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Objectives: The aims of the current study were 1) to provide the prevalence of five types of gender-based violence (GBV) among male and female healthcare students; 2) to describe perpetrators' status, where the GBV occurred, and psychological and behavioural impacts of the GBV; and 3) to identify factors associated with GBV. Design: A cross-sectional study was conducted among voluntary healthcare students in France. Setting: Health Campus at Rouen and nursing schools in Normandy, France. Participants: Volunteer healthcare students of 18 years and over. Data collected: Five types of GBV were recorded: GBV1: damage to a person's image due to a sexual connotation on social networks, GBV2: sexist remarks and behaviour, GBV3: comments with sexual connotations, GBV4: sexual assaults and GBV5: rape or attempted rape. Perpetrators' status, where the GBV occurred, psychological and behavioural impacts of GBV were also recorded. Results: One thousand one hundred and fifty-two students were included. The mean age was 20.8 years (SD = 2.26), 82.6% of students were women (0.4% non-binary). Since the beginning of their healthcare study, 41.2% of students CI 95% [39.7–42.6] were victim of at least one type of GBV: 15.8% among men CI 95% [13.2–18.4] and 46.0% CI 95% [44.4–47.6] among women (p < 0.001). The perpetrators were student peers, regardless of the type of GBV, healthcare workers for the GB2 and GBV3, and patients except for GBV5. The main consequences of GBV on health was psychological and eating related. After multivariate analysis, being a woman, LGBTQ+ (Lesbian, Gay, Bi, Trans, Queer and other), a nurse, a physiotherapist student, having a job, living with roommates and year of study were risk factors for GBV. Conclusion: GBV is so common at healthcare universities and could have such severe consequences for students that more work is needed to generate a culture change and ensure safe learning environments. [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate tobacco smoking, cannabis use, and binge drinking among university students from different curricula in France between 2009 and 2016 and the associated factors. Six repeated cross-sectional studies with self-administered anonymous questionnaires were performed among university students. Data collected included age, gender, curriculum, tobacco smoking, cannabis use, and binge drinking over the previous 12 months. From 2009 to 2016, 4755 students filled out the questionnaire. Mean age of students was 20.1 years (standard deviation = 1.8) and sex-ratio (M:F) was 0.54. During the study period, 21.4% of university students were tobacco smokers, 28.4% were cannabis users and 54.6% were binge drinkers. The logistic regression showed no significant change for tobacco smoking for cannabis use during the period and a significant decrease for binge drinking only in 2016. Male gender, living in rented accommodation and job holder status were positively associated and grant holder status was negatively associated with these consumptions. Students from the engineering schools' and healthcare group were found more at risk of binge drinking, compared to the mixed discipline university group. Binge drinking remains a concern among university students in France. This trend could be deserved to be confirmed in a few years. Our results also showed differences within those risks according to curriculum and socio-demographic characteristics, which could lead to targeted prevention. [ABSTRACT FROM AUTHOR]

Background: Eating disorders (ED) are a public health concern due to their increasing prevalence and severe associated comorbidities. The aim of this study was to identify mental health and health behaviours associated with each form of EDs. Methods: A case–control study was performed: cases were patients with EDs managed for the first time in a specialized nutrition department and controls without EDs were matched on age and gender with cases. Participants of this study filled self-administered paper questionnaire (EDs group) or online questionnaire (non-ED group). Collected data explored socio-demographics, mental health including anxiety and depression, body image, life satisfaction, substances and internet use and presence of IBS (Irritable Bowel Syndrome). Results: 248 ED patients (broad categories: 66 Restrictive, 22 Bulimic and 160 Compulsive) and 208 non-ED subjects were included in this study. Mean age was 36.0 (SD 13.0) and 34.8 (SD 11.6) in ED and non-ED groups, respectively. Among patients and non-ED subjects, 86.7% and 83.6% were female, respectively. Body Shape Questionnaire mean score was between 103.8 (SD 46.1) and 125.0 (SD 36.2) for EDs and non-ED group, respectively (p < 0.0001). ED patients had a higher risk of unsatisfactory friendly life, anxiety, depression and IBS than non-ED s (all p < 0.0001) Higher risk of anxiety, depression and IBS was found for the three categories of EDs. Higher risk of smoking was associated only with restrictive ED, while or assault history and alcohol abuse problems were associated only with bulimic ED. The risk of binge drinking was lower in all EDs categories than in non-ED. Conclusion: This study highlights the common comorbidities shared by all EDs patients and also identifies some specific features related to ED categories. These results should contribute to the conception of future screening and prevention programs in at risk young population as well as holistic care pathways for ED patients. Plain English summary: This case–control study evaluated mental health and health behaviours associated with the main categories of Eating Disorders (EDs). Cases were patients with EDs initiating care in a specialized nutrition department and controls without ED were matched on age and gender with cases. Self-administered paper questionnaires were filled by ED 248 patients (66 Restrictive, 22 Bulimic and 160 Compulsive) and online questionnaire by 241 non-ED controls. Body image satisfaction was significantly worse in ED patients than in controls. (p < 0.0001). Dissatisfactory life, anxiety, depression and irritable bowel syndrome were more found in patients with all EDs categories than in non-ED (p < 0.0001). Smoking risk was increased only in restrictive patients while and assault history and alcohol abuse was increased only in bulimic patients. These results highlight the global burden of ED and related comorbidities and provide useful information for future screening, prevention and care programs. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess vaccination perception and the prevalence of the overall vaccination coverage (VC) and associated factors among university students. An online study was conducted among students of a university in Rouen (Normandy), France, in January 2021, with questions about the VC and perception of the vaccines. The convenience sample included 3089 students (response rate of 10.3%), with a mean age of 20.3 (SD = 1.9). The overall VC was 27.8% (39.2% for the healthcare students (HCS) and 21.3% for the non-HCS; p < 0.0001). Confidence (efficacy and security) was lower than the conviction of usefulness. The characteristics associated with VC were having the intention to be vaccinated against COVID-19, high perceptions of usefulness for their own health, having confidence in the vaccines' efficacy and security, and a high estimated level of knowledge about vaccination. Education about the general interest and mechanism of action of vaccines could improve the perception of vaccines. Then, it is relevant to improve vaccination literacy and confidence in university students, who, as future adults and parents, will vaccinate themselves and their children; as well as healthcare students who are future healthcare workers and, therefore, will vaccinate and counsel their patients. [ABSTRACT FROM AUTHOR]

Background: Clinical research is mostly conducted among hospitalized patients, which restricts the generalizability of research results. The involvement of GPs in research has been consistently highlighted as a factor associated with successful study recruitment.Objectives: To assess GPs' motivations and willingness to participate in primary care research as investigators and to identify factors associated with their willingness.Methods: We conducted an observational, cross-sectional study in Normandy, France, with a self-questionnaire sent to 3002 GPs. We collected data on GPs' socio-demographic characteristics, their experiences and their expectations regarding research, and their reasons for non-participation.Results: Overall, 489 questionnaires were collected. Two hundred and forty-six GPs (50.3%) were interested in participating in clinical research as investigators. The two main conditions for participation as investigators were the relevance of the study topic for clinical practice (80.5%) and the feedback of study results (80.1%). The two main reasons for non-participation were lack of time (79.4%) and administrative burden (43.6%). Age between 27 and 34 years (adjusted odds ratio [AOR] = 2.86, P = 0.004) and GP trainer status (AOR = 2.41, P < 0.001) were associated with willingness to participate in primary care research. Age between 60 and 70 years (AOR = 0.53, P = 0.03) and locum status (AOR = 0.40, P = 0.04) were associated with non-participation in research.Conclusions: Based on our results, we were able to establish a profile of GPs willing to participate in primary care research as investigators. GPs' involvement should be based on their preferred areas of research. Different incentives such as a dedicated clinical research nurse or financial support could also be considered. [ABSTRACT FROM AUTHOR]

Background:Many studies indicate that a substantial part of the student population drinks excessively, yet most European universities do not have an alcohol policy. In the absence of an alcohol guideline at universities and the easy access to alcohol sold at the student cafeteria, for instance, this has the potential to place students at risk of overconsumption, which has adverse health consequences. Objectives: Therefore, our study objectives were to explore and compare university students' experiences and attitudes toward alcohol policy on their campus using a qualitative approach. Methods: 29 focus group discussions (FGDs) were conducted among students from universities in five European countries: Belgium (4 FGDs), Denmark (6 FGDs), France (5 FGDs), Hungary (6 FGDs), and the Slovak Republic (8 FGDs), with a total number of 189 participants. Results: Across the five European countries, students recognized that alcohol was a big problem on their campuses yet they knew very little, if any, about the rules concerning alcohol on their campus. Conclusions: Students will not support an on campus alcohol restriction and a policy should therefore focus on prevention initiatives. [ABSTRACT FROM AUTHOR]

Background: Studies conducted on characteristics of binge drinking and associated behaviours in college student populations are scarce especially in France. Hence, it is important to identify risk factors for binge drinking at university, especially those which may be changed. The aim of this study was to assess the prevalence of binge drinking and associated behaviours across a large sample of college students in Upper Normandy (France).Methods: A cross sectional study was performed between November 2009 and February 2013 and data on socioeconomic characteristics and behavioural risk factors were collected: alcohol (consumption and misuse of alcohol, occasional and frequent binge drinking), tobacco, cannabis, cyberaddiction, stress and depression. An anonymous self-administered questionnaire was filled out by college student volunteers from Upper Normandy (France) either online or by paper questionnaire. Analyses were performed using multivariate logistic regression models.Results: A total of 3286 students were included. The mean (Standard Deviation (SD)) age of students was 20.8 years (SD = 2.1) with a male-female ratio of 0.60. The prevalence of binge drinking in the never, occasional and frequent categories was respectively 34.9%, 51.3%, and 13.8%. The mean number of units of alcohol consumed per week (except BD episodes) was 0.78 for never, 3.7 for occasional and 10.5 for frequent binge drinkers (p < 0.0001). A positive relation was observed between frequent binge drinking and the following: male gender (AOR 4.77 95% CI (3.43-6.63); p < 0.0001), living in rented accommodation AOR 1.70 95% CI (1.21-2.40; p < 0.0001), attending business school AOR 4.72 95% CI (2.76-8.08; p < 0.0001), regular practice of sport AOR 1.70 95% CI (1.24-2.34; p = 0.001), smoking AOR 5.89 95% CI (4.03-8.60; p < 0.0001), occasional cannabis use AOR 12.66 95% CI (8.97-17.87;p < 0.0001), and alcohol abuse AOR 19.25 95% CI (13.4-27.72; p < .0001). A negative association was observed between frequent binge drinking and grant holder status, living in couples, and stress.Conclusions: This study highlights the spread of binge drinking among college students and identifies student populations at risk: male gender, living in rented accommodation, regular practice of sport, and other risk behaviours such as use of tobacco, cannabis and alcohol. These behaviours increase with the frequency of binge drinking. [ABSTRACT FROM AUTHOR]

Background: University students face multiple stressors such as academic overload, constant pressure to succeed, competition with peers as well as concerns about the future. Stress should not be considered on its own, but should be associated with potential risk behaviors leading to onset of substance use and related problems heightened during the university period. The aim of this study was to determine the prevalence of main substance use and behavioral addictions among students in higher education in France and to examine the relationship with perceived stress. Methods: A self-administered questionnaire was filled out by university student volunteers from Upper Normandy (France) either by anonymous online questionnaire or by paper questionnaire. Data collected included socioeconomic characteristics, Perceived Stress Scale (PSS), substance use (tobacco, alcohol, and cannabis) and hazardous behaviors: alcohol abuse problems, smoking, consumption of cannabis, eating disorders, and cyber addiction. Results: A total of 1876 students were included. Mean PSS score was 15.9 (standard deviation = 7.2). Highly stressed students (4th quartile) were compared with lesser stressed students (1st quartile). A positive relation was observed between female gender, regular smokers, alcohol abuse problems, risk of cyberaddiction and especially eating disorders (AOR = 5.45, 95% CI = 3.42-8.69), and increasing PSS score. PSS score however, was not significantly related to the curriculum, regular alcohol use, drunkenness or binge drinking even after additional controlling for use of other substances. We found a significant negative association between stress and practice of sport: students with the most physical activity were less likely to report perceived stress (4th quartile: AOR = 0.57, 95% CI = 0.39-0.80). Conclusions: This cross-sectional study among university students in France revealed that perceived stress was associated not only with known risks such as alcohol misuse, but also with new risks such as eating disorders and cyber addiction. These results could help to develop preventive interventions focussing on these risk behaviors and subsequently improving stress coping capacity in this high-risk population. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the ability of a surgical intensive care unit (SICU) medical staff to assess at admission the individual risk of nosocomial infection (NI) during SICU stay in patients admitted for at least 48 h.Design: Prospective observational study.Setting: A tertiary-care university hospital.Patients and Participants: 201 admissions to the SICU from November 19, 2003, until April 16, 2004.Measurements and Results: Assessment by medical staff at admission of each patient's estimated risk of NI (pneumonia, venous central catheter-related infection, symptomatic urinary tract infection, and bacteremia) during SICU hospitalization, in order to classify patients into four groups: NI risk very low or absent (group 1), low (group 2), high (group 3), very high or certain (group 4). NI was diagnosed via routine surveillance according to Centers for Disease Control case definitions.Results: 154 patients were assessed; the percentage of patients with NI increased with estimated risk at admission, from 0% in group 1 to 14.3% in group 4. Positive predictive value of medical assessment varied from 8.4% to 14.5%, according to the cutoff value. Negative predictive value varied from 92.1% to 100%.Conclusion: Our study suggests that ICU physicians encounter a major difficulty when informing patients or patients' families about the risk of NI occurrence, as they cannot predict this risk accurately. This limitation should be explained to patients and their families. [ABSTRACT FROM AUTHOR]

The objectives were to explore, among university students, the level of COVID-19 vaccine acceptance, hesitancy, and resistancy and to determine the motivations and barriers, and the reasons that may change student vaccination decision making. An online observational cross-sectional study was conducted among students of a French university in January 2021 with questions about the intention to be vaccinated against COVID-19, the motivations and the barriers. The convenience sample included 3089 students, with a mean of age of 20.3 (SD = 1.9). To the question on the intention to vaccinate against the COVID-19, 58.0% of students reported that they would choose to have a vaccination, 17.0% reported that they would not and 25.0% were not sure. The main motivations for vaccine acceptance were "I don′t want to transmit COVID-19 to others", the main barriers for vaccine resistance or hesitancy were "I prefer to wait until I have more experience with these new vaccines". Age, female gender, being in first three years of study, studied sciences courses and neither sciences nor healthcare courses of study were significantly associated with a higher risk of vaccine hesitancy or resistancy. Self-estimated knowledge of conventional vaccines and COVID-19 vaccines, and confidence in efficiency and safety of conventional vaccination were associated with a lower risk of vaccine hesitancy or resistancy. It is relevant to disseminate evidence-based interventions to promote COVID-19 vaccine acceptability for college students, especially for the students in neither sciences nor healthcare courses of study, as college students will soon be eligible to receive a COVID-19 vaccine. [ABSTRACT FROM AUTHOR]

Objective To determine the prevalence of eating disorders among university students and its relationship to behavioral characteristics and substance use. Design Cross-sectional study collected socioeconomic characteristics and behavioral risk. Setting University of Upper Normandy, France. Participants University student volunteers. Phenomenon of Interest The Sick, Control, One stone, Fat, Food (SCOFF) screening test was used to identify subjects with eating disorders by a confidential questionnaire self-administered either online or on paper. Analysis Multivariate logistic regression models with P < .05 considered significant. Results A total of 3,457 students were included with a male-to-female ratio of 0.57. The prevalence of positive SCOFF screening was 20.5% among students. A positive relation between the positive SCOFF was observed with female gender (adjusted odds ratio [AOR], 2.98; 95% confidence interval [CI], 2.28–3.89; P < .001), stress (AOR, 1.10; 95% CI, 1.09–1.12; P < .001), depression (AOR, 8.62; 95% CI, 3.37–22.10; P < .001) alcohol abuse problems (AOR, 1.52; 95% CI, 1.20–1.95; P = .006), and risk of cyber-addiction (AOR, 5.09; 95% CI, 2.69–9.62; P < .001). Conclusions and Implications Eating disorders are highly prevalent among university students in France and associated with other behavior risks, stress, and depression. It might prove necessary in the future to screen students with the SCOFF questionnaire upon entry to the university to inform student about the risk of eating disorders and advise them to consult with their general practitioner. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused stress as well as modified physical activity and eating habits among university students. The objectives were to identify the changes in body mass index (BMI) and eating disorders among university students between 2009 and 2021. Between 2009 and 2021, five repeated cross-sectional studies were conducted among university students who filled in an anonymous online self-questionnaire. Age, gender, and BMI were recorded, and the SCOFF questionnaire was used for ED screening which, in combination with BMI, allows to identify the four broad categories of ED with the Expali algorithm. With the five studies, 8981 university students were included in total. Obesity steadily increased between 2009 and 2021, for both men and women. The prevalence of ED was stable between 2009 and 2018 and significantly increased from 31.8% in 2018 to 51.8% in 2021 for women ( p &nbsp; trend < 0.0001), and from 13.0% in 2009 to 31.3% in 2021 for men ( p &nbsp; trend < 0.0001). All types of ED increased significantly between 2009 and 2021, except for restrictive ED among men. These results indicate for the first time a significant increase in ED prevalence among students since the COVID-19 pandemic. Initiatives to reinforce early screening of ED to implement targeted interventions in the student population are urgently needed.

Feeding and Eating Disorders (FED) are mostly described in infants and adolescents but are less well-known in children. Information on the prevalence of FED in the general pediatric population is still limited. The aim of this study was to estimate the prevalence and the care pathway of FED in a population aged 0-18 years old, using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 classification. Two physicians interviewed 401 families using a questionnaire including demographics, BMI, dietary behavior data, and age-appropriate screening tools. Qualitative and quantitative variables were compared using the Chi 2 test and Student's t-test, respectively. After a headcount adjustment based on the French population by age group, the estimated prevalence rate was 3% [95%CI (1.7-5.1)] for Avoidant and Restrictive Food Intake Disorder (ARFID), and 9.7% [95%CI (7.2-13.0)] for Unspecified FED (UFED), which included other restrictive and compulsive FED. The median age for ARFID was 4.8 years (0.8-9 years), and 7.5 years (0.6-17 years) for UFED. The interviews did not identify cases of anorexia, bulimia, binge eating disorder, other specified FED, pica or rumination. Only 15.2% of children with an FED were receiving medical care. The development of validated pediatric screening tools, as well as the training of health professionals in children FED is necessary.

This cross-sectional study aimed to determine the use of neuroenhancers, the motivations and factors associated with their use in French and Romanian university students. Students from two universities in France (Rouen and Opal Coast University) and one in Romania (Cluj-Napoca) were asked to complete a self-administered anonymous questionnaire, either online or on paper, about the use of three different categories of substance: Prescription drugs (methylphenidate, modafinil, and beta-blockers), drugs of abuse (alcohol, cannabis, cocaine, and amphetamines), and soft enhancers (coffee, vitamins, caffeine tablets, and energy drinks). In total, 1110 students were included: The users were 2.2% for prescription drugs, 4.3% for drugs of abuse, and 55.0% for soft enhancers. Students used neuroenhancement to stay awake for study (69.3%), to improve concentration (55.5%), to decrease stress (40.9%), and to improve memory (39.6%). Neuroenhancement was considered to meet expectations by 74.4% of users. The factors associated with the use of drugs of abuse were frequent binge drinking (Adjusted Odds Ratio-AOR: 6.49 [95% CI: 2.53-16.6]), smoking (AOR: 5.50 [95% CI: 2.98-10.14]), having a student job (AOR: 2.42 [95% CI 1.13-5.17]), and being male (AOR: 2.23 [95% CI:1.21-4.11]). No significant associations with eating disorders were detected for any of the three categories of substances. University students reported neuroenhancement with prescription drugs, drugs of abuse, and mainly soft enhancers. These substances were used mainly to increase the waking hours. Educational programs in universities seem to be required in order to increase student awareness of the problems caused by neuroenhancements, and to decrease the associated risks by changing students' attitudes and beliefs.

The aim of this paper was to identify the characteristics of broader categories of eating disorders (ED) and help- and care-seeking among college students. An online cross-sectional study was conducted among students of the University of Rouen-Normandy, France. The Expali-validated algorithmic tool, combining SCOFF test (Sick, Control, One stone, Fat, Food) and body mass index, was used to screen eating disorders into three diagnostic categories: restrictive eating disorders, bulimic eating disorders, and hyperphagic eating disorders. A total of 1493 college students were included; mean age was 20.1 years (SD = 1.9). The prevalence of likely cases of eating disorder was 24.8% (95% CI, 22.6-27.0). Percentage distributions of bulimic eating disorders, hyperphagic eating disorders, and restrictive eating disorders were 13.3%, 8.6%, and 2.9%, respectively. The two main resources for help-seeking in emotional stress situations were friends and family, whatever the ED. Students with eating disorders consulted their general practitioner more often for stress or anxiety than students without eating disorders: hyperphagic eating disorders (44.9%), restrictive eating disorders (35.1%), bulimic eating disorders (30.2%), and no eating disorder (20.4%) ( p < 0.0001). The prevalence of healthcare renunciation was 21.9%, with a higher risk among students with bulimic eating disorders (AOR CI 95% 1.91 (1.34-2.72). The findings show one quarter of students screened positive for an eating disorder. Stress management was not necessarily different between students with eating disorders and students without eating disorders, but the former had a greater risk of renouncing treatment, especially related to a fear of seeing a general practitioner.

Eating disorders (EDs) are increasingly frequent. Their pathophysiology involves disturbance of peptide signaling and the microbiota-gut-brain axis. This study analyzed peptides and corresponding immunoglobulin (Ig) concentrations in groups of ED. In 120 patients with restrictive (R), bulimic (B), and compulsive (C) ED, the plasma concentrations of leptin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and insulin were analyzed by Milliplex and those of acyl ghrelin (AG), des-acyl ghrelin (DAG), and α-melanocyte-stimulating hormone (α-MSH) by ELISA kits. Immunoglobulin G (in response to an antigen) concentrations were analyzed by ELISA, and their affinity for the respective peptide was measured by surface plasmon resonance. The concentrations of leptin, insulin, GLP-1, and PYY were higher in C patients than in R patients. On the contrary, α-MSH, DAG, and AG concentrations were higher in R than in C patients. After adjustment for body mass index (BMI), differences among peptide concentrations were no longer different. No difference in the concentrations of the IgG was found, but the IgG concentrations were correlated with each other. Although differences of peptide concentrations exist among ED subtypes, they may be due to differences in BMI. Changes in the concentration and/or affinity of several anti-peptide IgG may contribute to the physiopathology of ED or may be related to fat mass., Competing Interests: The authors declare no conflict of interest

Background: Clinical research is mostly conducted among hospitalized patients, which restricts the generalizability of research results. The involvement of GPs in research has been consistently highlighted as a factor associated with successful study recruitment., Objectives: To assess GPs' motivations and willingness to participate in primary care research as investigators and to identify factors associated with their willingness., Methods: We conducted an observational, cross-sectional study in Normandy, France, with a self-questionnaire sent to 3002 GPs. We collected data on GPs' socio-demographic characteristics, their experiences and their expectations regarding research, and their reasons for non-participation., Results: Overall, 489 questionnaires were collected. Two hundred and forty-six GPs (50.3%) were interested in participating in clinical research as investigators. The two main conditions for participation as investigators were the relevance of the study topic for clinical practice (80.5%) and the feedback of study results (80.1%). The two main reasons for non-participation were lack of time (79.4%) and administrative burden (43.6%). Age between 27 and 34 years (adjusted odds ratio [AOR] = 2.86, P = 0.004) and GP trainer status (AOR = 2.41, P < 0.001) were associated with willingness to participate in primary care research. Age between 60 and 70 years (AOR = 0.53, P = 0.03) and locum status (AOR = 0.40, P = 0.04) were associated with non-participation in research., Conclusions: Based on our results, we were able to establish a profile of GPs willing to participate in primary care research as investigators. GPs' involvement should be based on their preferred areas of research. Different incentives such as a dedicated clinical research nurse or financial support could also be considered., (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: A retrospective case-control study was conducted to evaluate whether frequent binge drinking between the age of 18 and 25 years was a risk factor for alcohol dependence in adulthood., Setting: The Department of Addictive Medicine and the Clinical Investigation Center of a university hospital in France., Participants: Cases were alcohol-dependent patients between 25 and 45 years and diagnosed by a psychiatrist. Consecutive patients referred to the Department of Addictive Medicine of a university hospital between 1 January 2017 and 31 December 2017 for alcohol dependence were included in the study. Controls were non-alcohol-dependent adults, defined according to an Alcohol Use Disorders Identification Test score of less than 8, and were matched on age and sex with cases. Data on sociodemographics, behaviour and alcohol consumption were retrospectively collected for three life periods: before the age of 18 years; between the age of 18 and 25 years; and between the age of 25 and 45 years. Frequency of binge drinking between 18 and 25 years was categorised as frequent if more than twice a month, occasional if once a month and never if no binge drinking., Results: 166 adults between 25 and 45 years were included: 83 were alcohol-dependent and 83 were non-alcohol-dependent. The mean age was 34.6 years (SD: 5.1). Frequent binge drinking between 18 and 25 years occurred in 75.9% of cases and 41.0% of controls (p<0.0001). After multivariate analysis, frequent binge drinking between 18 and 25 years was a risk factor for alcohol dependence between 25 and 45 years: adjusted OR=2.83, 95% CI 1.10 to 7.25., Conclusions: Frequent binge drinking between 18 and 25 years appears to be a risk factor for alcohol dependence in adulthood. Prevention measures for binge drinking during preadulthood, especially frequent binge drinking, should be implemented to prevent acute consequences as injury and death and long-term consequences as alcohol dependence., Trial Registration Number: NCT03204214; Results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Impulsivity is a psychological trait linked to health issues such as obesity. However, few studies have explored the relation between impulsivity, dietary intake, and eating disorders (EDs) in a general population., Objective: The aim of this cross-sectional study was to assess whether impulsivity was associated with energy intake, food-group consumption, snacking, and risk of EDs., Design: In 2014, 51,368 adult participants from the NutriNet-Santé Study completed the 11th version of the Barratt Impulsiveness Scale (BIS-11), which assesses impulsivity. Food-group consumption and diet quality were evaluated by using ≥3 self-reported 24-h dietary records (n = 35,830), whereas snacking behavior was evaluated by an ad hoc question (n = 48,562). Risk of EDs was assessed with the Sick-Control-One-Fat-Food Questionnaire (SCOFF), and categories of ED (restrictive, bulimic, hyperphagic, and other types of EDs) were determined with the Expali algorithm (n = 48,824). Logistic and linear regressions were used to analyze the associations between impulsivity and energy intake, food-group consumption, diet quality, snacking, and risk of EDs, taking into account sociodemographic and lifestyle factors., Results: Positive associations were found between impulsivity and consumption of alcoholic beverages and appetizers, whereas negative associations were found for fruit and vegetables, meat and poultry, processed meat, dairy products, milk-based desserts, and starchy foods. Impulsivity was positively associated with energy intake and negatively associated with diet quality. Impulsivity was also positively associated with snacking (OR: 3.32; 95% CI: 2.99, 3.68) and risk of EDs (OR: 3.02; 95% CI: 2.74, 3.33). The strongest associations were found for bulimic disorders (OR: 4.38; 95% CI: 3.66, 5.23) and hyperphagic disorders (OR: 2.91; 95% CI: 2.56, 3.31)., Conclusion: Impulsivity was associated with food intakes, snacking, and risk of EDs and could be taken into account in the promotion of healthy eating behavior. This study was registered at clinicaltrials.gov as NCT03335644.

Background: A previous study suggested that most surgical patients do not remember having received information about surgical site infection (SSI). In other fields, written information has been suggested to improve patient satisfaction and recollection of information. Our objective was to assess if providing patients with written information about SSI, in addition to oral information, could influence patient satisfaction, recall of information, and opinion regarding SSI., Methods: A total of 207 patients scheduled for digestive surgery at a university hospital were randomized between usual oral information about SSI, plus an information leaflet about SSI (group O/L), or usual oral information alone (group O). Patients were interviewed 5 weeks after surgery to assess their recall and satisfaction regarding information, opinion regarding SSI, and declared intention of seeking legal action in case of SSI. Surgeons and interviewer were blinded to patients' group allocation. Recruitment occurred between October 2005 and August 2006., Results: Of the original 207 patients, 161 patients (O/L=87, O=74) underwent operation and were interviewed as scheduled. Satisfaction was higher in group O/L (67% vs. O: 43%; P=0.003). The recall of having received information (O/L: 39% vs. O: 31%; P=0.29), was similar between the two groups. Judging SSI as always preventable was more frequent in group O/L (28% vs. O: 9%; P=0.004) with a trend toward a more frequent intention of seeking legal action (O/L: 10% vs. O: 3%; P=0.055)., Conclusions: The leaflet did not improve patient recall of information about SSI, but it was associated with an increased level of satisfaction. The association between the leaflet and judging SSI as always preventable was unexpected.

Objectives: To measure the prevalence of HCS and determine its socio-health characteristics., Methods: Subjects (> or = 18 years) included were patients seen in four hospital emergency rooms in Haute-Normandie for a disease requiring ambulatory care. HCS corresponded to the validated definition: did not intend to quit smoking, smoking every day and not having tried to quit during the past five years., Results: A total of 429 subjects were enrolled, including 156 smokers, 20 of which were HCS (12.8%, 95% CI = 8.2%-19.3%). After logistical regression, the status of HCS was significantly associated with: having a less frequent average consultation with a doctor in the last 6 months (adjusted odds ratio [ORa] = 0.14 95% CI = 0.02-0.84 p = 0.02); having been less frequently a beneficiary of supplementary health insurance (ORa = 0.15 CI 95% = 0.03-0.71, p = 0.02); and having more frequently sought assistance from social services (ORa = 26.67, 95% CI = 0.95-79.45 p = 0.06)., Conclusion: According to these results, there are between 1 and 2.5 million HCS estimated in France. The HCS in this study's patient population from emergency services seem to be more socially disadvantaged than other smokers and have less frequent access to care. Prevention messages must be adapted for this population who is easily identifiable in general practice.

Unlabelled: Hepatitis C viral infection (HCV) is a frequent and severe disease; screening strategies to-date remain insufficient., Objective: To assess the efficiency of HCV screening of high-risk groups among patients consulting general practitioners., Methods: A cost-effectiveness analysis was performed involving general medicine screening practices recorded during a survey of 127 practitioners (10,041 patients) conducted in 1997. A reference strategy, defined as HCV screening for illicit drug users and transfused patients, and five extended strategies, where the screening population was broadened to include other risk groups as well, were considered. Average cost and marginal cost-effectiveness ratios were determined for each extended strategy and compared with those observed for the reference strategy. The sensitivity of HCV screening to funding modalities, HCV seroprevalence and proportion of HCV high-risk groups among patients attending general practitioners was studied., Results: The reference strategy was the most cost-effective method irrespective of the funding modality considered. Fixed practitioner payment was the least efficient funding modality. The average cost of one positive test was sensitive to variations of HCV seroprevalence in the high-risk group as well as the proportion of high-risk patients among the general practitioners' patients., Conclusion: Extension of hepatitis C screening to risk groups other than transfused patients and illicit drug users implies a substantial increase in healthcare costs as well as social consensus for such expenditures.