Factors influencing language performance in boys and girls at age 2 in the French ELFE birth cohort.

Different environmental and biological variables affect the rhythm of language acquisition in children. A substantial amount of literature has shown that girls overtake boys, at least in the early stages of language acquisition. The goal of this study is to investigate how different factors affect language scores in girls and boys.

Health insurance coverage is the single most prominent socioeconomic factor associated with cardiovascular drug delivery in the French population.

Objective: Although the French population benefits from universal health coverage, prescribed drugs are in most cases only partially reimbursed by the national insurance plan (65% of the cost), raising the possibility of reduced drug access for patients with low socioeconomic status.

Methods: To explore this question, the delivery of cardiovascular drugs in relation to socioeconomic position was analysed in a cross-sectional survey of a nationally representative sample of patients with cardiovascular condition (n = 4646).

Results: Among eight socioeconomic indicators and after adjustment for healthcare needs, only health coverage is independently associated with cardiovascular drug delivery, which is reduced by half [odds ratio (95% confidence interval): 0.

Low back pain around retirement age and physical occupational exposure during working life.

Background: Physical occupational exposure is a risk factor for low back pain in workers but the long term effects of exposure remain unclear. As several countries consider increasing the retirement age, further information on this topic is relevant. This study aimed to describe the prevalence of low back pain among middle aged and aging individuals in the general French population according to physical occupational exposure and retirement status.

Subtle health impairment and socioeducational attainment in young adult patients with congenital hypothyroidism diagnosed by neonatal screening: a longitudinal population-based cohort study.

Context: Screening programs resulting in the early treatment of patients with congenital hypothyroidism (CH) have successfully improved neurodevelopmental outcome, but little is known about long-term health.

Objectives: The aim of the study was to assess health status, and socioeconomic attainment, for a population-based registry of young adult patients.

Design, Setting, And Participants: All 1748 eligible patients diagnosed during the first decade after the introduction of neonatal screening in France were invited to participate in this study at a median age of 23.

[Personal and occupational factors associated with low-back pain in a general working population in France].

Background: Low-back pain is a major public health concern because of its socioeconomic burden, especially for chronic forms. The purpose of this study was to analyse the associations between low-back pain and occupational and personal factors, with a special focus on interactions between age and occupational exposures.

Methods: The study population comprised a sample of 3958 and 4526 working women and men aged 30 to 59 derived from a national health survey (2002-2003 EDS).

Seeking care for lower back pain in the French population aged from 30 to 69: the results of the 2002-2003 Décennale Santé survey.

Objectives: To describe the frequency with which members of the French general population in the 30-to-69 age class sought care for lower back pain (LBP) from various healthcare professionals and to identify associated parameters.

Material And Methods: Data were collected in the 2002-2003 Décennale Santé survey, which is representative of ordinary households in continental France. We assessed the frequency with which the 17,792 surveyed individuals sought care for LBP by considering consultations with healthcare professionals in general and consultations with general practitioners and physiotherapists in particular.

Prevalence of educational inequalities in obesity between 1970 and 2003 in France.

This paper examines trends in obesity rates and education-related absolute and relative inequalities in obesity over the last 40 years in France. Data are drawn from the French Decennial Health Surveys of 1970, 1980, 1991 and 2003. The difference in obesity rates between the least- and most-educated, the Slope Index of Inequality, is used to estimate absolute inequalities in obesity.

Level of education and back pain in France: the role of demographic, lifestyle and physical work factors.

Purpose: To investigate the pathways from level of education to low back pain (LBP) in the adult population, especially concerning the role of physical working constraints, and personal factors (overweight, tobacco consumption, and tallness).

Methods: The study population consisted of 15,534 subjects from the National Health Survey, with data on LBP, level of education, personal factors, and physical working constraints. Logistic models for LBP (pain more than 30 days during the previous 12 months) were compared in order to check the consistency of the data with specific causal pathways.

Frequency of low back pain among men and women aged 30 to 64 years in France. Results of two national surveys.

Introduction: In France, most studies of low back pain (LBP) have been carried out among workers or patients. Until very recently, the frequency of LBP in the general population was not known, because National Health Surveys did not include questions on LBP.

Objective: To estimate the prevalence of LBP in the French population aged 30 to 64 years.

Lack of multiplicative transitivity in person trade-off responses.

Background: The person trade-off (PTO) is a technique for eliciting preferences for resource allocation across patient groups. In principle PTO responses should satisfy a requirement of multiplicative transitivity, i.e.

Costs of stroke care according to handicap levels and stroke subtypes.

Background: If new advances in stroke management are to be put into practice, crucial information about their costs needs to be considered in relation to clinically pertinent variables (e.g. handicap level and stroke subtypes).

Socioeconomic aspects of postacute care for patients with brain infarction in France.

Background: In France, the socioeconomic aspects of stroke have never been addressed. Such analyses are essential for health authorities to justify the establishment of new stroke units when resources are low, provided it can be shown that stroke units are effective in reducing both the morbidity and mortality of stroke. Only 6 dedicated stroke services exist for 60 million inhabitants in France.

A cost-minimization study of telemedicine. The case of telemonitored polysomnography to diagnose obstructive sleep apnea syndrome.

Objectives: In a context where sleep laboratories are overwhelmed by a growing demand to diagnose obstructive sleep apnea syndrome (OSAS), efficient substitutive solutions to in-laboratory polysomnography should be found. To compare the effectiveness and costs of home unattended polysomnography (Hpsg) and telemonitored polysomnography (TMpsg), a cost minimization study was performed.

Methods: In a crossover trial, 99 patients underwent on two consecutive nights TMpsg and Hpsg according to a randomized order.

Equivalence versus pragmatic trials for the economic evaluation of information and communication technologies; the case of polysomnography under telesurveillance in the diagnosis of sleep apnea syndrome.

This article deals with the choice of the appropriate protocols for the early economic evaluation of information and communication technologies, equivalence trial versus pragmatic trial. The reasoning put forward here is based on a concrete interrogation relative to polysomnography (PSG), a key diagnostic test for sleep apnoea syndrome (SAS). Is PSG under tele-surveillance more efficient than ambulatory PSG to diagnose SAS? After analyzing and discussing both advantages and limits of these two kinds of trial, we showed that one or the other can be used to obtain appropriate results.

Needs and costs of sleep monitoring.

Sleep disorders have a high prevalence in the general population: insomnia (10-20% of adults), sleep apnoea syndromes (4-6%). They are responsible for high costs of investigations and treatment modalities. The investigations are usually done in sleep laboratories at the expense of cost in personnel and long waiting lists.

Economic studies and 'technical' evaluation of telemedicine: the case of telemonitored polysomnography.

Information and communication technology (ICT) is not yet integrated into current medical practice and frequently, organizational patterns of health care production are held responsible for this situation. However, and quite paradoxically, measures recently taken in France indicate that a preferential role is granted to ICT in order to promote the development of healthcare networks. In this context, one should carefully examine which factors, other than organizational ones, can explain the very slow diffusion of telemedicine.

Transaction costs economics as a conceptual framework for the analysis of barriers to the diffusion of telemedicine.

Telemedecine has been talked about for more than 20 years, without it entering daily use with any success. Based on transaction costs economics, the present analysis of the exchange relationships between health care producers highlights certain characteristics of the current technical and legislative context, which leads to transaction costs. It also demonstrates that the introduction of telemedicine shifts the costs associated with agents' opportunism from patients to health-care producers themselves.

[Fragile X syndrome is still unrecognized: efficacy of molecular diagnosis in mentally retarded probands].

Background: The fragile X mental retardation syndrome is the most common cause of inherited mental retardation. Identification of the unstable mutation responsible for the disease has allowed the design of a fully reliable molecular test for the diagnosis of the disease and for genetic counselling (identification of clinically normal carriers and prenatal diagnosis). We started in July 1991 to search for the mutation in mentally retarded probands, with no known cause for their phenotype.

[Cost-effectiveness study of 2 long-term home oxygen therapy management systems].

In France, home oxygen therapy for patients with chronic obstructive pulmonary disease (COPD) is carried out by nonprofit associations (NP) or profit-making health organisations (PM). In a retrospective pragmatic approach we analysed the costs and the effectiveness of these 2 types of structures delivering oxygen at home. Between July 1985 and March 1994, 234 patients were involved in the survival study (chosen as an effectiveness indicator), 24% in PM and 76% in NP.

The cost of treating COPD patients with long-term oxygen therapy in a French population.

Objective: In greater Paris and its surrounding (as it is in all France), oxygen is home delivered by not-for-profit (NP) associations or profit-making (PM) health organizations. Both are financed by the national health insurance. This dual context and the current economic climate justify an economic evaluation of all respiratory care for patients with COPD receiving long-term oxygen therapy (LTO).