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This study compares two dimensions of parenting--emotional bonding and control--as perceived by adolescents living in three countries: Canada (province of Quebec), France, and Italy. A cross-sectional sample was composed of 1256 adolescents who filled out a self-report questionnaire. Multiple Correspondence Analyses provided a graphic synthesis of cross-cultural results. Results indicate that parents are perceived as highly emotionally bonded, yet the perception of parental control produced two contrasting models. Canadian adolescents perceive less control and disciplinary actions from parents, and more tolerance. Conversely, Italian adolescents perceive more requirements and rules, and stricter disciplinary actions, while French adolescents' perceptions fall between the two. Results also suggested a gradual decrease in the perception of parental control between the ages of 11 and 19 years across all three countries. This reduction in parental constraints is perceived earlier by Canadian adolescents and later by Italian adolescents. (Contains 3 tables and 2 figures.)

Abstract: This study compares two dimensions of parenting—emotional bonding and control—as perceived by adolescents living in three countries: Canada (province of Québec), France, and Italy. A cross-sectional sample was composed of 1256 adolescents who filled out a self-report questionnaire. Multiple Correspondence Analyses provided a graphic synthesis of cross-cultural results. Results indicate that parents are perceived as highly emotionally bonded, yet the perception of parental control produced two contrasting models. Canadian adolescents perceive less control and disciplinary actions from parents, and more tolerance. Conversely, Italian adolescents perceive more requirements and rules, and stricter disciplinary actions, while French adolescents’ perceptions fall between the two. Results also suggested a gradual decrease in the perception of parental control between the ages of 11 and 19 years across all three countries. This reduction in parental constraints is perceived earlier by Canadian adolescents and later by Italian adolescents. [Copyright &y& Elsevier]

Abstract: Cryphonectria hypovirus 1 (CHV-1) is responsible for hypovirulence (reduced virulence) in the chestnut blight fungus Cryphonectria parasitica and has been used as a biocontrol agent against this introduced tree pathogen. However, the development of self-sustaining hypovirulence following the deployment of virus strains has never clearly been demonstrated. We assessed the prevalence of subtypes of CHV-1 in south-eastern France, where a specific CHV-1 subtype (F1) has been released for biological control at several chestnut sites. Using these data, we explored the potential effects of control treatments, fungal vegetative incompatibility and the ecological fitness of viral subtypes on the establishment of CHV-1 in C.parasitica populations. The prevalence of CHV-1 in C. parasitica cankers varied from 31 to 90% between sites and was not related to biological control treatment or to the diversity of vegetative compatibility types of the fungal population. Our study revealed that the CHV-1 subtype F1 used for biological control did not become established in the study area. Of the 79 hypoviruses identified, 78 belonged to CHV-1 subtype I, and one to subtype F2. Fungal isolates infected with CHV-1 subtypes F1 or F2 grew significantly slower and had lower levels of sporulation than isolates infected with the naturally occurring subtype I viruses. The greater ecological fitness of subtype I than of subtypes F1 and F2 probably accounts for its greater invasiveness. Our results indicate that different CHV-1 subtypes could be used differently in the biological control of chestnut blight. [Copyright &y& Elsevier]

Introduction: In 2006, recommendations about the management of gout were issued by the European League Against Rheumatism (EULAR). The objective of this work was to compare these recommendations to practice patterns of physicians working in private practices in France.Method: In a prospective multicenter nationwide study conducted in France, a random sample of primary-care physicians (PCPs) and private-practice rheumatologists (PPRs) was taken in 2009. Each physician included 2 consecutive patients with gout. Each patient was evaluated twice at an interval of 3-6months. Information on EULAR 2006 management modalities were collected in a standardized manner.Results: Of 1003 patients, 771 were evaluated twice. Allopurinol was prescribed to 75.1% of patients in all and was initiated at the first study visit in 44 patients, among whom 19 (43.2%) 19 patients received the recommended starting dosage of 100mg/day. Colchicine therapy to prevent flares was prescribed to 74.3% of patients. Of the 522 patients on allopurinol therapy at the first visit, only 34.5% had serum uric acid levels≤360μmoL/L (mean dosage, 173 mg/day). Excessive dietary intake by patients who were overweight or obese was recorded in 31.5% of patients seen by PCPs and in 19.7% of those seen by OBRs. This finding prompted the delivery of nutritional advice to 45.8% of patients. Discontinuation of excessive alcohol intake was recommended to only 10% of patients. Diuretic therapy discontinuation was feasible in 175 patients but was recommended in only 7 patients.Conclusion: Differences between practice patterns and 2006 EULAR recommendations were identified. Simplifying the recommendations and teaching them during medical training and continued medical education may deserve consideration. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this sub-study was to assess the use of colchicine for the treatment of gout flares in real life conditions in the GOSPEL cohort following the 2006 EULAR recommendations for gout management.Methods: This national cross-sectional epidemiologic survey included outpatients with gout suffering from acute flare followed by randomly selected primary care physicians (n=398) and private practice rheumatologists (n=109) between October 2008 and September 2009 in France. Data regarding patient characteristics and treatment prescription was collected by each physician. Glomerular filtration rate (eGFR) was estimated using the Cockroft-Gault formula. Patients included in the survey for a gout flare filled in a specific self-questionnaire including colchicine effective intake and pain relief (numeric scale).Results: This analysis focused on the 349 patients presenting with gout flare and treated with colchicine. Mean (±SD) prescribed dose of colchicine was 2.8 (±0.7) mg within the first 24hours and the cumulative dose over the first three days of treatment was 6.9 (±1.8) mg. Patients with mild decline in eGFR (eDFG 60-80mL/min) were prescribed an average initial dose of 2.8mg (±0.8) mg (n=58), 2.7 (±0.8) mg in chronic kidney disease (CKD) stage 3 (n=43) and 2.5 (±0.7) mg in CKD stage 4 (n=2). Cumulative doses of colchicine did not take into account either renal impairment or age.Conclusions: This study draws attention to some misuse of colchicine in daily practice and the prescription of excessive doses especially in case of renal impairment. eGFR should be enforced in daily practice. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To assess diagnoses and management of acute and chronic gout in primary care and rheumatology settings relative to 2006 European League Against Rheumatism (EULAR) gout recommendations. Secondary objectives were to describe patient demographics, clinical features, lifestyle modifications, and short- and mid-term outcomes. Methods: Prospective, cross-sectional, descriptive survey of patients with chronic gout, acute gout, or suspected gout, included by randomly selected general practitioners (GPs, n =398) and rheumatologists (n =109) between October 2008 and September 2009, in France. At the first visit, a structured questionnaire was completed. Each patient completed self-questionnaires at the first visit and 3 to 6 months later. Results: We included 1003 patients, including 879 (87.6%) males (mean age, 61.6±11.4 years; 28.1% obese) and 124 (12.4%) females (70.2±11.9 years; 33.1% obese). Mean disease duration was 8.0±8.3 years and mean time since hyperuricemia diagnosis 8.2±8.4 years. Mean annual number of flares was 1.9±1.5. ACR criteria for gout were met in 855 pts. Gout was acute in 487 (48.6%) patients and chronic in 241 (24.4%). Tophi (19.4% of patients) were associated with disease duration but not gender or chronic kidney disease (CKD). The main co-morbidities were hypertension (53.8%), dyslipidemia (47.2%), and hyperglycemia/diabetes mellitus (15.0%). CKD 3-5 was present in 43% of patients but was identified by physicians in only 5.2%. CKD severity was significantly associated with age, gender, hypertension, and diuretic use. Conclusion: This cohort will prove valuable for addressing the concordance with EULAR recommendations and for future studies of gout in everyday practice, most notably regarding metabolic syndrome, other co-morbidities, and identification of difficult-to-treat patients. [Copyright &y& Elsevier]

Résumé: Objectif: Comparer les conditions du diagnostic et de la prise en charge de la goutte aiguë et chronique en médecine générale et en rhumatologie libérale par rapport aux recommandations EULAR 2006. Les objectifs secondaires étaient de décrire les caractéristiques des patients, leurs aspects cliniques, les modifications de mode de vie et l’évolution à court et moyen termes dans cette population de goutteux. Méthodes: Étude prospective descriptive, transversale de patients avec une goutte chronique, aiguë ou suspectée, recrutés par des omnipraticiens (n =398) et rhumatologues (n =109) libéraux sélectionnés entre octobre 2008 et septembre 2009 en France. Un questionnaire structuré a été rempli à l’inclusion. Chaque patient a rempli un auto-questionnaire à la visite initiale et à la première visite de suivi (entre trois et six mois). Resultats: On note que 1003 patients ont été inclus, dont 879 (87,6 %) hommes (âge moyen±DS, 61,6±11,4ans ; 28,1 % obèses) et 124 (12,4 %) femmes (70,2±11,9ans ; 33,1 % obèses). La durée moyenne de la maladie était de 8,0±8,3ans, et le délai moyen depuis la reconnaissance de l’hyperuricémie était de 8,2±8,4ans. Le nombre moyen de crises de goutte était de 1,9±1,5 par an. Un total de 855 patients répondait aux critères préliminaires du diagnostic de goutte selon l’American College of Rheumatology (ACR). Il s’agissait d’une goutte aiguë chez 487 (48,6 %) patients et chronique chez 241 (24,4 %). Les tophus (19,4 % des patients) étaient associés à la durée de la maladie mais ni au sexe ni à la présence d‘une maladie ou insuffisance rénale chronique (CKD [clairance de Cockroft-Gault]). Les principales comorbidités étaient une hypertension (53,8 %), une dyslipidémie (47,2 %), et une hypertriglycéridémie ou un diabète de type 2 (15,0 %). Une maladie rénale chronique était présente chez 43 % des patients mais n’avait été identifiée que chez 5,2 % des sujets par les médecins. La sévérité de la goutte était associée statistiquement à l’âge, au sexe, à l’hypertension et à l’utilisation de diurétiques. Conclusion: Cette cohorte va permettre de décrire la concordance des modalités de diagnostic et de prise en charge en France avec les recommandations EULAR 2006 et sera exploitable pour des études en pratique courante, notamment le syndrome métabolique, les autres comorbidités et les patients goutteux dits difficiles à traiter. [Copyright &y& Elsevier]