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Aim: To describe the progression of vigilance and sleepiness over the shift and the coping strategies of nurses working 12‐hr day or night shifts. Background: The spread of 12‐hr shift work in nursing raises the question of whether sufficient vigilance can be maintained to ensure quality of care. Method: 18 nurses working 12‐hr shifts filled out a Karolinska Sleepiness Scale questionnaire and a Brief Psychomotor Vigilance Test, at the beginning of the shift and then every 3 hr. Coping strategies and quality of care were assessed on self‐administered questionnaires, filled out at 3 hr, 6 hr, 9 hr and 12 hr after the start of the shift. Results: The present investigation did not show significantly excessive sleepiness or vigilance impairment or poor self‐perception of quality of work during 12‐hr nursing work shifts, although Psychomotor Vigilance Test results gradually deteriorated slightly over duty time (from start to end of shift). Certain coping strategies were preferred such as 'having a nap' later in the night shift. Conclusion: Attention needs to be paid to the health status of nurses working 12‐hr shifts, with regular medical monitoring by the occupational health service. Implications for Nursing Management: Coping strategies to maintain sufficient vigilance to ensure quality of care should be facilitated. [ABSTRACT FROM AUTHOR]

Abstract Breast and ovarian cancers increased in the last decades. Except rare cases with a genetic predisposition and high penetrance, these pathologies are viewed as a polygenic disease. In this concept, association studies look for genetic variations such as polymorphisms in low penetrance genes, i.e. genes in interaction with environmental factors. DNA repair systems that protect the genome from deleterious endogenous and exogenous damages have been shown to have significantly reduced. In particular, enzymes of the nucleotide excision repair pathway are suspected to be implicated in cancer. In this study, 2 functional polymorphisms in a DNA repair gene ERCC2 were analyzed. The population included 911 breast cancer cases, 51 ovarian cancer cases and 1000 controls. The genotyping of 2 SNP (Single Nucleotide Polymorphism) was carried out on the population with the MGB (Minor Groove Binder) probe technique which consists of the use of the allelic discrimination with the Taqman® method. This study enabled us to show an increase in risk of breast cancer with no oral contraceptive users and with women exhibiting a waist-to-hip ratio (WHR) > 0.85 for Asn homozygous for ERCC2 312.

Résumé: Peu de visites de pré-reprises réalisées par les médecins du travail lors d'arrêt maladie supérieur à trois mois sont à l'initiative des généralistes. Cet article explore les freins perçus par les médecins généralistes, les médecins du travail et les médecins-conseils dans la mise en place de la visite de pré-reprise et dans la communication autour de cette visite. L'étude montre qu'il est nécessaire de mieux informer les généralistes et les salariés de l'intérêt d'initier une visite de pré-reprise précocement et de développer les outils de communication entre les médecins généralistes, les médecins du travail et les médecins-conseils, tout trois acteurs dans la prévention de la désinsertion professionnelle. Few pre-recovery visits by occupational physicians during sick leave of more than 3 months are initiated by GPs. This article explores the obstacles perceived by GPs, occupational physicians and medical officers in setting up the pre-recovery visit and in the communication around this visit. The study shows that it is necessary to better inform GPs and employees of the benefits of initiating a pre-recovery visit at an early stage and to develop communication tools between GPs, occupational physicians and medical officers, all three players in the prevention of professional withdrawal. [ABSTRACT FROM AUTHOR]

Firefighters' activities increase the risk of sudden cardiac events. The main objective of this study was to describe the Loire firefighters' cardiovascular risk factors according to their cardiovascular risk and to their professional status. A retrospective study of the entire population of firefighters of the Loire department was conducted. Risk factors derived from the data collected during the occupational health follow-up medical examinations were described and the cardiovascular risk was assessed for 417 firefighters. The most frequent cardiovascular risk factors were: overweight and obesity (62.1%), high blood pressure (27.8%) and active smoking (16,1%). There were no significant differences between career firefighters and volunteers. The prevalence of risk factors for cardiovascular diseases is less than in the general population. Obesity remains the most common risk factor, especially among firefighters with high cardiovascular risk. [ABSTRACT FROM AUTHOR]

Résumé: Le médecin généraliste (MG) est régulièrement consulté par des personnes en situation de perte d'emploi. Des estimations modélisent que le chômage serait responsable en France de 14 000 morts par an et de quelques centaines de suicides. Dans un premier article, nous nous employions à faire une revue de la littérature afin de mettre en lumière le développement du chômage de masse, de définir la crise de la perte d'emploi et ses typologies. Puis dans un deuxième article, nous décrivions l'épidémiologie du phénomène. Enfin, ce troisième nous permettra d'élaborer un référentiel de pratique en MG et décrira la place des différents acteurs impliqués dans l'accompagnement et le soutien de la personne en situation de perte d'emploi. Ce travail configure une sorte de médecine du chômage à l'instar de la médecine du travail. The general practitioner (GP) is regularly consulted by people who are losing their jobs. Unemployment in France could be responsible for 14,000 deaths per year and a few hundred suicides. In a first article, we reviewed the literature to highlight the development of mass unemployment, define the job loss crisis and its typologies. Then in a second article, we described the epidemiology of the phenomenon. Finally, this third article will allow us to develop a reference framework for GP and will describe the place of the various actors involved in the accompaniment and support of the person in a situation of job loss. This work configures a kind of unemployment medicine in the same way as occupational medicine. [ABSTRACT FROM AUTHOR]