Sante Publique

Paris, France

Sante Publique

Paris, France
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Underner M.,Unite de Tabacologie | Peiffer G.,Unite de Tabacologie | Le Houezec J.,Sante Publique | Le Houezec J.,University of Nottingham | And 3 more authors.
Revue des Maladies Respiratoires | Year: 2012

Smoking cessation specialists are frequently confronted with smokers who have great difficulty in stopping smoking, and who are either motivated to stop or are forced to stop for health, economic or statutory reasons. These smokers are composed of a mixed population but they have in common a heavy dependence on tobacco and a significant level of cigarette consumption. They are exposed to serious morbidity induced by their uncontrollable smoking. Other factors unfavourable to the attempt to stop smoking are often present: anxiety-depressive disorders, socioeconomic difficulties or the use of psychoactive substances. They constitute a priority target for smoking cessation clinics, which must optimise and diversify proposals to improve their interventions. This review describes these highly dependent smokers unable to stop, and suggests medical treatments and therapeutic combinations to assist the practitioners trying to help the "hard-core" smokers. © 2012 SPLF.


Rieu I.,CHU Clermont Ferrand | Martinez-Martin P.,Alzheimer Center Reina Sofia Foundation and arlos Institute of HealthMadrid Spain | Pereira B.,Biostatistics Unit | De Chazeron I.,CHU Clermont Ferrand | And 11 more authors.
Movement Disorders | Year: 2015

The "Ardouin Scale of Behavior in Parkinson's Disease" is a new instrument specifically designed for assessing mood and behavior with a view to quantifying changes related to Parkinson's disease, to dopaminergic medication, and to non-motor fluctuations. This study was aimed at analyzing the psychometric attributes of this scale in patients with Parkinson's disease without dementia. In addition to this scale, the following measures were applied: the Unified Parkinson's Disease Rating Scale, the Montgomery and Asberg Depression Rating Scale, the Lille Apathy Rating Scale, the Bech and Rafaelsen Mania Scale, the Positive and Negative Syndrome Scale, the MacElroy Criteria, the Patrick Carnes criteria, the Hospital Anxiety and Depression Scale, and the Mini-International Neuropsychiatric Interview. Patients (n=260) were recruited at 13 centers across four countries (France, Spain, United Kingdom, and United States). Cronbach's alpha coefficient for domains ranged from 0.69 to 0.78. Regarding test-retest reliability, the kappa coefficient for items was higher than 0.4. For inter-rater reliability, the kappa values were 0.29 to 0.81. Furthermore, most of the items from the Ardouin Scale of Behavior in Parkinson's Disease correlated with the corresponding items of the other scales, depressed mood with the Montgomery and Asberg Depression Rating Scale (ρ=0.82); anxiety with the Hospital Anxiety and Depression Scale-anxiety (ρ=0.56); apathy with the Lille Apathy Rating Scale (ρ=0.60). The Ardouin Scale of Behavior in Parkinson's disease is an acceptable, reproducible, valid, and precise assessment for evaluating changes in behavior in patients with Parkinson's disease without dementia. © 2015 International Parkinson and Movement Disorder Society.


PubMed | Service de Biostatistiques, Sante Publique, Service des Maladies infectieuses et tropicales, Nice University Hospital Center and 3 more.
Type: Journal Article | Journal: PloS one | Year: 2015

In the interest of cost effectiveness, switching antiretroviral brand name medications to generics is recommended in France since 2013. The study objective was to evaluate the perception of generics per se and antiretroviral generics in HIV-infected patients and their hospital physicians.556 out of 703 (79%) adult HIV+ outpatients and 116 physicians in 33 clinics were included in a multicentric cross-sectional survey performed in September 2013. Patients completed a self-questionnaire on their perception and acceptability of generics. Physicians completed a questionnaire on their acceptability of switching antiretroviral to generic. Socio-demographic data, medical history and HIV history were collected. Among the 556 patients with a median HIV duration of 13 years, 77% were France native, 59% in active employment, 100% covered by social insurance, 95% on antiretroviral therapy. Seventy-six percent of the patients accepted generics and 55% trusted them overall. Antiretroviral generics were accepted by 44% of them but only by 17% if the pill burden was going to increase. The factor significantly associated with acceptability of antiretroviral generics was acceptance of generics per se (p<0.001). Among the 116 physicians following a median of 100 HIV-patients/year, 75% would prescribe generics, dropping to 26% if the combo had to be broken. Factors significantly associated with willingness to prescribe antiretroviral generics were the absence of concern regarding the chemical entity (OR = 0.33), being aware that the patient would accept generics for other pathologies (OR = 2.04) and would accept antiretroviral generics (OR = 1.94). No factor related to sociodemographic conditions, HIV status or comorbidities was associated with the acceptability of antiretroviral generics.Acceptability of antiretroviral generics in this French population was mostly dictated by the patients and physicians knowledge and use of generics overall. It should be improved with an efficient information of both patients and physicians.


Rieu I.,CHU Clermont Ferrand | Martinez-Martin P.,CIBER ISCIII | Pereira B.,Biostatistics Unit | De Chazeron I.,CHU Clermont Ferrand | And 15 more authors.
Movement Disorders | Year: 2015

The "Ardouin Scale of Behavior in Parkinson's Disease" is a new instrument specifically designed for assessing mood and behavior with a view to quantifying changes related to Parkinson's disease, to dopaminergic medication, and to non-motor fluctuations. This study was aimed at analyzing the psychometric attributes of this scale in patients with Parkinson's disease without dementia. In addition to this scale, the following measures were applied: the Unified Parkinson's Disease Rating Scale, the Montgomery and Asberg Depression Rating Scale, the Lille Apathy Rating Scale, the Bech and Rafaelsen Mania Scale, the Positive and Negative Syndrome Scale, the MacElroy Criteria, the Patrick Carnes criteria, the Hospital Anxiety and Depression Scale, and the Mini-International Neuropsychiatric Interview. Patients (n=260) were recruited at 13 centers across four countries (France, Spain, United Kingdom, and United States). Cronbach's alpha coefficient for domains ranged from 0.69 to 0.78. Regarding test-retest reliability, the kappa coefficient for items was higher than 0.4. For inter-rater reliability, the kappa values were 0.29 to 0.81. Furthermore, most of the items from the Ardouin Scale of Behavior in Parkinson's Disease correlated with the corresponding items of the other scales, depressed mood with the Montgomery and Asberg Depression Rating Scale (ρ=0.82); anxiety with the Hospital Anxiety and Depression Scale-anxiety (ρ=0.56); apathy with the Lille Apathy Rating Scale (ρ=0.60). The Ardouin Scale of Behavior in Parkinson's disease is an acceptable, reproducible, valid, and precise assessment for evaluating changes in behavior in patients with Parkinson's disease without dementia. © 2015 International Parkinson and Movement Disorder Society.


Bihan H.,Service Route | Ramentol M.,Service dendocrinologie diabetologie | Fysekidis M.,Service Route | Auclair C.,Sante publique | And 8 more authors.
Diabetes and Metabolism | Year: 2012

Aim: Deprivation has been linked to more complicated and uncontrolled diabetes. The validated évaluation de la précarité et des inégalités de santé dans les centres d'examens de santé (EPICES; Evaluation of the Deprivation and Inequalities of Health in Healthcare Centres) score could help to identify such deprived patients. The present study evaluated the relationships between deprivation and prevalence of complications, uncontrolled diabetes and quality of life. Methods: This prospective study was conducted in the diabetology department of a tertiary university hospital from November 2006 to July 2007. Patients with diabetes were divided into two groups, according to their deprivation status [non-deprived: EPICES score < 30.17; deprived: EPICES score ≥ 30.17 (56.5%)]. Diabetes control, complications and quality of life [Short Form Health Survey (SF-36)] were compared in the two groups. Results: Of a total of 102 patients, 97 completed all of the questionnaires: 18 had type 1 diabetes and 79 had type 2 diabetes, in a geographical area moderately affected by deprivation. No statistical relationship could be demonstrated between deprivation and HbA 1c. Deprived patients with diabetes presented with higher levels of fasting blood glucose, lower levels of LDL cholesterol and a significantly higher risk of obesity (P=0.0020). As for complications, microalbuminuria was linked to deprivation (P=0.03), but no associations with other complications were found. Quality of life was poorer for all physical, mental and social dimensions in deprived patients. Conclusion: In this diabetic population, deprivation and glycaemic control were not associated. However, more deprived subjects with diabetes were at higher risk of renal disease. A deprived state was related to an altered quality of life as assessed by the SF-36 score. © 2011 Elsevier Masson SAS.


Blochet C.,Presidente de Medissimo | Vetel J.-M.,Directeur Medical du Groupe Dolcea | Vial A.,Sante Publique
Revue de Geriatrie | Year: 2015

Background: Using an innovative information system, prepared treatment for old people allows to store a large amount of data on drug uses and treatment costs in nursing homes. Methods: This survey is based on 36 months drug administration data and concerns 35,788 residents (average population) living in 469 nursing homes supplied by 338 pharmacies for an amount of 4,841,060 drug boxes prescribed on 573,735 chronic orders. Results: The originality of this work, except the large sample, is the two way analyze on both indicators, annual indictors and individual indicators based on the length of stay in nursing home. Conclusion: This double approach shows the diminution of multi-prescriptions and poly-medications at the very beginning in nursing home. It also shows that a resident is prescribed with drugs from several different therapeutic classes all along its stay in nursing home. Its reveal the economic impact linked to the good use of drugs and the impact of generic drugs. At the end, it shows the interest to use in nursing homes an interoperable information system able to manage the drug delivery connected to doctors' activity. © La Revue de Gériatrie, Tome 40, No4 AVRIL 2015.


Lesourd B.,Toulouse University Hospital Center | Juchet A.,Toulouse University Hospital Center | Broue-Chabbert A.,Toulouse University Hospital Center | Colineaux H.,Sante publique
Revue Francaise d'Allergologie | Year: 2014

Aim: Asthma, the most common chronic disease in pediatrics, has a significant impact on children's lives. The purpose of patient education sessions is to help families in the management of this disease. Here, we will evaluate the sessions available at the School of Asthma in Toulouse in order to make them more efficient. Patients and methods: This assessment was performed by means of two questionnaires (before/after sessions) filled out from November 2011 to December 2012 by 26 children and their families who participated in patient education sessions; these questionnaires were complemented by the patients' medical data. Results: The results showed significant improvement (more than 80%) in the level of asthma control after the sessions as well as a decrease in the number of hospitalizations and emergency consultations. Secondary analyses showed an improvement in crisis management and crisis prevention and a clear improvement of inhalation techniques for all the children. However, the ability of a child to warn an adult and the use of breathing techniques taught in physiotherapy were disappointing, inciting us to develop new strategies. Conclusion: Evaluation of patient education sessions at the School of Asthma in Toulouse showed an improvement in the level of asthma control and inhalation techniques in the children. However, because of the limited power of our study, our results merit to be confirmed by further studies with bigger samples. Finally, we were able to demonstrate the improvement brought about by these sessions. © 2014.


PubMed | DRCI, Sante Publique, Clermont University, Psychiatrie de lAdulte A et Psychologie medicale Pole de Psychiatrie and 2 more.
Type: | Journal: European child & adolescent psychiatry | Year: 2016

Our objectives were to assess health-related quality of life (HRQoL), anxiety, depression of Gilles de la Tourette syndrome (GTS) adolescents parents compared to controls; to assess GTS adolescents HRQoL compared to controls; to investigate which parental and adolescent variables are associated with poorer parental HRQoL. The controlled study involved GTS outpatients and their parents, adolescent healthy controls matched for gender and age and their parents. Parents HRQoL was assessed using SF-36 and WHOQOL-BREF; anxiety, depression using HADS. Adolescents HRQoL was assessed by adolescents using VSP-A instrument and by their parents using VSP-P. A total of 75 GTS adolescents, 75 mothers, 63 fathers were compared to 75 control adolescents, 75 mothers, 62 fathers. GTS mothers had worse HRQoL than controls on 5 of the 8 SF-36 dimensions and 1 of the 4 WHOQOL-BREF dimensions, while GTS fathers had worse HRQoL on 2 of the WHOQOL-BREF dimensions. GTS mothers had poorer HRQoL than fathers. GTS mothers had more depression than control mothers and GTS fathers had more anxiety than control fathers. GTS adolescents had worse HRQoL than controls on 5 of the 9 VSP-A dimensions. Factors significantly related to parental HRQoL were anxiety, depression, GTS adolescents HRQoL and, concerning mothers, behavioural and emotional adolescents problems; concerning fathers, severity of vocal tics, duration since first symptoms. This study provides a better understanding of poorer HRQoL and psychiatric morbidity of GTS adolescents parents. Clinicians should pay attention to their emotional well-being and HRQoL and be aware that mothers and fathers are differently affected.


PubMed | Sante Publique
Type: Journal Article | Journal: Bulletin de l'Academie nationale de medecine | Year: 2010

Population health metrics have been developed to help to determine public health priorities. Disability-Adjusted Life Years (DALYs) is an index used to express the number of years of good health lost due to a given disorder, based not only on mortality but also on the duration and sequelae. Based on the DALYs index, the leading health disorders in France, regardless of gender, are neuropsychiatric disorders (7.8%) and depression (11.8%).


News Article | November 1, 2016
Site: globenewswire.com

aXichem AB (publ), som utvecklar och marknadsför naturanaloga industrikemikalier, för användning inom områden såsom fodertillskott för djur, påväxthämmande båtbottenfärg, samt enskilda farmaceutiska områden, har lämnat in ansökan för godkännande enligt Novel Food, för bolagets syntetiska capsaicn, aXiphen®. Ansökan har lämnats till ”Service public Federal Sante Publique, securite de la chaine alimentaire et environment” i Belgien, som är en av de myndigheter i Europa som hanterar Novel Food-ären

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