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Saias T.,Institute National Of Prevention Et Deducation Pour La Sante
Global health promotion | Year: 2013

Although France has one of the most generous health and social care systems for infant and maternal well-being in the Western world, professionals have been increasingly concerned by the rising number of children being referred for mental health problems. The present article describes the first home-visiting program in France to specifically target mental health questions in families living in vulnerable contexts. The CAPEDP project, involving 440 women and their families, took place in Paris and its inner suburbs from 2006 to 2011. To be eligible for inclusion, women had to be (i) under 26 years old, (ii) less that 27 weeks pregnant, (iii) sufficiently fluent in French to give truly informed consent to participate in the study and benefit from the intervention and (iv) presenting with one or more of the following social vulnerability factors: low income, low educational level, and/or intending to bring up the child without the child's father. The intervention consisted of 44 home visits from the third trimester of pregnancy through to the child's second birthday. The aim of the intervention was to promote infant mental health and reduce the incidence of infant mental health problems at the age of two years. The intervention paid particular attention to postnatal maternal depression and promoting parenting skills and attachment security, particularly through the use of video during home-visits. A major issue was that of adapting international best practice recommendations with regard to home-visiting programs to the particularities of the existing French social and health care system. An original aspect of the intervention was to use trained clinical psychologists to conduct all home visits. Source


Hill C.,Institute Gustave Roussy | Jougla E.,French Institute of Health and Medical Research | Beck F.,Institute National Of Prevention Et Deducation Pour La Sante
Bulletin Epidemiologique Hebdomadaire | Year: 2010

Introduction - Lung cancer mortality is the most specific indicator of the effects of tobacco smoking on health at a population level. We describe the trends in lung cancer mortality since the 1950s in France and discuss them in the light of the trends in tobacco consumption. Methods - Cause specific lung cancer mortality data come from the death certificates. Tobacco sales and survey data have been used to estimate the sex and age-specific tobacco consumption. The sex-specific consumption has been estimated by correcting the survey data to account for the sales data. This sex-specific consumption has then been adapted to each age-group on the basis of the age and sex-specific proportions of regular smokers, derived from survey data by linear interpolation. Results - Lung cancer mortality has been decreasing recently in the male population, as a consequence of the reduced consumption of tobacco, whereas one observes a large increase in lung cancer mortality in the female population who started smoking much more recently. By far the largest variations are observed in the age-group 35 to 44: male lung cancer mortality decreased by a factor 2 in 10 years and female lung cancer mortality increased by a factor 4 in 15 years. Conclusion - Anti-smoking actions in the last decades have had a clear beneficial effect on the risk of lung cancer in the male population, but the epidemic in the female population will continue with the aging of the generations who started smoking regularly. One can also expect the decrease in male lung cancer mortality to stop, given the end of the downward trend in tobacco sales observed since 2004. Source


Lebrun-Vignes B.,Pitie Salpetriere Hospital | Kreft-Jais C.,Agence Francaise de Securite Sanitaire des Produits de Sante AFSSaPS | Kreft-Jais C.,Institute National Of Prevention Et Deducation Pour La Sante | Castot A.,Agence Francaise de Securite Sanitaire des Produits de Sante AFSSaPS | And 2 more authors.
British Journal of Dermatology | Year: 2012

Background: The question of quantitative and qualitative differences between adverse drug reactions (ADRs) to tetracyclines was raised many years ago, especially for minocycline and doxycycline. Objectives: To assess and compare ADRs related to tetracyclines according to sales figures in France through a national survey. Methods ADR data were collected from the French Pharmacovigilance Database (FPD), marketing authorization holders (MAH) and the literature. Sales analyses were based on MAH data provided annually to the French Drugs Agency. Results: Among the tetracyclines available in France, doxycycline and minocycline are the most frequently used. However, their sales decreased between 1995 and 2007, more sharply for minocycline than doxycycline. According to the FPD, based on MAH data and published reports, minocycline-associated ADRs were more serious and were reported more frequently than for the other tetracyclines. Minocycline and doxycycline ADR patterns differed: gastrointestinal disorders (especially oesophageal lesions) predominated with doxycycline, while intracranial hypertension and hepatic disorders were primarily reported with minocycline. Autoimmune disorders, drug reaction with eosinophilia and systemic symptoms (DRESS) and other hypersensitivity reactions were also more frequent with minocycline. ADRs reported with lymecycline and metacycline were essentially cutaneous and gastrointestinal disorders. Conclusions: In the absence of markedly better efficacy against the various indications for tetracyclines, the minocycline benefit/risk ratio was clearly lower than that of doxycycline, and possibly those of lymecycline and metacycline. In light of these findings, minocycline should no longer be considered first-line therapy for inflammatory skin disorders, especially acne. © 2012 British Association of Dermatologists. Source


Saias T.,Institute National Of Prevention Et Deducation Pour La Sante | Saias T.,University of Quebec at Montreal | Beck F.,Institute National Of Prevention Et Deducation Pour La Sante | Beck F.,University of Paris Descartes | And 3 more authors.
PLoS ONE | Year: 2012

Objective: Few studies on elders' suicide and depression have integrated social and community factors in their explicative models. Most of the studied variables used are focused on individual and based on psychopathological models. The purpose of this study is to investigate the impact of socio-environmental factors on death ideations, using data from the European SHARE cohort. Method: Social support components and death ideations have been studied, together with known individual risk factors, within a sample of 11,425 European participants in the SHARE study, aged over 64. The item evaluating death ideations was extracted from the EURO-D12 questionnaire. Results: The high prevalence of death ideations (6.9% for men and 13.0% for women) confirmed that elders' death ideations, as it is known to be linked to suicidal behaviors, is a major public health issue. Bivariate analyses revealed a strong association between community participation and death ideations. This association was no longer significant while adjusting for depressive symptomatology. The logistic model identified that factors significantly associated with death ideations, when adjusted for the other factors were: having multiple depressive symptoms (OR = 1.64 per symptom) being aged, especially over 84 (OR = 1.58), being retired for fewer than five years (OR = 1.46), being widowed (OR = 1.35) and having a long-term illness (OR = 1.28). Conclusions: Although social and community participation is associated to death ideations, this link becomes non-significant in a regression model taking into account other factors. It is important to notice that depressive symptoms, which are obviously closely related to death ideations, take the greatest part in the association among all associated factors. Our results suggest that, consistently with the literature, while addressing death ideation or suicide prevention, professionals have to consider first the secondary prevention of depressive symptomatology. Strategies targeting social isolation and community participation should be considered as part of primary prevention policies. © 2012 Saïas et al. Source


Foucaud J.,Institute National Of Prevention Et Deducation Pour La Sante | Hamel E.,Institute National Of Prevention Et Deducation Pour La Sante
Sante Publique | Year: 2014

Introduction: Health education concerns all professionals with an impact on the health of populations, especially social welfare, health care and education professionals. The skills of health educators are central to the development of training in this field, but no common guidelines have been defined concerning the qualifications of these professionals which is why the National Institute of Prevention and Health Education, under the aegis of the National Advisory Committee for the Elaboration of Health Education Training Programmes (CCNEPF) conducted the present study. Methods: This study was conducted according to a robust methodology comprising analysis of professional practices by means of interviews with a repeated construction and successive consultation phases with the professionals concerned by these questions (national and regional authorities, national associations, professional bodies, health education bodies). Results: A total of 126 health care, social welfare and education professionals were interviewed. Analysis of the interviews, National Advisory Committee expert opinions and stakeholder consultations helped to formalize a mission statement, 4 functions/ situations, 66 activities and 11 key skills common to all health education professionals. Discussion: This study provides a common basis for health education training, especially in terms of common skills and to consider new training modalities. It also opens up various research perspectives. © S.F.S.P.. Tous droits réservés pour tous pays. Source

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