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See detailLife satisfaction two-years after stroke onset: the effects of gender, occupational status, memory function and quality of life among stroke patients (Newsqol) and their family caregivers (Whoqol-bref) in Luxembourg
Baumann, Michèle UL; Couffignal, Sophie; Le Bihan, Etienne UL et al

in BMC Neurology (2012), 12

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective ... [more ▼]

Life satisfaction (LS) of cerebrovascular disease survivors and their family caregivers may relate to socioeconomic factors, impaired functions, health-related quality of life (QoL), but their respective influences remain unclear. This study assessed, two years post-stroke onset, the effects of these factors on patients' LS and family caregivers' LS in Luxembourg. METHODS: All stroke patients admitted to all hospitals in Luxembourg were identified by the 'Inspection Général de la Sécurité Sociale' using the only national system database for care expenditure reimbursement. Their diagnosis was confirmed by medical investigator. The sample included ninety four patients living at home having given consent (mean age 65.5 years) and sixty two main caregivers (mean age 59.3 years). Questionnaires were completed during face-to-face interviews. LS was assessed via European single question (range 1-10), survivors' QoL via Newsqol (11 dimensions), and caregivers' QoL via Whoqol-bref (4 domains) (range 0-100). Data were analysed using multiple regression models. RESULTS: Two years after stroke onset, 44.7% of patients suffered from impaired sensory function, 35.1% from impaired motor function, and 31.9% from impaired memory function. Mean patient' LS was 7.1/10 (SD 1.9). It was higher in women (+12.4) and lower among unemployed socioeconomically active patients (-13.1, vs. retired people). Adjusted for sex, occupation, impaired motor and memory functions, LS positively correlated with scores of Newsqol feelings, sleep, emotion, cognition and pain dimensions (slopes 0.20 to 0.31), but did not correlate with those of caregivers' Whoqol-bref domains. Family caregiver' LS was 7.2 (SD 1.7). It was lower in those with patients suffering from impaired memory function (-12.8) as well as from feelings and emotion issues (slopes 0.22). It was associated with all caregivers' Whoqol-bref domains (physical health, psychological health, environment, and social relationships) (slopes 0.53 to 0.68). CONCLUSIONS: Two-year post-cerebrovascular disease patient' LS was associated with gender, occupation, and impaired memory function. It correlated with feelings, sleep, emotion, cognition, and pain issues. Family caregivers of patients with impaired memory function had lower LS. Family caregiver' LS correlated with dimensions of patients' feelings (less independent, yourself, life changed, depressed, useless, less control because of stroke) and emotion (get more emotional, fear of another stroke or to become dependent on others), and with their own QoL. LS, Newsqol, and Whoqol appeared to be appropriate tools. Our findings may be useful for policy makers in relation to family and medical-social issues of stroke home-based rehabilitation. [less ▲]

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See detailWhat Social Inequalities of Quality of Life (NEWSQOL domains) amongst patients does appear, two years after a stroke?
Baumann, Michèle UL; Lurbe-Puerto, Katia UL; Le Bihan, Etienne UL

in European Society for Health and Medical Sociology (2010)

The quality of live “capability” must be taken into consideration because it affects stroke patients’ ability to make health choices. We aimed to analyse the relations between their socio-demographic ... [more ▼]

The quality of live “capability” must be taken into consideration because it affects stroke patients’ ability to make health choices. We aimed to analyse the relations between their socio-demographic characteristics and their quality of life (domains selected: interpersonal relationship, emotions, feelings, pain, sleep, fatigue). Methods: Two years after their stroke, 72 volunteers participated to a Luxembourg national survey. Completed at their home, the questionnaire included the six NEWSQOL* domains that responded to the criterion of an absence of direct consequence of the injuries caused by the stroke. For each domain, a multiple regression model was fit and adjusted by impairments (motor, vision, sensory, language, and memory). We performed a backward selection discarding, in succession, variables associated with highest p-values, until we obtained a set of explanatory variables significantly linked at the 10% level. Results: To be a woman is positively linked to a better quality of life (interpersonal relationships, feelings, sleep). The older patients and the ones living in couple have a less good quality of life with regards to fatigue. The current professional situation does not have any impact on quality of life; which is not the case for the occupation at the time of the stroke. Compared to the executives’ ones, the patients who never had a job, employees, and manual workers have a worse quality of life in terms of feelings. The manual workers, employees and the ones who never had a job show a minor good quality of life in relation to fatigue. When the patients’ educational level is lower than the first cycle of secondary education, their quality of life deteriorates in terms of interpersonal relationship, emotion, feelings, pain. After the stroke, changes in the financial position resulted in a less good quality of life in relation to interpersonal relationship, feelings, pain, sleep, whilst the ones in the occupational situation only worsened patients’ feelings and fatigue. “Feelings” (depression, control, independent) is the most associated NEWSQOL-domain with the socio-economic factors. Conclusion: Patients’ level of education and the changes in their financial position are determinants of social inequalities of quality of life amongst stroke survivors. A better elementary health education on stroke would make upcoming patients to gain in quality of life capacity. They will better adhere to the advice given within the therapeutics framework and psychological counseling as well as to the social accompaniment provided and the administrative requirements they have to accomplish to obtain financial aids. [less ▲]

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See detailTwo years post-stroke, Luxembourgish informal caregivers’ life satisfaction and their couple and family repercussions
Lurbe-Puerto, Katia UL; Baumann, Michèle UL; Le Bihan, Etienne UL

in Sociology of Health (2010)

This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS ... [more ▼]

This study aims to improve our understanding of the changes in the couple and family lives of stroke survivors’ caregivers and to analyse the relationships between the Caregivers’ Life Satisfaction (CLS) and the social and emotional repercussions of the caregiving role, two years after this event. Life satisfaction, optimism about the future, happiness and other subjective well-being aspects have attracted the European policymakers, leading to the Eurofund to introduce a “life satisfaction” dimension in the European Quality of Life Surveys (EQLS). The general subjective appraisal of one’s life is now an indicator next to objective measures of economic performance, such as GDP. How is life satisfaction for the main informal caregivers of stroke-survivors, at the Grand-duchy of Luxembourg (one of the smallest UE country, 502 500 hab. (01/2010), 2600 km2). Individual and family upheavals stroke-related have a major effect on the survivor’s life, and on the close relatives and friends’ ones. «The self-assertion on the harmony of the stroke survivor-caregiver pairs» is the strategy to approach the issue. The implications of these changes are determined by the partners’ trajectory. The CLS is disrupted by stroke, but a lack of information remains on caregivers’ needs, mostly on the repercussions on the couple and family relationships and projects. Over twelve months, 62 pairs (among them 51 couples) of stroke survivors (64.4 mean age; majors impairments: sensory 53.2% and memory 38.7%) and their main informal caregivers (62 mean age, 61.7% women) consented to participate at a National Survey. Research assistants interviewed them at home, with a face-to-face questionnaire. Caregivers evaluated, on a four-point scale, a list of repercussions; these assertions were built up from a qualitative exploratory study. The LS ten-point scaled was dichotomised in “low (<=7 of 10)” and “high (>7 of 10) life satisfaction” (LLS vs HLS)”. Our research protocol was approved by the National Committee of Research Ethics and the Committee for Data Protection. Stroke survivors’ LS were lightly inferior than the CLS (mean=8) and no significant differences were observed between their socio-demographic characteristics. Comparing the responses obtained on the couple repercussions, the caregivers with LLS had emphasised the impacts of the care provided to their recipients: « The stroke was experienced as a drama that our couple has never overcome” (54.2 LLS vs 17,2% HLS; p≤0.001);“I cannot leave anymore the stroke survivor alone for a long time” (60.7% LLS vs 17.4% HLS; p=0.001); « The stroke has ended with all the life projects that as a couple we made» (45.8 LLS vs 11.1% HLS ; p≤ 0.05); “The stroke has brought serious turnovers in my couple” (57.1 LLS vs 25.9% HLS ; p≤ 0.05). Regarding family repercussions, the caregivers with LLS had underlined the impacts of their caregiving role: "The stroke is often a cause of the distance problems we have with our children" (23.1% LLS vs 0.0% HLS; p≤0.01), and “The stroke has brought serious turnovers in my family” (82.8% LLS vs 51.7% HLS; p≤0.05). CLS and survivors LS were close. Inequalities regarding CLS were identified. Evaluating repercussions on CLS is needed in enabling stroke survivors to live at home. Long-term informal care sustainability has been overlooked; innovative accompaniment and counselling are developed to follow Helsingborg Declaration on European Stroke Strategies. [less ▲]

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See detailHarmony within stroke patient-caregiver pairs concerning psychological and social repercussions, two years post-stroke in Luxembourg and Portugal.
Baumann, Michèle UL; Lurbe-Puerto, Katia UL; Le Bihan, Etienne UL

in International Sociology Association. (2010)

This study aims to improve our understanding of the impact of stroke on the lives of patients & principal caregivers (PCs). The objective was to analyze agreement within patient-caregiver couples in ... [more ▼]

This study aims to improve our understanding of the impact of stroke on the lives of patients & principal caregivers (PCs). The objective was to analyze agreement within patient-caregiver couples in responses to statements concerning the psychological & social repercussions of stroke. Two years post-stroke, 97 patient-PC pairs were administered questionnaires at home. Logistic regression was used to analyze data on 50 couples of questionnaires from Luxembourg (Lux) & 47 from Portugal (Por); 60% of patients were men, with average ages of 65 years in Luxembourg & 71 years in Portugal; 75% of carers were women aged on average 61.5 years (Lux) & 61 years (Por). Responses to the question "Are you happy or not?" were more correlated with concordance within patient-caregiver couples’ statements concerning the psychological and social repercussions of stroke than were socioeconomic characteristics (nationality, age, having finished elementary school or not). Patients who considered themselves happy were more likely to give answers close to those of their caregivers. This was true particularly in the domain of stroke repercussions on relationships with friends: “sympathy shown by friends and relations”, “loss of friends”, “friends bothered by the handicap” & "ties maintained & even strengthened”. Conversely, PCs who described themselves as happy were less likely to agree with the patient they cared for. Patient-PC couples emphasised the consequences of a stroke on self-image in the face of the “loss of many friends" & the fact that "the patient feels devalued ". Family & social life is disrupted by stroke, and friendly relationships are put under stress. Patient-caregiver coherence is central, not least in its effect on quality of life. Do couples’ feelings about life have a decisive role in the reconstruction of the identities of patients and caregivers? What part will trust play in that process? [less ▲]

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See detailTandems patient-aidant face au retentissement familial et social deux ans après la survenue d’un AVC au Grand-duché de Luxembourg
Baumann, Michèle UL; Kovincic, P.; Le Bihan, Etienne UL

in Sociologie de la Santé (2009)

Notre problématique s’inscrit dans l’identification et la compréhension des conséquences que peut avoir la survenue d’un accident cérébro-vasculaire sur la famille et les proches de la personne qui en a ... [more ▼]

Notre problématique s’inscrit dans l’identification et la compréhension des conséquences que peut avoir la survenue d’un accident cérébro-vasculaire sur la famille et les proches de la personne qui en a été victime. En effet, l’AVC produit des effets sur l’organisation des relations entre les patients et les aidants, ce réaménagement dépendant en grande partie de la situation antérieure des liens affectifs. La personne atteinte de plein fouet par cet accident n’est pas la seule au centre de cette étude, nous avons fait le choix de privilégier également la personne désignée par le patient comme son « aidant principal ». Au sein des tandems patient-aidant qui partagent désormais le quotidien entaché des conséquences produites par un AVC, s’installe ou non une harmonie en fonction de la manière dont l’évènement est ressenti et intériorisé. La façon dont le patient et l’aidant vivent l’adaptation à cette nouvelle situation et la façon dont les personnes rencontrées réagissent devant les comportements de la personne atteinte font appels ou non à une complicité qui mérite d’être étudiée. Face au retentissement psychologique et social, aux activités culturelles et de loisirs abandonnées ou maintenues, aux aides, services et informations obtenus ou non depuis l’AVC, les objectifs de ce travail ont été de comparer les réponses fournies par les patients et les aidants et d’analyser les domaines dans lesquels elles sont concordantes au sein des diades. [less ▲]

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See detailHow patients perceive the therapeutic communications skills of their general practitioners, and how that perception affects adherence: use of the TCom-skill GP scale in a specific geographical area
Baumann, Michèle UL; Baumann, Cédric; Le Bihan, Etienne UL et al

in BMC Health Services Research (2008), 8

To study: (1) the structure and test-retest reliability of a measure of how patients perceive the therapeutic communications skills of their general practitioners (TCom-skill GP), and (2) the associations ... [more ▼]

To study: (1) the structure and test-retest reliability of a measure of how patients perceive the therapeutic communications skills of their general practitioners (TCom-skill GP), and (2) the associations of that scale with socio-demographic and health-related characteristics, and adherence. Methods: A total of 393 people who lived in the same geographic area and invited to attend a preventive medical centre for a check up were asked to complete a self-administered questionnaire concerning TCom-skill GP (15 items), socio-demographic and health-related characteristics, and to answer two questions on perceived adherence. Results: The average age of respondents was 46.8 years (SD 14), and 50.4% were men. The TCom-skill GP score was one-dimensional, had high internal coherence (Cronbach α 0.92), and good test-retest reliability (intra-class correlation coefficient 0.74). The overall score was positively related to increasing age. Respondents aged 60+ were more likely to be adherent. The higher the score, the higher the probability of adherence. Multivariate analysis showed that the TCom-skill score was associated with advancing age and the number of consultations with the GP during the previous 3 months, but not with gender, living alone, being employed, job category or educational level. Multivariate analysis also showed that adherence was associated with TCom-skill GP score which concealed the association between adherence and advancing age observed in univariate analysis. Conclusion: The TCom-skill GP scale probably has value in assessing the quality of doctor-patient relationships and therapeutic communications. The psychometric properties of the TCom-skill GP scale were appropriate for its use in this context. Adherence related to the TCom-skill GP and the latter related to the age of patients and the number of their previous consultations. The TCom-skill GP scale may be a useful way to assess, in a specific geographical location, the impact of medical professional training on therapeutic communication. [less ▲]

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See detailMental health (GHQ12; CES-D) and attitudes towards the value of work among inmates of a semi-open prison and the long-term unemployed in Luxembourg
Baumann, Michèle UL; Meyers, Raymond UL; Le Bihan, Etienne UL et al

in BMC Public Health (2008), 8(214),

Aim: To analyse the relationships between mental health and employment commitment among prisoners and the long-term unemployed (LTU) trying to return to work. Method: Fifty-two of 62 male inmates of a ... [more ▼]

Aim: To analyse the relationships between mental health and employment commitment among prisoners and the long-term unemployed (LTU) trying to return to work. Method: Fifty-two of 62 male inmates of a semi-open prison (Givenich Penitentiary Centre, the only such unit in Luxembourg), and 69 LTU registered at the Luxembourg Employment Administration completed a questionnaire exploring: 1) mental health (measured by means of scales GHQ12 and CES-D); 2) employment commitment; 3) availability of a support network, selfesteem, empowerment; and 4) socio-demographic characteristics. Results: Compared with LTU, inmates were younger, more had work experience (54.9% vs 26.1%), and more were educated to only a low level (71.1% vs 58.0%). The link between employment commitment and mental health in the LTU was the opposite of that seen among the prisoners: the more significant the perceived importance of employment, the worse the mental health (GHQ12 p = 0.003; CES-D p < 0.001) of the LTU; in contrast, among prisoners, the GHQ12 showed that the greater the perceived value of work, the lower the psychic distress (p = 0.012). Greater empowerment was associated with less depression in both populations. The education levels of people who did not reach the end of secondary school, whether inmates or LTU, were negatively linked with their mental equilibrium. Conclusion: The two groups clearly need professional support. Future research should further investigate the link between different forms of professional help and mental health. Randomized controlled trials could be carried out in both groups, with interventions to improve work commitment for prisoners and to help with getting a job for LTU. For those LTU who value employment but cannot find it, the best help may be psychological support. [less ▲]

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See detailAssociation between leisure time physical activity and health-related quality of life changes over time.
Tessier, Sabrina; Vuillemin, Anne; Bertrais, Sandrine et al

in Preventive Medicine (2007), 44(3), 202-208

Objective This study aimed to assess whether changes in leisure-time physical activity over 3 years are associated with changes in health-related quality of life. Method Among the adults enrolled in the ... [more ▼]

Objective This study aimed to assess whether changes in leisure-time physical activity over 3 years are associated with changes in health-related quality of life. Method Among the adults enrolled in the Supplementation en VItamines et Minéraux Antioxidants study in France, 3891 completed the Modifiable Activity Questionnaire to assess leisure-time physical activity and the Medical Outcomes Study 36-item Short-Form to assess health-related quality of life in 1998 and 2001. Multivariate analyses involving logistic and linear regressions determined the association between changes in leisure-time physical activity and changes in health-related quality of life. Results Over 3 years, increased leisure-time physical activity was associated with high scores in health-related quality of life dimensions: physical functioning, mental health, vitality for both sexes as well as social functioning for women only. An increase of 1 h per week of leisure-time physical activity was associated with a 0.17- and 0.39-point increase in the vitality dimension in men and women, respectively. The mental component score was also increased in women increasing their leisure-time physical activity. Conclusion The long-term association between leisure-time physical activity and health-related quality of life changes is limited and has little clinical significance, especially for men and for the physical health-related quality of life dimensions. The long-term association needs to be further explored before formulating public health recommendations. [less ▲]

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See detailHealth status among French, Polish and Romanian students
Baumann, Michèle UL; Le Bihan, Etienne UL; Amara, Marie-Emmanuelle UL et al

in Health Psychology and Society. Congressboock (2007)

Research question. Students face many school and living difficulties which alter health status and favour substance use which were assessed in this study among university students from France, Poland and ... [more ▼]

Research question. Students face many school and living difficulties which alter health status and favour substance use which were assessed in this study among university students from France, Poland and Romania. Methods. In total 934 French, 480 Polish, and 195 Romanian students from the Universities of Metz, Iaşi, and Silésie, completed a self-administred questionnaire. The data were analyzed using adjusted odds ratios (OR) and variance analysis taking age and sex into account, vs. French. Results. Mean age 20 (SD = 2) years. Female represented 58% French and 80% Polish/Romanian. Although most students were satisfied with their university integration (81-97%), many students had deteriorated heath status compared with the period before the university (13-22%), suffered from tiredness (11-85%), nervousness (42-56%), sleep disorders (19-48%), financial difficulty (15-39%), and being alone (8-23%). Were also common increasing tobacco use (15-32%), alcohol use every day (15-40%), tranquilizer pill use (1-6%), hashish/marijuana use (2-42%), suicide thinking (15-19%), and frequent consultation of health professionals (7-30%). Bad heath status was more frequent among French and Romanian overall, and suicide thinking among Polish. Higher PSS-14 and GHQ-12 scores among Polish compared with their French counterparts who used more hashish/marijuana. Satisfied social support was similar between the three groups. Conclusion. A better guidance for those who are in need of adapted mental health care seem nevertheless recommended to support them through their university success. [less ▲]

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See detailAdaptation and validation of a telephone questionnaire serbian version for case detection of Rheumatoid Arthritis and Spondyloarthropathy (multicentric Eular study)
Zlatkovic-Svenda, M. I.; Stojanovic, R. M.; Milenkovic, M. P. et al

in Clinical and Experimental Rheumatology (2007), 25(1), 75-84

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See detailRheumatoid Arthritis and Spondyloarthropathies : geographical variations in prevalence in France
Roux, C.; Saraux, A.; Le Bihan, Etienne UL et al

in Journal of Rheumatology (2007), 34(1), 117-122

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See detailUtilisation d'un modèle de réponse à l'item pour la validation d'une échelle des attitudes professionnelles des médecins généralistes
Le Bihan, Etienne UL; Baumann, Cédric; Alla, François et al

in Journal of Educational Measurement and Applied Cognitive Sciences (2007)

Nous avons développé une échelle des attitudes professionnelles des médecins généralistes destinée à évaluer le niveau de communication thérapeutique dispensé durant les consultations. La construction de ... [more ▼]

Nous avons développé une échelle des attitudes professionnelles des médecins généralistes destinée à évaluer le niveau de communication thérapeutique dispensé durant les consultations. La construction de l'échelle a abouti à un questionnaire constitué de 15 items à 10 modalités de réponse allant de "Jamais" à "Toujours". Après avoir étudié les propriétés métriques de l’échelle selon une méthodologie classique, nous avons employé un modèle de réponse à l’item (le Generalized Partial Credit Model, GPCM) pour explorer un éventuel fonctionnement différentiel d’item (FDI) selon le genre des individus. Le modèle a été construit dans un cadre bayésien en utilisant un algorithme MCMC. La détection du FDI est basée sur le test de rapport de vraisemblance, en comparant le modèle de référence où tous les paramètres associés aux items sont communs aux hommes et aux femmes, à un modèle incluant deux ensembles de paramètres distincts selon le genre des individus pour un item particulier. La démarche a été appliquée aux 338 observations de l'échantillon de validation ne comportant pas de données manquantes. Parmi les 15 items de l'échelle, seul l'item 6 ("Mon médecin m’informe sur les effets secondaires des médicaments") présente un FDI significatif au niveau de signification de 5% (p = 0.016). Cet item est plus discriminant chez les hommes. De plus, il semble que, à un niveau de communication thérapeutique égal, les hommes ont une probabilité supérieure aux femmes de répondre aux catégories les plus élevées. Finalement, nous avons décidé de ne pas écarter cet item car 1) le FDI est modéré (si nous ajustons le test pour les comparaisons multiples, celui-ci n'est plus significatif au niveau 5%) et 2) nous n'avons aucune interprétation qualitative de cette différence. [less ▲]

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See detailStatistical Analysis of Piglet Stillbirth
Canario, L.; Cantoni, E.; Le Bihan, Etienne UL et al

Scientific Conference (2006, August)

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See detailLean mass plays a gender-specific role in familial resemblance for femoral neck bone mineral density in adult subjects
Blain, Hubert; Vuillemin, Anne; Guillemin, Francis et al

in Osteoporosis International (2006), 17(6), 897-907

Introduction Whether the femoral neck bone mineral density (FN BMD) of children may be better predicted from that of their parents when taking into account the anthropometry of the children was assessed ... [more ▼]

Introduction Whether the femoral neck bone mineral density (FN BMD) of children may be better predicted from that of their parents when taking into account the anthropometry of the children was assessed in a healthy adult sample consisting of 86 mother-daughter, 32 mother-son, 32 father-daughter, and 23 father-son pairs from 128 families. Heritability for FN BMD, which is considered to be a measurement of general resemblance, was defined as the regression coefficient of the mean of the parents’ BMD. Among the anthropometric factors, lean mass was the most strongly associated with FN BMD following the adjustment for age in women (r=0.52, p<0.0001) and men (r=0.25, p=0.02). After adjustment for age, calcium intake, physical activity, and menopause and hormonal replacement therapy if relevant, heritability estimates (h2) for FN BMD were 0.68±0.23 [95% credible interval (CI): 0.15–0.99] in father-daughter pairs, 0.40±0.17 (95% CI: 0.08–0.74) in mother-daughter pairs, and 0.19±0.15 (95% CI: 0.01–0.57) in father-son pairs. Adjustment for lean mass of children increased the h2 for FN BMD in mother-son pairs [from 0.24±0.17 (95% CI: 0.01–0.57) to 0.66±0.18 (95% CI: 0.26–0.95)]. The present results show that FN BMD is heritable in adult father-daughter pairs (7.2% of a daughter’s FN BMD variance was explained by the father’s FN BMD) and that taking into account the lean mass of sons might improve the prediction of their FN BMD based on that of their mother’s (reduction of sons’ FN BMD residual variance by 5.1%). Taking the lean mass of children into account might improve the prediction of their FN BMD by 9.1% in daughters and by 18.1% in sons, irrespective of their parent’s FN BMD. These results, obtained using a Bayesian regression model, have to be confirmed in further studies involving a greater number of adult parent-offspring pairs of both genders before extrapolation to clinical practice. [less ▲]

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See detailBetween-breed variability of stillbirth and its relationship with sow and piglet characteristics
Canario, Laurianne; Cantoni, E.; Le Bihan, Etienne UL et al

in Journal of Animal Science (2006), 84

Litter characteristics at birth were recorded in 4 genetic types of sows with differing maternal abilities. Eighty-two litters from F1 Duroc × Large White sows, 651 litters from Large White sows, 63 ... [more ▼]

Litter characteristics at birth were recorded in 4 genetic types of sows with differing maternal abilities. Eighty-two litters from F1 Duroc × Large White sows, 651 litters from Large White sows, 63 litters from Meishan sows, and 173 litters from Laconie sows were considered. Statistical models included random effects of sow, litter, or both; fixed effects of sow genetic type, parity, birth assistance, and piglet sex, as well as gestation length, farrowing duration, piglet birth weight, and litter size as linear covariates. The quadratic components of the last 2 factors were also considered. For statistical analyses, GLM were first considered, assuming a binomial distribution of stillbirth. Hierarchical models were also fitted to the data to take into account correlations among piglets from the same litter. Model selection was performed based on deviance and deviance information criterion. Finally, standard and robust generalized estimating equations (GEE) procedures were applied to quantify the importance of each effect on a piglet’s probability of stillbirth. The 5 most important factors involved were, in decreasing order (contribution of each effect to variance reduction): difference between piglet birth weight and the litter mean (2.36%), individual birth weight (2.25%), piglet sex (1.01%), farrowing duration (0.99%), and sow genetic type (0.94%). Probability of stillbirth was greater for lighter piglets, for male piglets, and for piglets from small or very large litters. Probability of stillbirth increased with sow parity number and with farrowing duration. Piglets born from Meishan sows had a lower risk of stillbirth (P < 0.0001) and were little affected by the sources of variation mentioned above compared with the 3 other sow genetic types. Standard and robust GEE approaches gave similar results despite some disequilibrium in the data set structure highlighted with the robust GEE approach. [less ▲]

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See detailUn baromètre de la qualité de vie des étudiant-e-s au sein des universités européennes : une nécessité éthique.
Baumann, Michèle UL; Amara, Marie-Emmanuelle UL; Le Bihan, Etienne UL

in Analyse des Systèmes de Santé (2006)

Les politiques d’éducation et de formation doivent doter les étudiant-e-s d’aptitudes, de capacités et de compétences nécessaires pour affronter les transformations socioéconomiques (Conseil Européen de ... [more ▼]

Les politiques d’éducation et de formation doivent doter les étudiant-e-s d’aptitudes, de capacités et de compétences nécessaires pour affronter les transformations socioéconomiques (Conseil Européen de Lisbonne 2000). Pour augmenter la compétitivité des ressources humaines, la croissance économique et la cohésion sociale en Europe (Déclaration de Bologne 1999), la question de l'employabilité s'impose progressivement comme une des finalités des enseignements. Dans un contexte de massification des universités, les questions de politique globale suscitent plus d'intérêt que la qualité de vie et les jugements des étudiant-e-s sur leur expérience universitaire. Une attention particulière est cependant accordée dans les recherches à l'analyse des conditions de leur socialisation, de leur intégration dans l'institution (rapports avec les autres étudiant-e-s, avec leurs enseignants, épanouissement personnel, engagement civique...) et de ce qu'ils ont retiré pour leur parcours ultérieur. Des travaux sur l'évaluation de la qualité et de la satisfaction des services rendus aux étudiant-e-s sont également de plus en plus engagés par les établissements d'enseignement supérieurs pour répondre aux exigences des processus d'accréditation. Parallèlement à ces études, la problématique du bien-être des étudiant-e-s reste peu documentée. Or une bonne santé constitue un facteur positif de réussite. La qualité de vie des étudiant-e-s est pourtant une priorité de santé publique pour ces jeunes à qui on demande aujourd'hui de relever un tel défi. Dans l'enceinte de trois universités européennes, nous avons réalisé auprès d'étudiants polonais (Po), roumains (Ro) et français (Fr) de 1ère année en sciences humaines et sociales. Notre objectif est de présenter les principaux résultats de ce travail afin de susciter une discussion éthique sur la place de la qualité de vie et de la santé au sein des universités européennes. La méthode s'est appuyée sur un questionnaire auto-administré, 1602 étudiants (93 français (Fr), 190 roumains (Ro), 480 polonais (Po)) ont répondu. Des mesures sur les consommations de psychotopes, tabac, alccol, drogues, tc. ont été réalisées. La santé psychique a été évaluée à l'aide d'échelles validées (Brief Cope, Estime de soi, Général Health Qquestionnaire, etc.). Les principaux résultats. L'âge moyen est de 20 ans. Globalement, les Ro se sentent en moins bonne santé que les Fr et les Po alors qu'ils jouissent de la meilleure estime de soi. Ils sont les plus nombreux à consulter leur médecin et à vouloir rencontrer un psychiatre. Les Fr et les Po sont les plus nombreux à avoir mal au dos, mal à la tête, à se dire fatigués et à déclarer consommer des tranquillisants. Les Po consomment davantage de stimulants et de somnifères. Les Fr sont les plus nombreux à boire de l'alcool et à prendre des amphétamines et de l'ecstasy. Depuis la rentrée universitaire, les Po sont les plus nombreux à avoir modifié leur prise de drogues, et comme les Ro, ils ont augmenté leur consommation de tabac. Pour faire face à leurs problèmes, les Fr dédramatisent les situations grâce à l'humour et aux distractions, les Po recherchent un soutien social et affectif, les Ro libèrent leurs sentiments par la parole et positivent le sens qu’ils donnent aux événements. Durant les derniers mois, les Ro sont les plus nombreux à avoir entamé une action contre le stress. Discussion. L'entrée à l'universitaire exerce une influence sur l'équilibre psychique des étudiants. Les comportements à l’égard de leur qualité de vie et de leur santé méritent d’être observés, leur compréhension est une nécessité éthique: - D'abord, parce qu'il est vraisemblablement peu efficace d’agir sur ces comportements sans agir sur leurs causes. On sait aujourd’hui que des comportements considérés comme nocifs (alcool, tabac, drogues) sont produits en réponse à des carences ou à des agressions de l’environnement pour faire face à la souffrance psychique, à l’isolement, au manque de perspectives. Ce que l'on nomme "problèmes" sont plutôt « des comportements de survie ou des appels au secours » dans le contexte où ils s’expriment. - Ensuite parce qu'il paraît peu acceptable de considérer les étudiant-e-s comme responsables de ce qui leur est imposé : stress, solitude, manque de respect des droits de l’étudiant, … L'équité d'accès à la formation et à l’éducation nécessite de repenser la santé au sein des universités comme partie intégrante d’un dispositif d’accompagnement des etudiants-e-s dans leur réussite universitaire. Perspectives. Un « Baromètre européen de la qualité de vie des étudiant-e-s » permettrait d’analyser l’apparition et l’adoption des comportements bénéfiques ou délétères à l'égard de la santé et du bien-être. Ce type de recherche saisirait à la fois les représentations des jeunes et l’intrication intime, qui prédomine à l’adolescence, ente les problèmes à dominante physique et les problèmes à dominante affective ou relationnelle. Cette connaissance constituerait un support pour des programmes de prévention et de promotion de la santé qui mériterait d'être mené aussi bien du côté des étudiant-e-s que du côté des professionnels de la santé et des enseignants. [less ▲]

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See detailTwo professional attitudes measurement scales evaluated by patients for general practitioners and dispensing chemists
Baumann, Michèle UL; Le Bihan, Etienne UL

in Society for Health and Medical Sociology (2006)

To construct and validate a scale of Professional Attitudes for both General Practitioners (in french, Attitudes Professionnelles des Médecins Generalistes) and dispensing chemists (Attitudes ... [more ▼]

To construct and validate a scale of Professional Attitudes for both General Practitioners (in french, Attitudes Professionnelles des Médecins Generalistes) and dispensing chemists (Attitudes Professionnelles des Pharmaciens d’Officine). Methods: Stage 1. The construction and qualitative validation of a scale. By interviewing 40 patients in a preventive-care center in east of France in addition to 21 general practitioners and 22 dispensing chemists, we targeted items which could possibly help us formalize a theoretical construction of professional attitudes which intervened in the instauration and follow-up of patient treatments. Then, with the help of a group of experts, we determined which generic items in the questionnaire could be validated and, finally, identified the functions which fulfilled these attitudes. Stage 2. We statistically validated the APMG and APPO scales and then studied the classic metric characteristics of the scales by using a questionnaire which was auto-administered to 393 patients from East of France. We have completed this validation with a differential item functioning analysis to determine if the questions have similar properties among men and women. Results: 15 relational items in general practitioners and 9 in dispensing chemists were identified. They are associated with information, communication and education. Each scale is one-dimensional. Analysis showed high internal coherence (Cronbach’s alpha coefficient was 0.91 and 0.87 respectively) and acceptable reproducibility (intra-class correlation coefficients were respectively 0.74 and 0.72). Differential item functioning analysis for gender is in progress. Conclusion: The professional attitudes, we isolated represent important criteria in the quality of interpersonal doctor-patient and chemist-patient relationships. The metric characteristics of the two scales were deemed satisfactory. This suggests that they can be used as an aid in training in the healthcare professional-patient relationship, in decision-making and in assessing relational competencies. [less ▲]

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See detailPrevalence of Spondylarthropathies in France : 2001
Saraux, A.; Guillemin, Francis; Guggenbuhl, P. et al

in Annals of the Rheumatic Diseases (2005), 64(10), 1431-1435

Detailed reference viewed: 43 (1 UL)
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See detailPrevalence of Rheumatoid Arthritis in France : 2001
Guillemin, Francis; Saraux, A.; Guggenbuhl, P. et al

in Annals of the Rheumatic Diseases (2005), 64(10), 1427-1430

Detailed reference viewed: 117 (1 UL)