French adult population. Four mental health outcomes occurring in the preceding year or currently were examined in relation to sexual minority status using multivariate logistic regressions: (a) current depressive symptoms, (b) having experienced a major depressive episode, (c) suicidal ideation, and (d) suicide attempt. Further we conducted mediation analyses to evaluate the contribution that verbal victimisation experienced in the preceding year has in the association between sexual minority status and the listed outcomes. All analyses were also stratified by sex. Results: Sexual minority adults were more likely to experience verbal victimisation in the last year compared to heterosexual individuals (22% vs 11.4%). They were also more likely to have experienced each of the four mental health outcomes, even after adjusting for potential confounders. In adjusted mediation analysis, verbal victimisation in the preceding year was found to significantly mediate the association between sexual orientation and mental health outcome with mediated proportions varying between 15 and 22%. Conclusion: Sexual minority individuals are more at risk of depressive symptoms and suicidal ideation compared to heterosexuals, and this may be partially mediated by verbal victimisation. [ABSTRACT FROM AUTHOR]

Background Inappropriate visits to emergency departments (EDs) could represent from 20% to 40% of all visits. Inappropriate use is a burden on healthcare costs and increases the risk of ED overcrowding. The aim of this study was to explore socioeconomic and geographical determinants of inappropriate ED use in France. Method The French Emergency Survey was a nationwide cross- sectional survey conducted on June 11 2013, simultaneously in all EDs in France and covered characteristics of patients, EDs and counties. The survey included 48 711 patient questionnaires and 734 ED questionnaires. We focused on adult patients (≥15 years old). The appropriateness of the ED visit was assessed by three measures: caring physician appreciation of appropriateness (numeric scale), caring physician appreciation of whether or not the patient could have been managed by a general practitioner and ED resource utilisation. Descriptive statistics and multilevel logistic regression were used to examine determinants of inappropriate ED use, estimating adjusted ORs and 95% CIs. Results Among the 29 407 patients in our sample, depending on the measuring method, 13.5% to 27.4% ED visits were considered inappropriate. Regardless of the measure method used, likelihood of inappropriate use decreased with older age and distance from home to the ED >10 km. Not having a private supplementary health insurance, having universal supplementary health coverage and symptoms being several days old increased the likelihood of inappropriate use. Likelihood of inappropriate use was not associated with county medical density. Conclusion Inappropriate ED use appeared associated with socioeconomic vulnerability (such as not having supplementary health coverage or having universal coverage) but not with geographical characteristics. It makes us question the appropriateness of the concept of inappropriate ED use as it does not consider the distress experienced by the patient, and segments of society seem to have few other choices to access healthcare than the ED. [ABSTRACT FROM AUTHOR]

Background: Electronic cigarettes (e-cigarettes) are sold in France since 2010 and have rapidly become popular. However, factors associated with e-cigarette use among young adults are not well known. Methods: We used data from the 2015 French TEMPO community based cohort study, restricted to current and former smokers with data on e-cigarette use (n = 368 adults, 23-41 years). Participants completed a self-administered questionnaire including information on family status, educational attainment, occupation and type of work contract, health problems, alcohol and cannabis use, electronic cigarette use, as well as perceptions of e-cigarettes. Use of traditional tobacco was assessed in 2011 and 2015. Data were analyzed using logistic regression models. Results: Among current and former smokers, 26.9% reported lifetime e-cigarettes use and 15.2% current use. Factors associated with lifetime use were: low socioeconomic position (OR = 2.2; 95% CI = 1.2-4.2), traditional cigarette use (OR associated with smoking in 2011 and 2015 = 13.1; 95% CI = 5.2-32.6) and positive perceptions of e-cigarettes (OR = 4.4; 95% CI = 2.4-8.1) as well as asthma (OR = 2.1; 95% CI = 0.9-4.9) and overweight/obesity (OR = 2.5, 95% CI = 0.9-6.9). Factors associated with current use were traditional cigarette smoking (OR associated with smoking in 2011 and 2015 = 3.9; 95% CI= 1.3-12.2) and positive perceptions of e-cigarettes (OR =4.4; 95% CI = 2.3-8.4). Conclusions: Young adults who use e-cigarettes tend to persist in smoking traditional cigarettes. The conditions under which e-cigarette use can help individuals quit traditional tobacco products remain to be elucidated. [ABSTRACT FROM AUTHOR]

Although several studies have shown a positive association between socio‐economic position and size at birth, not enough is known about the modifiable factors that may be involved. We aimed to investigate whether maternal prepregnancy body mass index (BMI), smoking, diet, and depression during pregnancy mediate the positive association between maternal education and birth size. Weight and length z‐scores specific for gestational age and sex were calculated for 1,500 children from the EDEN mother–child cohort. A mediation analysis of the associations between maternal education and birth size was conducted with a counterfactual method, adjusted for recruitment centre, parity, maternal height, and age. In the comparison of children of mothers with low versus intermediate education levels, maternal smoking during pregnancy explained 52% of the total effect of education on birth weight. Similar findings were observed with birth length z‐score (37%). The comparison of children of mothers with high versus intermediate education levels yielded a non‐significant total effect, which masked opposite mediating effects by maternal BMI and smoking during pregnancy on both birth weight and length. Prepregnancy BMI and maternal smoking during pregnancy mediate the positive association between maternal education and birth weight and length z‐scores. These mediators, however, act in opposite directions, thereby masking the extent to which healthy prenatal growth is socially differentiated. [ABSTRACT FROM AUTHOR]

Context: France has high smoking rates, and recently intensified tobacco control policies spearheaded by the introduction of plain tobacco packaging (PP), and an increase in graphic health warnings (GHW). We examine smoking and e-cigarettes use rates, as well as smoking-related perceptions before (2016) and one year after (2017) comprehensive tobacco control measures.Methods: DePICT is a two waves cross-sectional national telephone survey of French adults aged 18-64 years (2016: 4456 - 2017: 4114). Data were weighted to be representative of the French adult population. Adjusted prevalence ratios (PR, 95% CI) estimating changes between the two study waves were calculated using multivariate Log-Binomial regression models.Main Findings: In 2017, as compared with 2016, smoking rates (PR = 0.93 (0.88-0.99) and current e-cigarette use (PR = 0.76 (0.61-0.96)) decreased in France. Further, French adults were more likely to report fear of the consequences of smoking (PR = 1.10 (1.06-1.14)) and that smoking is dangerous (PR = 1.08 (1.06-1.11)). Smokers were also more likely to report that health messages on tobacco products are efficient (PR = 1.18 (1.05-1.32)).Conclusions: Our study provides early and encouraging results on potential effects of the comprehensive tobacco control strategies in France introduced in 2017, including PP and larger GHW. Our findings also suggest that e-cigarettes did not replace traditional smoking. [ABSTRACT FROM AUTHOR]

Background: Although some studies have questioned whether cardiopulmonary resuscitation (CPR) in older people could be futile, age is not considered an essential out-of-hospital cardiac arrest (OHCA) prognostic factor. However, in the daily clinical practice of mobile medical teams (MMTs), age seems to be an important factor affecting OHCA care. Aims: The purpose of this study was to compare OHCA care and outcomes between young patients (<65 years old) and older patients. Methods: We performed a case-control study based on data extracted from the French National Cardiac Arrest (CA) registry. All adult patients with CA recorded between July 2011 and May 2014 were included. Each older patient was matched on three criteria: sex, initial cardiac rhythm and no-flow duration. Results: We studied 4347 pairs. We found significantly less basic life support initiation, shorter advanced cardiac life support duration, less MMT automated chest compression, less MMT ventilation and less MMT epinephrine injection in the older patients. Significant differences were also observed for return of spontaneous circulation (odds ratio (OR)=0.84, 95% confidence interval (CI) 0.77–0.92, p<0.001), transport to hospital (OR=0.58, 95% CI 0.51–0.61, p<0.001), vital status at hospital admission (OR=0.55, 95% CI 0.50–0.60, p<0.001) and vital status 30 days after CA (OR=0.42, 95% CI 0.35–0.50, p<0.001). Conclusion: All OHCA guidelines, ethical statements and clinical procedures do not propose age as a discrimination criterion in OHCA care. However, in our case-control study, we notice a shorter duration and less intensive care among older patients. This finding may partly explain the lower survival rate compared with younger people. [ABSTRACT FROM AUTHOR]

Background: Mental health problems in the perinatal period are common. We examined associations between different categories of migrant status and region of origin in relation to mental health during pregnancy and at 2 months post-partum. Methods: We analyzed data from the French nationally representative Etude Longitudinale Francaise depuis l'Enfance birth cohort (n = 17 988). Migrant status was divided into five categories: 'majority population', 'descendants with one migrant parent', 'descendants with two migrant parents', 'naturalized migrant' and 'non-naturalized migrant women'. Multivariate logistic regression models were implemented to examine associations between migrant status and mental health outcomes: persistent psychological difficulties during pregnancy as well as mother's depression and poor self-reported health at 2 months post-partum. Results: After adjusting for covariates, migrant status was not associated with psychological difficulties during pregnancy. Descendants of migrants had comparable mental health to the majority population. Non-naturalized migrant women were more likely to experience depression (odd's ratio (OR)= 1.66, 95%confidence interval (CI): 1.27, 2.20) and poor self-reported health (OR = 1.45, 95%CI: 1.06, 1.98) during the post-partum period. The region of origin was associated with post-partum health independently of migrant status, such that women from Africa and Turkey were most likely to have depression or poor self-rated health. Conclusion: First, but not second, generation migrant women appear to have high levels of mental health difficulties during the post-partum period. Women from North Africa, Sub-Saharan Africa, and Turkey have higher levels of distress than those from other regions. In particular, non-naturalized migrant appear to be a vulnerable group; they may disproportionately face stressors that increase their risk for post-partum depressive symptoms. [ABSTRACT FROM AUTHOR]

Background: In France, rates of perinatal smoking are among the highest worldwide; however, perinatal smoking trajectories and associated factors have still not been adequately researched.Methods: Among women participating in the French nationally representative etude longitudinale française depuis l'enfance birth cohort (n = 15,540), perinatal smoking trajectories were estimated using group-based modelling. Associated characteristics were studied using multinomial logistic regression.Results: Four trajectories were identified: non-smokers (59%), quitters (20%), persistent moderate (12%) and persistent heavy (9%) smokers. Older age, being native French, low socioeconomic position, persistent psychological difficulties and alcohol use in pregnancy, lack of social support, partner's smoking, mistimed pregnancy, and child formula feeding at birth were associated with persistent heavy smoking. Most of these factors were also associated, but to a lesser extent, with persistent moderate smoking, except for age and migrant status, which had opposite effects. Women who successfully lost weight prior to pregnancy had higher levels of quitting smoking.Conclusion: Women's long-term smoking trajectories vary in terms of initial tobacco consumption level but also in relation to socio-demographic, psychological, behavioral and partner characteristics. Health professionals in contact with pregnant smokers should address perceived risks and benefits of smoking, including partner's smoking and weight-gain concerns. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives: The aim of this study was to describe the cohort of persons having experiences fatal and non‐fatal drowning events, registered in the French cardiac arrest registry and to identify termination of resuscitation criteria. Methods: We performed a prospective multicenter study based on data from French cardiac arrest registry database. All patients with cardiac arrest after drowning (CAD) recorded between July 2011 and November 2014 were included. The population description was carried out by medians [interquartile ranges (IQR)] or frequencies. The characteristics were compared in terms of the primary endpoint (alive vs dead at hospital admission) using chi‐square or Fisher's exact and the Mann–Whitney U test. The predictive model was carried out using the multivariate logistic regression. Results: The analysis included 234 CAD. The majority of patients were adults (83.6%) and males (64.5%). Most of the submersions occurred out of home (75.6%). We recorded 66.7% of incidents in fresh water. About a third of CAD was witnessed of which 33.8% had an immediate basic life support. Most of CAD patients received an advanced cardiac life support (87.2%). The median Mobile Medical Team response time was 22 [15–30] minutes. At hospital, 40.6% of patients were alive. Twenty one patients (9.0%) were discharged alive. Among them, 17 had a good neurological outcome. Faster interventions generally resulted in higher survival chances (Mobile Medical Team response time OR: 0.960[0.925; 0.996]; P = 0.0.031; no flow duration OR: 0.535[0.313; 0.913]; P = 0.022) if associated with ventilation (OR: 6.742[2.043; 22.250]; P = 0.002). Age (OR: 0.971[0.955; 0.988]; P = 0.001) and location outside (OR: 0.203[0.064; 0.625]; P = 0.007) are the other criteria of our model. Conclusions: The model is helpful to highlight explanative variables concerning CAD patients' outcome. The next step is the validation of these five factors by a larger study. Prevention and public training to lifesaving behaviours must be considered as priorities in French public health programmes. [ABSTRACT FROM AUTHOR]

In 2004, breast cancer screening will be effective in France. This evolution has a strong impact on our mammographic practice that becomes a real mission of public health. Digital mammography, compared to screen-film mammography, provides the same results for the detection of breast cancer; computer-aided detection systems represent the most relevant application of this technology at this time. The setting up of a quality control will allow the introduction of this technology in screening during 2004. Percutaneous imaging-guided procedures are now currently used for the diagnosis of nonpalpable breast lesions and allow the selection of patients for surgery. These procedures have emphasized the need for a multidisciplinary approach of the patients. Indications of MRI have not changed because of its moderated specificity and no relevant development of interventional-guided procedures. Work on standardization of radiological reports and assessment categories goes on. This classification is already applied for mammography, and new classifications for lesions detected by ultrasound or MRI will be published by the American College of Radiology (Breast Imaging Reporting and Data System, 4th edition, available in 2003). [Copyright &y& Elsevier]

Whilst the prevalence of autistic students attending university in France is increasing, limited research has explored the experiences of university professors and disability support staff in French higher education. The current study sought to fill this gap in the literature using a qualitative research design. Semi-structured interviews were conducted with 26 university staff members (14 university professors, 8 disability support office staff, 4 ‘other support professionals’). Data was analysed using thematic analysis. Six main themes were identified: (1) Taking a holistic approach, (2) Adapting communication, (3) Relying on intuition, (4) What diagnosis? (5) The benefits of inclusion and (6) Navigating levels of support. Themes describe how participants engaged autistic students in higher education, their challenges, and their successes. Whilst professionals sought to provide personalised support to students, the analysis indicates more training and support is required as university staff reported a range of difficulties supporting autistic students at university. Results from the current study can contribute to the development of policy and practice with regard to the implementation of inclusive practices in French higher education. Of note, participants highlighted the need to access more holistic support from a range of professionals in addition to further training. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the effectiveness of a two-year programme of balance training exercise in preventing injurious falls among elderly women aged 75-85. The study focused on the Ossébo exercise programme. Based on the results, the programme is effective in lowering injurious falls among older women in said age group.

Aims: There are large differences between emergency medical systems, which may account for variability in outcomes. We seek to compare prehospital organizations, response modes, patient characteristics and outcomes after out-of-hospital cardiac arrest, between France and Canada, and discuss the need for the first European-North American prehospital research network on out-of-hospital cardiac arrest.Methods: Preliminary comparative description of data drawn from two nation-wide, population-based, Utstein-style prospectively implemented registries for out-of-hospital cardiac arrest in France and Canada (France: RéAC, Canada: CanROC), covering approximately 80 million people, and soon to be participating in an international research network in 2020.Results: Since creation, 103,722 cases were included in France and approximately 99,317 in Canada. Data used in this work were drawn from 2011 to 2016, and comprised around 33,688 adult, non-traumatic, treated cases in Canada, and 55,358 in France, leading to estimated incidence rates of 75.3/100,000 inhabitants in France and 83/100,000 in Canada. In both countries, out-of-hospital cardiac arrest predominantly occurred in male patients, in their late sixties, at home, of presumed cardiac aetiology. Bystander cardiopulmonary resuscitation was provided in half of the cases. First assessed cardiac rhythm was shockable in 16% (France) vs. 22% (Canada). Professional resuscitation was attempted in 82% (France) and 60% (Canada). Prehospital organizations and response modes differed in the constitution of responding teams (France: physician-led advanced life support, Canada: trained paramedics), in response time intervals (call to first professional responders' arrival at scene 6.5 min (interquartile range IQR [5.2-8.3]) (Canada) vs. 10 min [7-15] (France)), in on-scene interventions, type of referral at hospital (France: systematic bypass of emergency department, tertiary hospital first, Canada: occasional bypass, mainly closest hospital first), and in outcomes (overall survival at hospital discharge in France: 5% vs. Canada: 11%).Conclusion: Despite similarities in some out-of-hospital cardiac arrest Utstein variables, several differences exist between French and Canadian prehospital systems, and ultimately, between outcomes. The creation of the ReACanROC research network will facilitate the conduction of further analyses to better understand predictors of this variability. [ABSTRACT FROM AUTHOR]

Background: Even if age is not considered the key prognostic factor for survival in cardiac arrest (CA), some studies question whether cardiopulmonary resuscitation (CPR) in the elderly could be futile.Objective: The aim of this study was to describe differences in out-of-hospital CA survival rates according to age stratification based on the French National CA registry (RéAC). The second objective was to analyze the differences in resuscitation interventions according to age.Methods: We performed a retrospective cohort study based on data extracted from the RéAC. All 18,249 elderly patients (>65 years old) with non-traumatic CA recorded between July 2011 and March 2015 were included. Patients' ages were stratified into 5-year increments.Results: Cardiopulmonary resuscitation (CPR) was started significantly more often in younger patients (p = 0.019). Ventilation and automated external defibrillation by bystanders were started without any difference between age subgroups (p = 0.147 and p = 0.123, respectively). No difference in terms of rate of external chest compressions or ventilation initiation was found between the subgroups (p = 0.357 and p = 0.131, respectively). Advanced cardiac life support was started significantly more often in younger patients (p = 0.023). Total CPR duration, return of spontaneous circulation, and survival at hospital admission and at 30 days or hospital discharge decreased significantly with age (p < 10-3). The survival decrease was linear, with a loss of 3% survival chances each 5-year interval.Conclusions: This study found that survival in older persons decreased linearly by 3% every 5 years. However, this diminished rate of survival could be the consequence of a shorter duration and less advanced life support. [ABSTRACT FROM AUTHOR]

Comme pour les autres virus respiratoires, des cas de transmission intra-hospitalière de SRAS-CoV-2 ont été signalés. Dans le contexte d'un taux d'incidence élevé du SRAS-CoV-2 dans la communauté, une augmentation significative du taux de transmission nosocomiale est attendue. Ce risque pourrait même être plus élevé dans les pays à faible revenu qui ont des systèmes de santé plus fragiles, ceci en raison de facteurs tels que le retard de diagnostic, le manque d'infrastructures, de personnel qualifié, d'unités d'isolement et de programmes de contrôle des infections. Une meilleure compréhension des chaînes de transmission du SRAS-CoV-2 et de l'impact des mesures de contrôle dans les unités de soins est essentielle pour maîtriser la pandémie. Cette étude a pour l'objectif principal d'estimer la prévalence et l'incidence des cas suspects ou confirmés d'infection par le SRAS-CoV-2 chez le personnel soignant et les patients dans les hôpitaux participants. Il s'agit d'une étude prospective internationale, observationnelle en milieu hospitalier. Il regroupera des patients et des professionnels de santé en France, au Brésil et dans les hôpitaux affiliés au réseau GABRIEL, un réseau d'institutions de recherche principalement situées dans les pays à faible revenu. Les données démographiques et cliniques sont collectées à l'aide de questionnaires conçus spécialement pour le projet. Un écouvillon nasopharyngé est prélevé et testé pour le SRAS-CoV-2 par RT-PCR. Une modélisation multivariée appropriée sera utilisée pour identifier les déterminants associés à la transmission nosocomiale. À la date du 12 juin 2020, 1478 patients COVID-19 confirmés et 740 professionnels de santé ont été inclus par les 13 centres Français et 368 patients et professionnels de santé ont été recrutés dans les centres internationaux. Les résultats de ce projet fourniront des résultats originaux qui pourraient : – constituer des preuves supplémentaires pour une meilleure compréhension de la durée de l'incubation et de la période contagieuse du SRAS-CoV-2 ; – renforcer les campagnes de prévention de la transmission nosocomiale du virus ; – ouvrir la voie à de nouvelles recommandations en termes de prévention ; – compléter les recommandations existantes grâce aux données supplémentaires concernant la transmission du virus, contribuant ainsi à améliorer les directives de contrôle pour des épidémies virales respiratoires similaires. La communication des résultats aux personnels soignants permettrait de les sensibiliser sur leur rôle dans la prévention de la propagation du virus dans les hôpitaux et dans leur environnement immédiat et pourrait être utilisée pour soutenir la couverture vaccinale si un vaccin devenait disponible. [ABSTRACT FROM AUTHOR]