Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100016
Jenna Luzet (Conceptualization, Methodology, Investigation, Data curation, Writing - original draft, Writing - review & editing) , Any Beltran Anzola (Formal analysis, Data curation, Writing - original draft, Writing - review & editing. Visualization) , Marc Gilibert (Conceptualization, Methodology, Validation, Writing - review & editing) , Barthelemy Tosello (Writing - original draft, Writing - review & editing) , Catherine Gire (Conceptualization, Methodology, Validation, Writing - original draft, Writing - review & editing, Supervision)
Objectives
The COVID-19 pandemic has strongly affected France and has put a strain on its health professionals. As documented by literature, health professionals are at higher risk than the general population regarding their mental welfare. The study's objective was to measure the anxiety levels and its determinants of general practitioners of a French department during the first COVID-19 pandemic containment.
Materials and Methods
A survey through a self-completion questionnaire was sent to 250 general practitioners of the Bouches-du-Rhône department. Their anxiety state was measured using the Spielberg validated questionnaire the STAI-Y. Their experience, work organizations, and doctor/patient relationship were measured by ad hoc items developed during a focus group of five general practitioners.
Results
Of the 60 general practitioners included in the survey, nearly 40% had high to very high levels of anxiety. The determinants of this anxiety were the female gender, the unsatisfactory working conditions, the constrains required to work reorganization (consultations and waiting room), and the worry of not being able to respond to the fears and questions of patients, thus a lower decision latitude in their work.
Conclusion
This survey documented the levels of general practitioners’ anxiety, as well as the determinants of this anxiety. Physicians offered a unanimous opinion of their general feeling of "disorganization and loneliness". General practitioners have demonstrated great adaptability and flexibility despite the difficulties, which has caused them major anxiety. This pandemic's resultant experiences can help better understand the vulnerability of caregivers to mental anguish/stress in order to strengthen primary prevention strategies.
Objectifs
La pandémie de COVID-19 a fortement touché la France et a mis à rude épreuve les professionnels de santé. Étant déjà plus à risque que la population générale sur le plan de la santé mentale, l'objectif de cette étude était de mesurer les niveaux d'anxiété et ses déterminants des médecins généralistes d'un département français, pendant la première période de confinement.
Méthode
Une enquête a été envoyée à 250 médecins généralistes du département des Bouches-du-Rhône. Leur état d'anxiété a été mesuré par le questionnaire de Spielberg. Leur vécu, l'organisation du travail et la relation médecin/patient ont été mesurés par des items ad-hoc.
Résultats
Sur les 60 médecins généralistes inclus, près de 40% présentaient des niveaux d'anxiété élevés à très élevés. Les déterminants de cette anxiété étaient le sexe féminin, les conditions de travail insatisfaisantes, les contraintes de la réorganisation du travail (consultations et salle d'attente), et le souci de ne pas pouvoir répondre aux craintes et interrogations des patients donc une moindre
{"title":"General practitioners' experiences during the Covid-19 epidemic in the Bouches-du-Rhône department: Anxiety, impact on practice and doctor-patient relationship","authors":"Jenna Luzet (Conceptualization, Methodology, Investigation, Data curation, Writing - original draft, Writing - review & editing) , Any Beltran Anzola (Formal analysis, Data curation, Writing - original draft, Writing - review & editing. Visualization) , Marc Gilibert (Conceptualization, Methodology, Validation, Writing - review & editing) , Barthelemy Tosello (Writing - original draft, Writing - review & editing) , Catherine Gire (Conceptualization, Methodology, Validation, Writing - original draft, Writing - review & editing, Supervision)","doi":"10.1016/j.lpmope.2021.100016","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100016","url":null,"abstract":"<div><h3>Objectives</h3><p>The COVID-19 pandemic has strongly affected France and has put a strain on its health professionals. As documented by literature, health professionals are at higher risk than the general population regarding their mental welfare. The study's objective was to measure the anxiety levels and its determinants of general practitioners of a French department during the first COVID-19 pandemic containment.</p></div><div><h3>Materials and Methods</h3><p>A survey through a self-completion questionnaire was sent to 250 general practitioners of the Bouches-du-Rhône department. Their anxiety state was measured using the Spielberg validated questionnaire the STAI-Y. Their experience, work organizations, and doctor/patient relationship were measured by ad hoc items developed during a focus group of five general practitioners.</p></div><div><h3>Results</h3><p>Of the 60 general practitioners included in the survey, nearly 40% had high to very high levels of anxiety. The determinants of this anxiety were the female gender, the unsatisfactory working conditions, the constrains required to work reorganization (consultations and waiting room), and the worry of not being able to respond to the fears and questions of patients, thus a lower decision latitude in their work.</p></div><div><h3>Conclusion</h3><p>This survey documented the levels of general practitioners’ anxiety, as well as the determinants of this anxiety. Physicians offered a unanimous opinion of their general feeling of \"disorganization and loneliness\". General practitioners have demonstrated great adaptability and flexibility despite the difficulties, which has caused them major anxiety. This pandemic's resultant experiences can help better understand the vulnerability of caregivers to mental anguish/stress in order to strengthen primary prevention strategies.</p></div><div><h3>Objectifs</h3><p>La pandémie de COVID-19 a fortement touché la France et a mis à rude épreuve les professionnels de santé. Étant déjà plus à risque que la population générale sur le plan de la santé mentale, l'objectif de cette étude était de mesurer les niveaux d'anxiété et ses déterminants des médecins généralistes d'un département français, pendant la première période de confinement.</p></div><div><h3>Méthode</h3><p>Une enquête a été envoyée à 250 médecins généralistes du département des Bouches-du-Rhône. Leur état d'anxiété a été mesuré par le questionnaire de Spielberg. Leur vécu, l'organisation du travail et la relation médecin/patient ont été mesurés par des items ad-hoc.</p></div><div><h3>Résultats</h3><p>Sur les 60 médecins généralistes inclus, près de 40% présentaient des niveaux d'anxiété élevés à très élevés. Les déterminants de cette anxiété étaient le sexe féminin, les conditions de travail insatisfaisantes, les contraintes de la réorganisation du travail (consultations et salle d'attente), et le souci de ne pas pouvoir répondre aux craintes et interrogations des patients donc une moindre","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100016"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100013
C. Rat, Laurie Blachier, Sandrine Hild, F. Molinié, A. Gaultier, B. Dréno, J. Nguyen
{"title":"Targeted screening for melanoma after a 5-year follow-up: Comparison of melanoma incidence and lesion thickness at diagnosis in screened (versus unscreened) patients","authors":"C. Rat, Laurie Blachier, Sandrine Hild, F. Molinié, A. Gaultier, B. Dréno, J. Nguyen","doi":"10.1016/j.lpmope.2021.100013","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100013","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88486883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100006
Anne-Laure Lenoir , Caroline De Troyer , Carole Demoulin , Ingrid Gillain , Marie Bayot
Objective
Burnout is a multidimensional stress syndrome that is particularly prevalent in physician populations. While the literature expands on preventive and curative interventions, relatively little is known about factors that may hamper their success. The aim of this study was (1) to identify the specific challenges to treat physician burnout and (2) to explore the origins of these challenges.
Methods
We conducted semi-structured interviews with twelve psychologists who had treated physicians with burnout and performed thematic analysis of data.
Results
Psychologists identified two specific challenges in treating physician burnout. First, physicians were reluctant to seek help from health professionals and tended to so at more severe stages of exhaustion. Second, physicians were feeling uncomfortable in the role of patient, and many of them had difficulties to accept treatment. Psychologists suggested the following causes of these challenges: (1) most physicians did not have a general practitioner, (2) they felt guilty about reducing their workload, and (3) tended to confuse professional and personal engagement. According to participants, medical education, the professional culture and the image of the profession in the wider community were likely factors contributing to physicians’ reluctance to seek and accept care.
Discussion
This research showed that the specific challenges to treat physician burnout are mostly related to their reluctance to ask for help and to put their trust in other caregivers. Among the reasons for this behavior, most are linked with physician's representation of professional identity as enduring and selfless.
Conclusion
Further studies are needed to explore how medical education and professional culture can be changed to reduce the risk of physician burnout and facilitate care when it nonetheless arises.
{"title":"Challenges in treating physician burnout: The psychologist's perspective","authors":"Anne-Laure Lenoir , Caroline De Troyer , Carole Demoulin , Ingrid Gillain , Marie Bayot","doi":"10.1016/j.lpmope.2021.100006","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100006","url":null,"abstract":"<div><h3>Objective</h3><p>Burnout is a multidimensional stress syndrome that is particularly prevalent in physician populations. While the literature expands on preventive and curative interventions, relatively little is known about factors that may hamper their success. The aim of this study was (1) to identify the specific challenges to treat physician burnout and (2) to explore the origins of these challenges.</p></div><div><h3>Methods</h3><p>We conducted semi-structured interviews with twelve psychologists who had treated physicians with burnout and performed thematic analysis of data.</p></div><div><h3>Results</h3><p>Psychologists identified two specific challenges in treating physician burnout. First, physicians were reluctant to seek help from health professionals and tended to so at more severe stages of exhaustion. Second, physicians were feeling uncomfortable in the role of patient, and many of them had difficulties to accept treatment. Psychologists suggested the following causes of these challenges: (1) most physicians did not have a general practitioner, (2) they felt guilty about reducing their workload, and (3) tended to confuse professional and personal engagement. According to participants, medical education, the professional culture and the image of the profession in the wider community were likely factors contributing to physicians’ reluctance to seek and accept care.</p></div><div><h3>Discussion</h3><p>This research showed that the specific challenges to treat physician burnout are mostly related to their reluctance to ask for help and to put their trust in other caregivers. Among the reasons for this behavior, most are linked with physician's representation of professional identity as enduring and selfless.</p></div><div><h3>Conclusion</h3><p>Further studies are needed to explore how medical education and professional culture can be changed to reduce the risk of physician burnout and facilitate care when it nonetheless arises.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100006"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
One potential COVID-19 treatment, hydroxychloroquine has been the focus of much debate since its first publication by a French research team. To an unusual degree, this debate has extended outside of the medical community into the public sphere.
Objective
To know if this interest, which conceals the reality of scientific debate, occurred worldwide.
Methods
Methodological use of the Google-Trends was standardized. We researched the web queries for “hydroxychloroquine” and “chloroquine” and “amoxicillin” and “acetaminophen” as reference. Analysis was detailed by country. The relationship between these queries and the COVID-19 epidemic was supported by analysis of the main “related queries”. Google-Trends provided results on a relative value basis, on a scale from 0 to 100, with a value of 100 indicating the most researched criterion over the study period.
Results
Web queries for “amoxicillin” never exceeded the value of 1. Searches for “acetaminophen” peaked on March 13 with a value of 13. “Hydroxychloroquine” was the most frequently researched term. It reached its peak value of 99 on April 7. Queries for “chloroquine” peaked (value 100) on March 24. Searches for “hydroxychloroquine” came essentially from Asia and the United States, with France in 22nd position (value of 21). Searches for “chloroquine” came essentially from Africa, with France in 8th position (value of 55). The five main related searches were in both cases associated with the COVID-19 epidemic.
Conclusion
Interest in chloroquine is not specific to France. Results of ongoing studies have been and will be scrutinized attentively in all corners of the globe.
{"title":"COVID-19 Epidemic: Chloroquine, a French Obsession?","authors":"Fréderic Lapostolle, Isabelle Vianu, Carla De Stefano, Laurent Goix, Tomislav Petrovic, Frédéric Adnet","doi":"10.1016/j.lpmope.2021.100007","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100007","url":null,"abstract":"<div><h3>Introduction</h3><p>One potential COVID-19 treatment, hydroxychloroquine has been the focus of much debate since its first publication by a French research team. To an unusual degree, this debate has extended outside of the medical community into the public sphere.</p></div><div><h3>Objective</h3><p>To know if this interest, which conceals the reality of scientific debate, occurred worldwide.</p></div><div><h3>Methods</h3><p>Methodological use of the Google-Trends was standardized. We researched the web queries for “hydroxychloroquine” and “chloroquine” and “amoxicillin” and “acetaminophen” as reference. Analysis was detailed by country. The relationship between these queries and the COVID-19 epidemic was supported by analysis of the main “related queries”. Google-Trends provided results on a relative value basis, on a scale from 0 to 100, with a value of 100 indicating the most researched criterion over the study period.</p></div><div><h3>Results</h3><p>Web queries for “amoxicillin” never exceeded the value of 1. Searches for “acetaminophen” peaked on March 13 with a value of 13. “Hydroxychloroquine” was the most frequently researched term. It reached its peak value of 99 on April 7. Queries for “chloroquine” peaked (value 100) on March 24. Searches for “hydroxychloroquine” came essentially from Asia and the United States, with France in 22<sup>nd</sup> position (value of 21). Searches for “chloroquine” came essentially from Africa, with France in 8<sup>th</sup> position (value of 55). The five main related searches were in both cases associated with the COVID-19 epidemic.</p></div><div><h3>Conclusion</h3><p>Interest in chloroquine is not specific to France. Results of ongoing studies have been and will be scrutinized attentively in all corners of the globe.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100007"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100014
J. Birebent, A. Palmaro, Céline Tanios-Dulot, D. Driot, Julie Dupouy, M. Rougé-Bugat
{"title":"Impact of the notice of the high council of public health amending the age of human papillomavirus vaccination on teen vaccination rates","authors":"J. Birebent, A. Palmaro, Céline Tanios-Dulot, D. Driot, Julie Dupouy, M. Rougé-Bugat","doi":"10.1016/j.lpmope.2021.100014","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100014","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72663904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melanoma incidence and mortality rates are increasing worldwide. While screening appears to be inefficient, targeted screening might be effective.
Objective
To assess the relative risk of developing a melanoma in a population that participated in targeted screening program compared with the general population. The secondary objective was to identify the factors related to melanoma thickness at the time of diagnosis.
Design, setting, and participants
We assessed the incidence of melanoma from 2011 to 2015 in a cohort of 3832 patients at elevated risk of melanoma living on the west coast of France. The patients were older than 20 years, selected using the Self-Assessment of Melanoma risk score, and invited each spring to undergo a complete skin examination as part of a pilot targeted screening program for melanoma.
Main outcome, measures
We calculated the relative risk of developing a melanoma, based on the comparison of melanoma incidence in patients who participated in the targeted screening and in the general population in the geographic area. Data collection was performed by the regional cancer registry, in accordance with international standards. Demographical variables and histological variables related to the identification of a thick melanoma (stage 2 and higher) were also analyzed.
Results
3 169 patients developed melanomas between April 2011 and December 2015. The relative risk of developing a melanoma during the five years of follow-up was 4.33 [4.17;4.50] in patients who participated in the pilot targeted screening program compared with the general population. The following factors were associated with the identification of thick melanomas: male gender (OR = 1.40; 95% CI [1.18–1.66]), age older than 75 years (OR = 1.72; 95% CI [1.38–2.14]), and residence in a rural area (OR = 1.48; 95% CI [1.21–1.80]). The targeted screening program did not lead to a lower proportion of thick melanomas at the time of diagnosis (OR=0.48 [0.11–1.40]).
Conclusions and relevance
Targeted screening for melanoma allows general practitioners to focus their attention, energy, and time on at-risk populations with greater efficiency. However, participation in the pilot screening program was not associated with the identification of thinner melanomas at the time of diagnosis.
Trial registration
This trial was registered in the Clinical Trials database before study enrollment commenced (ClinicalTrials.gov; Registration number: NCT01610531).
{"title":"Targeted screening for melanoma after a 5-year follow-up: Comparison of melanoma incidence and lesion thickness at diagnosis in screened (versus unscreened) patients","authors":"Cédric Rat , Laurie Blachier , Sandrine Hild , Florence Molinie , Aurélie Gaultier , Brigitte Dreno , Jean-Michel Nguyen","doi":"10.1016/j.lpmope.2021.100013","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100013","url":null,"abstract":"<div><h3>Importance</h3><p>Melanoma incidence and mortality rates are increasing worldwide. While screening appears to be inefficient, targeted screening might be effective.</p></div><div><h3>Objective</h3><p>To assess the relative risk of developing a melanoma in a population that participated in targeted screening program compared with the general population. The secondary objective was to identify the factors related to melanoma thickness at the time of diagnosis.</p></div><div><h3>Design, setting, and participants</h3><p>We assessed the incidence of melanoma from 2011 to 2015 in a cohort of 3832 patients at elevated risk of melanoma living on the west coast of France. The patients were older than 20 years, selected using the Self-Assessment of Melanoma risk score, and invited each spring to undergo a complete skin examination as part of a pilot targeted screening program for melanoma.</p></div><div><h3>Main outcome, measures</h3><p>We calculated the relative risk of developing a melanoma, based on the comparison of melanoma incidence in patients who participated in the targeted screening and in the general population in the geographic area. Data collection was performed by the regional cancer registry, in accordance with international standards. Demographical variables and histological variables related to the identification of a thick melanoma (stage 2 and higher) were also analyzed.</p></div><div><h3>Results</h3><p>3 169 patients developed melanomas between April 2011 and December 2015. The relative risk of developing a melanoma during the five years of follow-up was 4.33 [4.17;4.50] in patients who participated in the pilot targeted screening program compared with the general population. The following factors were associated with the identification of thick melanomas: male gender (OR = 1.40; 95% CI [1.18–1.66]), age older than 75 years (OR = 1.72; 95% CI [1.38–2.14]), and residence in a rural area (OR = 1.48; 95% CI [1.21–1.80]). The targeted screening program did not lead to a lower proportion of thick melanomas at the time of diagnosis (OR=0.48 [0.11–1.40]).</p></div><div><h3>Conclusions and relevance</h3><p>Targeted screening for melanoma allows general practitioners to focus their attention, energy, and time on at-risk populations with greater efficiency. However, participation in the pilot screening program was not associated with the identification of thinner melanomas at the time of diagnosis.</p></div><div><h3>Trial registration</h3><p>This trial was registered in the Clinical Trials database before study enrollment commenced (ClinicalTrials.gov; Registration number: NCT01610531).</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100013"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Since the beginning of the pandemic, COVID-19 affected specifically elderly people aged 70 years and over in whom the mortality rate is high. We may underestimate asymptomatic people or persons with atypical COVID-19 symptoms who may spread the disease.
Objective
A large screening campaign was launched all over France in several retirement homes in order to screen asymptomatic persons for SARS-CoV-2 to isolate carriers from other residents.
Methods
From April 24th to 27th 2020, mobile teams of nurses from the Hôtel-Dieu Hospital were sent to five Parisian nursing homes to conduct SARS-CoV-2 RT-PCR screening tests among all asymptomatic.
Results
This cross-sectional study included 297 residents: 274 asymptomatic participants (92.3%) were tested for COVID-19, mostly women (n = 249/274), median age was 90 (IQR 95% [86–94]) with females being significantly older than males (90 versus 88 years, P = 0.028). A total of 35 residents (12.8%) were tested positive for COVID-19: 29 women (11.7%) and six men (24%). The proportion of PCR-positive residents was extremely variable between retirement homes and analysis of COVID-19 positive cases dispersion in each nursing home showed there was no area cluster.
Conclusion
There is a real public health interest in tracking SARS-CoV-2 positive asymptomatic elderly people in nursing homes.
{"title":"Interest of screening asymptomatic older adults for SARS-CoV-2 in nursing homes","authors":"Elise Sourdeau , Delphine Cantin , Jean-François Meritet , Dominique Salmon , Etienne Ravault , Jean-Paul Viard , Laurence Slama , HP COVID 19 research collaboration","doi":"10.1016/j.lpmope.2021.100011","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100011","url":null,"abstract":"<div><h3>Importance</h3><p>Since the beginning of the pandemic, COVID-19 affected specifically elderly people aged 70 years and over in whom the mortality rate is high. We may underestimate asymptomatic people or persons with atypical COVID-19 symptoms who may spread the disease.</p></div><div><h3>Objective</h3><p>A large screening campaign was launched all over France in several retirement homes in order to screen asymptomatic persons for SARS-CoV-2 to isolate carriers from other residents.</p></div><div><h3>Methods</h3><p>From April 24th to 27th 2020, mobile teams of nurses from the Hôtel-Dieu Hospital were sent to five Parisian nursing homes to conduct SARS-CoV-2 RT-PCR screening tests among all asymptomatic.</p></div><div><h3>Results</h3><p>This cross-sectional study included 297 residents: 274 asymptomatic participants (92.3%) were tested for COVID-19, mostly women (<em>n</em> <!-->=<!--> <!-->249/274), median age was 90 (IQR 95% [86–94]) with females being significantly older than males (90 versus 88 years, <em>P</em> <!-->=<!--> <!-->0.028). A total of 35 residents (12.8%) were tested positive for COVID-19: 29 women (11.7%) and six men (24%). The proportion of PCR-positive residents was extremely variable between retirement homes and analysis of COVID-19 positive cases dispersion in each nursing home showed there was no area cluster.</p></div><div><h3>Conclusion</h3><p>There is a real public health interest in tracking SARS-CoV-2 positive asymptomatic elderly people in nursing homes.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100011"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100012
Isabelle Cisamolo , Marie Michel , Marie Rabouille , Julie Dupouy , Emile Escourrou
Purpose
Video gaming is one of the main recreational activities of children and adolescents. The American Psychiatric Association and the World Health Organization recently proposed diagnostic criteria for a pathological use of video games. The objective is to explore the perceptions of adolescents concerning pathological video game use.
Methods
Qualitative study by semi structured individual interviews in the homes of adolescent gamers and non-gamers living in France. The sampling was theoretical. The analysis followed an inductive approach following the phases of thematic analysis. The researchers used triangulation. Collection was concluded when theoretical saturation had been reached.
Results
Seventeen adolescents aged 10–18 were interviewed between April 2018 and March 2019. The adolescents recognised that video games use can be pathological. Deleterious consequences to physical, mental, and social wellbeing associated with gaming were discussed. Mental health, family and social environments, and the type of game seemed to influence the transition from recreational to pathological video-game use. The adolescents agreed on the need to regulate their gaming, particularly through parental control and self-control.
Conclusions
Risks and protective factors related to the types of video game, the adolescent, and the environment were identified. Parental support would help lower the risk of pathological gaming.
{"title":"Perceptions of adolescents concerning pathological video games use: A qualitative study","authors":"Isabelle Cisamolo , Marie Michel , Marie Rabouille , Julie Dupouy , Emile Escourrou","doi":"10.1016/j.lpmope.2021.100012","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100012","url":null,"abstract":"<div><h3>Purpose</h3><p>Video gaming is one of the main recreational activities of children and adolescents. The American Psychiatric Association and the World Health Organization recently proposed diagnostic criteria for a pathological use of video games. The objective is to explore the perceptions of adolescents concerning pathological video game use.</p></div><div><h3>Methods</h3><p>Qualitative study by semi structured individual interviews in the homes of adolescent gamers and non-gamers living in France. The sampling was theoretical. The analysis followed an inductive approach following the phases of thematic analysis. The researchers used triangulation. Collection was concluded when theoretical saturation had been reached.</p></div><div><h3>Results</h3><p>Seventeen adolescents aged 10–18 were interviewed between April 2018 and March 2019. The adolescents recognised that video games use can be pathological. Deleterious consequences to physical, mental, and social wellbeing associated with gaming were discussed. Mental health, family and social environments, and the type of game seemed to influence the transition from recreational to pathological video-game use. The adolescents agreed on the need to regulate their gaming, particularly through parental control and self-control.</p></div><div><h3>Conclusions</h3><p>Risks and protective factors related to the types of video game, the adolescent, and the environment were identified. Parental support would help lower the risk of pathological gaming.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100012"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-06-01DOI: 10.1016/j.lpmope.2021.100010
L. Gimenez , J. Dupouy , P. Ricordeau , P. Durand , M. Davila , M. Bensoussan , J.-F. Bouscarain , M.-E. Rouge-Bugat , S. Oustric
{"title":"Primary healthcare practitioners were in the front line to deal with COVID-19 and reorganize their practice to avoid inappropriate use of hospital services","authors":"L. Gimenez , J. Dupouy , P. Ricordeau , P. Durand , M. Davila , M. Bensoussan , J.-F. Bouscarain , M.-E. Rouge-Bugat , S. Oustric","doi":"10.1016/j.lpmope.2021.100010","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100010","url":null,"abstract":"","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100010"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100010","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72108626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although many studies have examined the mention of smoking status in case files, a more important issue in clinical practice is physicians’ ability to identify smokers. We sought to analyze physicians’ detection of smokers according to characteristics of patients (social especially) and physicians.
Methods
In 2005–2006, 59 randomly recruited general practitioners from the Paris metropolitan area enrolled every man aged 35–64 years seen during a two-week period. Physicians’ detection of smokers was analyzed in a logistic mixed model that considered patient (occupational class, education, income, and social integration) and physician (general demographics, practice organization, smoking control practices, personal smoking status) characteristics.
Results
Of the 1096 participating men, 35% smoked. The detection rate (55%) did not vary between physicians. Detection was better for men with low social integration (versus high or intermediate-high, OR = 8.33, 95% CI = 2.23–31.1) and low income (< 1000 versus ≥ 3500 €, OR = 2.88, 95% CI = 1.00–8.25) and for physicians in practice for less than 20 years (OR = 0.43, 95% CI = 0.23–0.82) and ex-smokers (versus never-smoker, OR = 2.97, 95% CI = 1.45–6.01), independently of patient age, physical activity, chronic disease and length of the patient-physician relationship.
Conclusions
The better detection observed for smokers at the bottom of the social scale and among newer physicians are positive factors that merit confirmation.
{"title":"Physicians’ detection of smokers: A multilevel analysis of the Paris Prevention in General Practice survey","authors":"Laurent Rigal , Hendy Abdoul , Hector Falcoff , Olivier Moncade , Marie-Josèphe Saurel-Cubizolles , Virginie Ringa","doi":"10.1016/j.lpmope.2021.100008","DOIUrl":"https://doi.org/10.1016/j.lpmope.2021.100008","url":null,"abstract":"<div><h3>Objective</h3><p>Although many studies have examined the mention of smoking status in case files, a more important issue in clinical practice is physicians’ ability to identify smokers. We sought to analyze physicians’ detection of smokers according to characteristics of patients (social especially) and physicians.</p></div><div><h3>Methods</h3><p>In 2005–2006, 59 randomly recruited general practitioners from the Paris metropolitan area enrolled every man aged 35–64 years seen during a two-week period. Physicians’ detection of smokers was analyzed in a logistic mixed model that considered patient (occupational class, education, income, and social integration) and physician (general demographics, practice organization, smoking control practices, personal smoking status) characteristics.</p></div><div><h3>Results</h3><p>Of the 1096 participating men, 35% smoked. The detection rate (55%) did not vary between physicians. Detection was better for men with low social integration (versus high or intermediate-high, OR<!--> <!-->=<!--> <!-->8.33, 95% CI<!--> <!-->=<!--> <!-->2.23–31.1) and low income (<<!--> <!-->1000 versus ≥<!--> <!-->3500<!--> <!-->€, OR<!--> <!-->=<!--> <!-->2.88, 95% CI<!--> <!-->=<!--> <!-->1.00–8.25) and for physicians in practice for less than 20 years (OR<!--> <!-->=<!--> <!-->0.43, 95% CI<!--> <!-->=<!--> <!-->0.23–0.82) and ex-smokers (versus never-smoker, OR<!--> <!-->=<!--> <!-->2.97, 95% CI<!--> <!-->=<!--> <!-->1.45–6.01), independently of patient age, physical activity, chronic disease and length of the patient-physician relationship.</p></div><div><h3>Conclusions</h3><p>The better detection observed for smokers at the bottom of the social scale and among newer physicians are positive factors that merit confirmation.</p></div>","PeriodicalId":100860,"journal":{"name":"La Presse Médicale Open","volume":"2 ","pages":"Article 100008"},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.lpmope.2021.100008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72067641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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