Health status and healthcare trajectory of vulnerable asylum seekers hosted in a French Reception Center.

Background: Europe lacks studies related to asylum-seekers' health.

Methods: We described the health status, healthcare and follow-up of men seeking asylum, accommodated in a primary reception center in Paris (CPA). This observational study included volunteer patients presenting for care at the CPA primary care unit (PCU) from January to March 2018.

[Establishing a public policy for migrant health].

Based on nursing reports and interviews, a public health program was set up in the Paris region in order to respond to the health needs of thousands of refugees with the goal of steering them, if necessary toward medical care. Elaborated gradually and interfacing with refugee social policies, this organization seems effective. Although subject to certain conditions, this experience provides lessons that could be generalized to other areas of public health and other populations.

Postdetoxification Factors Predicting Alcohol-Related Emergency Room Visits 12 to 24 Months After Discharge: Results from a Prospective Study of Patients with Alcohol Dependence.

Background: Relapse is common in patients with alcohol dependence, even after detoxification. The aims of this prospective study were to investigate changes affecting patients during the first 6 months after discharge from hospitalization for detoxification and to determine the influence of these changes on the likelihood of alcohol-related emergency room (ER) visits in the following 18-month period.

Methods: The study included 88 patients hospitalized for participation in a detoxification program in the addiction department of a university hospital in Rennes, France.

When Physicians Report Having Used Medical Drugs to Deliberately End a Patient's Life: Findings of the "End-of-Life in France" Survey.

Context: The debate on the decriminalization of active assistance in dying is still a topical issue in many countries where it is regarded as homicide. Despite the prohibition, some physicians say they have used drugs to intentionally end a patient's life.

Objectives: To provide some empirical grounding for the ongoing debate.

Reference system of competence and engagement in adapted physical activities of people with recent spinal cord injury.

Purpose: This study tested whether persons with Recent Spinal Cord Injury (RSCI) who practice adapted physical activities (APA) and those who do not differ with regard to achievement goals, physical self-perceptions, and global self-esteem.

Method: Adults with RSCI in rehabilitation centers voluntarily completed questionnaires of achievement goals and self-esteem. Then, based on whether they engaged or not in APA programs, they were considered participants or non-participants in APA.

[The places of death of people aged 80 and over in France].

While the places and causes of death are the subject of abundant literature, the circumstances surrounding the end of life, the ultimate phase of existence, remain largely not explored in France. The pathways through different living places taken by people aged 80 and over during the last month of existence and the factors associated with them are described thanks to the unique information and data collected by the "End of Life in France" survey.

[Nursing staff's knowledge and attitudes concerning preventive oral hygiene in palliative care].

Preventive mouth care is essential for the well-being of palliative care patients, though it is not performed enough outside units devoted to these patients. Our study aimed at getting a better knowledge of carers' attitudes and knowledge regarding this basic care. A validated questionnaire was sent anonymously to nurses and nursing aides working in the medical units of ten hospitals in Brittany.

[Cervical Pap smear in an epidemiologically exposed population: ideas, facts and arguments].

Objectives: To analyse the prevalence of abnormal papsmears in a primary care center and the screening practices.

Materials And Methods: Single-center retrospective study on 1,430 FCU performed in 1,251 patients between January 2009 and December 2011 with analysis of demographic, clinical and epidemiological chararacteristics of the women, and the monitoring of the patients with pathological papsmears.

Results: The study population was predominantly young (under 25), unmarried, nulliparous, and using contraception.

Psychological effect of exercise in women with breast cancer receiving adjuvant therapy: what is the optimal dose needed?

Background: Several meta-analyses have examined the role of exercise interventions in improving psychological outcomes in cancer survivors but most did not focus on adjuvant therapy period and did not investigate the optimal dose of exercise needed. The present meta-analysis examines the impact of exercise interventions delivered at this particular period on fatigue, anxiety, depression, and quality of life (QoL) as well as dose-response relationships between volume of prescribed exercise and these psychological outcomes.

Materials And Methods: Randomized, controlled trials that proposed an exercise intervention to patients with breast cancer undergoing chemotherapy and/or radiotherapy were systematically identified and coded.

Neoplasia detection rates after positive fecal occult blood test results are not affected by endoscopy center: a population-based study.

Background: We previously showed a significant variability in adenoma detection among colonoscopists who were participating in a mass screening program. The reasons for such variability remain largely unknown.

Objective: To study intercenter variations in neoplasia detection.

The positive predictive value of guaiac faecal occult blood test in relation to the number of positive squares in two consecutive rounds of colorectal cancer screening.

The aim of this study was to define the positive predictive values of a positive guaiac faecal occult blood test according to the number of positive squares, in two consecutive rounds of colorectal cancer mass screening in a French region. A total of 4172 colonoscopies were analyzed. Sex, age, number of positive squares, and colonoscopic and histopathologic findings were studied.

Accuracy of computed tomographic colonography in a nationwide multicentre trial, and its relation to radiologist expertise.

Objective: Reports on the accuracy of computed tomographic colonography (CTC) mainly involve series from expert institutions. The aims of this study were to assess CTC accuracy in a nationwide population and to relate it to radiologist performance in their initial training.

Design: Nationwide multicentre trial.

Factors associated with treatment lag in infantile spasms.

Aim: the aim of this study was to evaluate the conditions in which infantile spasms are diagnosed and their possible impact on the course of the disease.

Method: we carried out a retrospective study of the reasons for delayed treatment of infantile spasms (treatment lag) in western France over the period 1990-2003. A total of 156 infants, 87 male (55%) and 69 female (45%), with infantile spasms were identified, in 45 (29%) of whom the spasms were symptomatic.

Prevalence, characteristics and comorbidities of anxiety disorders in France: results from the "Mental Health in General Population" survey (MHGP).

Purpose: Only a few European countries have carried out large, community-based, national surveys about psychiatric morbidity. Here is presented the first national French survey, aiming to estimate the prevalence of anxiety disorders and associated comorbidities according to sociodemographic characteristics.

Materials And Methods: The Mental Health in General Population (MHGP) database is derived from a representative national survey of the French adult population (n=36,105), conducted between 1999 and 2003.

Yield of high-grade dysplasia based on polyp size detected at colonoscopy: a series of 2295 examinations following a positive fecal occult blood test in a population-based study.

Purpose: The aim was to determine the rate of high-grade dysplasia among patients with all adenomas, and its prevalence in patients with adenomas of different sizes in a well-defined population-based study.

Population And Methods: We performed a secondary analysis of the 2295 colonoscopies performed following a positive fecal occult blood test result during the first round of colorectal cancer screening in one French district. The rates of high-grade dysplasia were calculated for 3 size categories of adenoma (diminutive, or=10 mm).

Variations between endoscopists in rates of detection of colorectal neoplasia and their impact on a regional screening program based on colonoscopy after fecal occult blood testing.

Background: There are few data about the performance variability among endoscopists participating to nationwide or regionwide colorectal cancer screening programs.

Objective: To assess the variability of neoplasia detection rates among endoscopists participating in a regional colorectal cancer screening program based on colonoscopy after biennial fecal occult blood testing (FOBT).

Design: Two rounds of colonoscopy were performed: round 1 took place in 2003 and 2004, and round 2 took place in 2005 and 2006.

[Impact of care pathway on the delay for initiation of antituberculosis treatment in Conakry, Guinea].

Complex care pathways can result in detrimental treatment delay particularly in tuberculosis patients. The purpose of this retrospective study was to assess the care pathways followed by tuberculosis patients prior to diagnosis and to assess impact on the delay for initiation of treatment in Conakry, Guinea. A total of 112 patients were interviewed at the time of first admission for pulmonary tuberculosis with positive bacilloscopy.

Does comparison of performance lead to better care? A pilot observational study in patients admitted for hip fracture in three French public hospitals.

Objective: To assess whether comparison of quality of hip fracture care among three teams located in different hospitals is associated with improvement in process and outcomes.

Design: A baseline assessment was performed using quality indicators selected by professionals.

Results: were discussed among the three teams followed by a post-comparison assessment of the same indicators.

Cost-effectiveness of colorectal cancer screening with computed tomography colonography according to a polyp size threshold for polypectomy.

Objective: Computed tomography colonography (CTC) has an acceptable accuracy in detecting colonic lesions, especially for polyps at least 6 mm. The aim of this analysis is to determine the cost-effectiveness of population-based screening for colorectal cancer (CRC) using CTC with a polyp size threshold.

Methods: The cost-effectiveness ratios of CTC performed at 50, 60 and 70 years old, without (PL strategy) or with (TS strategy) polyp size threshold were compared using a Markov process.

Results of a 12-month quality-circle prescribing improvement programme for GPs.

The impact of a quality-circle GP prescribing improvement programme, implemented in France in 2001-2002, was assessed by a controlled study. The study involved all 27 GPs of three semi-rural areas of Brittany, France. Practice data (overall prescribing cost and markers of prescribing efficiency) were collated in an intention-to-treat analysis, using the Mann-Whitney U test.

[Clinical guidelines: what are the viewpoints of physicians and housestaff working in hospital medical departments?].

Background: Factors facilitating use of clinical guidelines by physicians working in French public hospitals are unknown. We wanted to ascertain the desires of physicians and housestaff working in medical departments.

Methods: A cross-sectional survey using a self-administered questionnaire with closed-ended questions and free comment was conducted in the two academic regional hospitals and the 20 district hospitals of Brittany.

[A qualitative study for identifying determinants of the quality of stroke patient referral].

Background: Referral of patients from acute to rehabilitation care is a key stage in the overall quality of stroke care. The aim is to choose the most appropriate care pathway taking into account patient needs and preferences, as well as constraints such as bed availability. The objective of the project was to identify factors contributing to the quality of transfer decisions.