References of "Le Bihan, Etienne 50002178"
     in
Bookmark and Share    
Full Text
Peer Reviewed
See detailCross-border mobility in European countries: associations between cross-border worker status and health outcomes
Nonnenmacher, Lucas UL; Baumann, Michèle UL; Le Bihan, Etienne UL et al

in BMC Public Health (2021)

Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk ... [more ▼]

Mobility of workers living in one country and working in a different country has increased in the European Union. Exposed to commuting factors, cross-border workers (CBWs) constitute a potential high-risk population. But the relationships between health and commuting abroad are under-documented. Our aims were to: (1) measure the prevalence of the perceived health status and the physical health outcomes (activity limitation, chronic diseases, disability and no leisure activities), (2) analyse their associations with commuting status as well as (3) with income and health index among CBWs. Based on the ‘Enquête Emploi’, the French cross-sectional survey segment of the European Labour Force Survey (EU LFS), the population was composed of 2,546,802 workers. Inclusion criteria for the samples were aged between 20 and 60 years and living in the French cross-border departments of Germany, Belgium, Switzerland and Luxembourg. The Health Index is an additional measure obtained with five health variables. A logistic model was used to estimate the odds ratios of each group of CBWs, taking non-cross border workers (NCBWs) as the reference group, controlling by demographic background and labour status variables. A sample of 22,828 observations (2456 CBWs vs. 20,372 NCBWs) was retained. The CBW status is negatively associated with chronic diseases and disability. A marginal improvement of the health index is correlated with a wage premium for both NCBWs and CBWs. Commuters to Luxembourg have the best health outcomes, whereas commuters to Germany the worst. CBWs are healthier and have more income. Interpretations suggest (1) a healthy cross-border phenomenon steming from a social selection and a positive association between income and the health index is confirmed; (2) the existence of major health disparities among CBWs; and (3) the rejection of the spillover phenomenon assumption for CBWs. The newly founded European Labour Authority (ELA) should take into account health policies as a promising way to support the cross-border mobility within the European Union. [less ▲]

Detailed reference viewed: 39 (2 UL)
Full Text
Peer Reviewed
See detailSocioeconomic and behavioural factors associated with access to and use of Personal Health Records
Paccoud, Ivana UL; Baumann, Michèle UL; Le Bihan, Etienne UL et al

in BMC Medical Informatics and Decision Making (2021), 21

Background: Access to and use of digital technology are more common among people of higher socioeconomic status. These differences might be due to lack of interest, not having physical access or having ... [more ▼]

Background: Access to and use of digital technology are more common among people of higher socioeconomic status. These differences might be due to lack of interest, not having physical access or having lower intentions to use this technology. By integrating the digital divide approach and the User Acceptance of Information Technology (UTAUT) model, this study aims to further our understanding of socioeconomic factors and the mechanisms linked to different stages in the use of Personal Health Records (PHR): desire, intentions and physical access to PHR. Methods: A cross-sectional online and in-person survey was undertaken in the areas of Lorraine (France), Luxembourg, Rhineland-Palatinate and Saarland (Germany), and Wallonia (Belgium). Exploratory factor analysis was performed to group items derived from the UTAUT model. We applied linear and logistic regressions controlling for country-level heterogeneity, health and demographic factors. Results: A total of 829 individuals aged over 18 completed the questionnaire. Socioeconomic inequalities were present in the access to and use of PHR. Education and income played a significant role in individuals' desire to access their PHR. Being older than 65 years, and migrant, were negatively associated with desire to access PHR. An income gradient was found in having a physical access to PHR, while for the subgroup of respondents who expressed desire to have access, higher educational level was positively associated with intentions to regularly use PHR. In fully adjusted model testing the contribution of UTAUT-derived factors, individuals who perceived PHRs to be useful and had the necessary digital skills were more inclined to use their PHR regularly. Social influence, support and lack of anxiety in using technology were strong predictors of regular PHR use. Conclusion: The findings highlight the importance of considering all stages in PHR use: desire to access, physical access and intention to regularly use PHRs, while paying special attention to migrants and people with lower socioeconomic backgrounds who may feel financial constraints and are not able to exploit the potential of PHRs. As PHR use is expected to come with health benefits, facilitating access and regular use for those less inclined could reduce health inequalities and advance health equity. [less ▲]

Detailed reference viewed: 65 (5 UL)
Full Text
See detailThe patients’ perspective on access to and use of Personal Health Records
Paccoud, Ivana UL; Baumann, Michèle UL; Le Bihan, Etienne UL et al

Scientific Conference (2020, October 29)

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with ... [more ▼]

We present the patients' perspective regarding the use of Personal Health Records, and give insights on patients' characteristics, such as socioeconomic and behavioural factors, that are associated with the access to and use of Personal Health Records. The findings come from the INTERREG APPS project that investigated preferences for and intention to use Personal Health Records in four cross-border regions, in Lorraine/France, Luxembourg, Rhineland-Palatinate and Saarland/Germany, and Wallonia/Belgium. [less ▲]

Detailed reference viewed: 47 (6 UL)
Full Text
See detailOrienter les soins vers le patient partenaire. Un livre blanc pour la Grande Région
Pétré Benoit, Consortium APPS Lux; Baumann, Michèle UL; Chauvel, Louis UL et al

Book published by INTERREG APPS (2020)

Les différents chapitres de ce livre proposent une approche holistique pour faire évoluer le système de santé vers le partenariat de soins. Résultat de trois années de recherche et de concertation, le ... [more ▼]

Les différents chapitres de ce livre proposent une approche holistique pour faire évoluer le système de santé vers le partenariat de soins. Résultat de trois années de recherche et de concertation, le Livre Blanc s’appuie sur des recherches documentaires (analyse de la littérature scientifique et de la législation spécifique de chaque pays), des entretiens et des enquêtes auprès de nombreux acteurs, le repérage et l’analyse d’initiatives en GR et la discussion orientée vers le consensus. Par ailleurs, les propositions de recommandations ont été élaborées et discutées lors d’un séminaire interrégional réalisé en décembre 2019. Le Livre Blanc est structuré en 5 parties qui s’adressent chacune à un public ciblé. La première partie situe le contexte dans lequel s’est réalisé le projet et décrit la méthodologie du programme. La seconde partie est consacrée aux aspects réglementaires de l’approche patient partenaire et à leurs conséquences sur les pratiques et les initiatives analysées sur le terrain. Elle est destinée de manière privilégiée aux mandataires politiques. La troisième partie propose une réflexion sur le développement de stratégies de partenariat au niveau des institutions de santé. Elle concerne les gestionnaires des établissements de santé. La quatrième partie vise à amener les professionnels à s’interroger sur ce que le partenariat de soins peut leur apporter dans leurs pratiques de soins. Elle s’adresse, en particulier, aux acteurs en contact direct avec les patients. La cinquième et dernière partie suggère différentes voies possibles de développement de l’APPS dans les domaines de l’enseignement et de la recherche. Toutes ces parties s’adressent bien évidemment au patient, qui est au coeur de l’APPS. Les prises de position proposées par ce Livre Blanc s’appuient sur les données collectées par le consortium de recherche de 2017 à 2020. Dès lors, ce document ne peut être exhaustif et est appelé à évoluer, basé davantage sur une fonction vectrice de normes que de règles. Pour davantage d’information et pour connaitre nos activités et nos publications, rendezvous sur le site web du projet APPS (https://www.patientpartner.org/). [less ▲]

Detailed reference viewed: 72 (9 UL)
Full Text
Peer Reviewed
See detailHospital practices for the implementation of patient partnership in a multi-national European region
Scholtes, Beatrice; Breinbauer, Mareike; Voyen, Madeline et al

in European Journal of Public Health (2020)

The extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the ... [more ▼]

The extent to which patients are involved in their care can be influenced by hospital policies and interventions. Nevertheless, the implementation of patient participation and involvement (PPI) at the organisational (meso) level has rarely been assessed systematically. The aim of this study was to assess the occurrence of PPI practises in hospitals in Belgium, France, Germany and Luxembourg and to analyze if, and to what extent, the hospital vision and the presence of a patient committee influence the implementation of PPI practises. Methods: A cross-sectional study was carried out using an online questionnaire in hospitals in the border regions of the four countries. The data were analyzed for differences between regions and the maturity of PPI development. Results: Full responses were obtained from 64 hospitals. A wide range of practices were observed, the degree of maturity was mixed. A majority of hospitals promoted patient partnership in the hospital's philosophy of care statement. However, the implementation of specific interventions for PPI was not found uniformly and differences could be observed between the countries. Conclusions: Hospitals in the region seem to be motivated to include patients more fully, however, implementation of PPI interventions seems incomplete and only partially integrated into the general functioning of the hospitals. The implementation of the concept seems to be more mature in the francophone part of the region perhaps due, in part, to a more favourable political context. [less ▲]

Detailed reference viewed: 66 (2 UL)
Full Text
Peer Reviewed
See detailAdolescent Body Dissatisfaction in ContrastingSocioeconomic Milieus, Coming from a French andLuxembourgish Context
Regnier, Faustine; Le Bihan, Etienne UL; Tichit, Christine et al

in International Journal of Environmental Research and Public Health (2020), 17(61),

: To analyze the relationships between body mass index (BMI), ideal body,current declared body shape, and gap between ideal and declared body shape, and the associationsthat these have with social and ... [more ▼]

: To analyze the relationships between body mass index (BMI), ideal body,current declared body shape, and gap between ideal and declared body shape, and the associationsthat these have with social and cultural factors among 329 adolescents (11 to 15 years i.e., at two stagesof adolescence, the early and late adolescence), attending an international school in Luxembourg,and 281 from Paris.Methods:A cross-sectional survey was conducted using an online questionnaire.Missing data were addressed using the data augmentation method in a Bayesian framework.Results: For both sets, higher the BMI and bigger their current body shape (CBS), the slimmertheir ideal body shape, especially for those who perceive a link between body shape and beauty.For girls, slimness is a shared ideal; for boys, older they are, more they want a muscular body shape.Most students want slimmer bodies, but in affluent or intermediate social milieu students in relationsto identification to personalities such as celebrities, while students from modest milieus, this isexpressed in relation to success in love. In addition, they declared that their “talk diet with friends”were associated with large gap between ideal and declared body shape.Conclusions:A social controlnorm was revealed involving a displacement of values affecting body weight and health in the latestage of adolescence to early adolescence, especially for boys. [less ▲]

Detailed reference viewed: 63 (0 UL)
Full Text
Peer Reviewed
See detailLife Satisfaction and mobility: Their associations with career attitudes, and health-related factors among postgraduates having studied in universities intra EU and outside EU
Odero, Angela UL; Chauvel, Louis UL; Hartung, Anne UL et al

in BMC Public Health (2020), 20(3),

Background. University postgraduates’ mobility towards, and outside the EU is continuously increasing, creating a competitive context in which maintaining a high life satisfaction (LS) is a public health ... [more ▼]

Background. University postgraduates’ mobility towards, and outside the EU is continuously increasing, creating a competitive context in which maintaining a high life satisfaction (LS) is a public health challenge. However, the relationship between LS and its determinants among this population are under-documented. Our aims were to measure LS indicators of mobile postgraduates (Intra EU: Who pursue part of their studies in Europe; Outside EU: Who study outside of Europe) versus non-mobile (pursue their studies in Luxembourg), and to analyze the associations between LS and career attitudes, socioeconomic characteristics, and health-related factors for each group. Method. Six hundred and sixty-four (644) students obtained financial aid from the Luxembourgish government independent of their family’s socioeconomic situation. Contacted by post, they completed an online questionnaire. Analyses included a multiple linear regression model in which only significant relationships (p < 0.05) were used. Results.Three groups were created: Mobile intra EU (n = 381), mobile outside EU (n = 43) and non-mobile (n = 66) postgraduates. Health satisfaction was positively linked to LS, in all groups. Among the mobile outside EU group, majority (63.2%) were men and 57.9% did not live alone - health was the only determinant which contributed to their LS. Among the mobile intra EU, majority (57.8%) were women, and 64.3% not living alone. Autonomy and career adaptability attitudes were positively associated with their LS (b: 0.210 and 0.119, respectively), whereas the worry factor was negatively (b: − 0.153 and -0.159) associated. The non-mobile, were the oldest of the three groups. Majority (51.6%) were women, and 93.7% did not live alone. Career optimism and planning attitudes were positively correlated to their LS (regression parameter estimates (b: 0.400 and 0.212, respectively). Conclusions.Attention should be devoted to the LS of local and cosmopolitan students, as it seems to be a relevant health indicator. Overall, the farther the mobility was, the higher the postgraduates’ general LS (8.5/10) was; this indicator was higher than the LS indicator for the age group 25–34 years 7.53/10 (EU-28, in 2013). University’ services could promote the development of career projects and the promotion of health to enhance postgraduates’ LS. University policy makers need to ensure this for all students. [less ▲]

Detailed reference viewed: 225 (7 UL)
Full Text
Peer Reviewed
See detailReversing social gradient: Impact of patients’ communication with their practitioners on adherence to preventive behaviours
Baumann, Michèle UL; Bucki, Barbara; Tchicaya, Anastase et al

in "Health Psychology across the Lifespan: Uniting Research, Practice and Policy” (2018)

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation ... [more ▼]

Good communication with a physician has positive effects on the patients’ adopting preventive behaviours. Knowing social inequalities in health, we aimed at analysing in what extent financial situation influences the associations between quality of communication and improved secondary preventive behaviours and limited risk factors - in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. Methods: 1,289 patients who underwent a coronary angiography in Luxembourg completed a self-administered questionnaire in 2008/09 and 2013/14. The association between improving each preventive eating behaviour (decrease of salt, sugar, fat consumption; increase of fruits/vegetables) and the quality of physician-patient communication (5-items scale) was evaluated using logistic regression models. Perceived financial situation (difficult, easy, and very easy) was introduced in interaction with the communication score. Findings: Patients declared in a difficult or easy financial situation had a higher probability of decreasing their salt intake when physician-patient communication quality was higher (OR [95% CI] respectively: 1.139 [1.045; 1.240], 1.105 [1.032; 1.182]). The pattern was similar for increased consumption of fruits/vegetables in patients with hypertension, diabetes, overweight and hypercholesterolemia. Reduced sugar consumption was associated with communication quality in hypercholesterolemia patients in financial difficulty (OR [95% CI]: 1.095 [1.009; 1.189]). Discussion: The quality of communication has a higher impact on adopting healthy behaviours in patients declaring themselves in financial difficulty. These findings raise awareness on the importance, in patients with perceived financial difficulties, of physician-patient quality to improve adherence to the secondary preventive recommendations. Across the lifespan, it highlights the role of physicians in reversing their patients’ social gradient. [less ▲]

Detailed reference viewed: 113 (6 UL)
Full Text
Peer Reviewed
See detailLife Satisfaction and longitudinal changes in physical activity, diabetes and obesity among patients with cardiovascular diseases.
Baumann, Michèle UL; Tchicaya, Anastase; Lorentz, Nathalie et al

in BMC Public Health (2017), (17), 925

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular ... [more ▼]

Patients with cardiovascular disease who underwent coronary angiography at the National Institute of Cardiac Surgery and Cardiological Intervention (INCCI) in Luxembourg were surveyed for cardiovascular risk factors (CVRF) (hypertension, hypercholesterolemia, diabetes, obesity, physical inactivity, tobacco consumption). In 2013/14, their life satisfaction (LS) was also assessed. Our aim was to analyse the relationships between LS on one hand and <br />longitudinal changes in CVRF between 2008/09 and 2013/14 and socioeconomic factors on the other. <br />Methods: 1289 patients completed a self-administered questionnaire. Life Satisfaction, originally recorded on a 1 to 10 scale of complete satisfaction was dichotomized into two groups: ≤ 7 and. >7. We then performed logistic multiple regressions. The event on which the probability was modelled, was LS > 7. Data were adjusted on age, sex and income. Longitudinal changes in CVRF were assessed by their presence or absence in 2008/09 and 2013/ 14 (categories: ‘no-no’; ‘no-yes’; ‘yes-no’; ‘yes-yes’). <br />Results: Physical activity in 2008/09 and 2013/14 was associated with a lower LS (OR = 0.469). The same pattern was observed for obesity and physical inactivity: lower LS was related to the presence of these risks (yes-yes; no-yes) in 2013/14 (mean OR for obesity and physical inactivity in 2013/14: 0.587 and 0.485 respectively), whereas their presence or absence in 2008/09 was not related to LS. Finally, patients who suffered from diabetes in 2008 <br />were more likely to experience a decline in LS, particularly if their diabetes was less severe in 2013/14 (OR = 0.462). <br />Conclusions: The lowest LS was observed when obesity or physical inactivity was present in 2013/14, newly or otherwise. The same trend was seen in diabetes among patients who had it in 2008/9, but were less severely affected in 2013/14. In secondary prevention, CVD-related upheavals could be minimised if professionals and patients ecame ‘Partners in Healthcare’ to better adhere to healthy lifestyles, as well as to reduce CVRF, and thereby enhance LS. [less ▲]

Detailed reference viewed: 126 (10 UL)
Full Text
Peer Reviewed
See detailQuality of doctor-patient communication in cardiovascular diseases and secondary preventive adherence. The role of gender
Bucki, Barbara UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in Innovative ideas in Health Psychology (2017)

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity ... [more ▼]

The doctor-patient communication intervenes on the preventive behaviours of chronic patients by reducing their risk factors – in cardiovascular diseases: hypertension, overweight, obesity, hypercholesterolemia, diabetes. What are the associations between the quality of communication and the improvement of secondary preventive behaviours? How does gender influence these relationships? Methods: 1,289 patients who underwent a coronary angiography in 2008/09 in Luxembourg completed a self-administered questionnaire at the time of the visit, and at a five-year follow-up. The probability of improving each preventive eating behaviour (decrease of salt, sugar, fat consumption and increase of fruits/vegetables), and the quality of doctor-patient communication (5-item scale) were evaluated using logistic regression models. Sex was introduced in interaction with the communication score. Findings: Among hypertensive respondents, a higher quality of communication was associated with a higher probability of decreasing the salt intake in women (OR [95% CI]: 1.139 [1.060; 1.223]) whereas in men, the OR was only 1.086 [1.017; 1.159]. ORs were also higher in women among patients with hypertension, overweight and hypercholesterolemia regarding the increase of fruits/vegetables consumption; among patients with diabetes and hypercholesterolemia regarding sugar decrease or cessation; and among patients with overweight and hypercholesterolemia regarding fat reduction or stop. ORs were slightly higher among men only among diabetic and obese patients, regarding the increase of fruits/vegetables consumption. Discussion: The quality of the communication showed an effect on the adoption of secondary preventive eating behaviours, especially in women patients. Motivational interviews could encourage, especially men patients, to adhere to the recommendations about lifestyle change. [less ▲]

Detailed reference viewed: 260 (13 UL)
Full Text
Peer Reviewed
See detailImpact of Patients’ Communication with the Medical Practitioners, on Their Adherence Declared to Preventive Behaviours, Five Years after a Coronary Angiography, in Luxembourg
Baumann, Michèle UL; Tchicaya, Anastase; Lorentz, Nathalie et al

in PLoS ONE (2016), 11(6), 0157321

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and ... [more ▼]

Patients of the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg who underwent coronary angiography were surveyed for hypertension, hypercholesterolemia, diabetes and overweight/obesity between 2008/9 and 2013/4. For each cardiovascular risk factor (CVRFs), we analysed the associations between the quality of the patients' communication with the medical practitioner and their adherence declared to preventive behaviours. Methods 1,289 completed a self-administered questionnaire on communication with the medical practitioner (P’Com-5 items scale; Cronbach 0.87). 61.8%stopped smoking, 57.9% reduced or stopped their consumption of salt, 71.9% of fat, and 62.8%of sugar, and whereas 65% increased their consumption of fruit and vegetables and 19.8% increased their physical activity. Around 37% reported having made changes following their doctor's advice. 90% were followed by a cardiologist and 95.9% by an attending physician. Results No link was observed between declaration of physical activity, smoking, fats, and quality of communication. Significant associations: for increased consumption of fruit and vegetables was linked with the quality of doctor-patient communication when patients were overweight (OR = 1.081), obese (OR = 1.130), hypercholesterolemic (OR = 1.102), hypertensive (OR = 1.084) or diabetic (OR = 1.103). Reduction in salt intake was linked only to patients with hypertension (OR = 1.102), whereas reduction or cessation of sugar consumption was linked to overweight (OR = 1.093), and more so obese, (OR = 1.106), hypercholesterolemics (OR = 1.103) and diabetics (OR = 1.173). Conclusions Good doctor-patient communication was related to nutrition, particularly increased consumption of fresh fruits and vegetables. Accurate perception of CVRFs by both patients and medical practitioners is essential for CV protection. The aim of instructing patients is to encourage them to make informed decisions about how to change their lifestyle. In routinely, P’Com-5 scale can collect data to assess the improvement of the professional skills. It can be used in medical training to enhance the quality of the therapeutic communication, especially for nutritional coaching, and to evaluate its efficacy in reducing CVRFs. [less ▲]

Detailed reference viewed: 112 (3 UL)
Full Text
Peer Reviewed
See detailHealth capability of family caregivers: how different factors interrelate and their respective contributions using a Bayesian approach
Bucki, Barbara UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in BMC Public Health (2016), 16

The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk ... [more ▼]

The lifestyles of family caregivers pose risks to their physical, mental and social health. The capability to stay healthy may be protective in the context of poor socioeconomic conditions and risk behaviours, but the interrelations between its aspects and their respective influences remain unclear. The aim of this study was to evaluate the interrelations between the factors comprising health capability of family caregivers (HCFC) and the respective contributions of its components. Methods: All stroke patients admitted to all hospitals in Luxembourg were identified by the ‘Inspection Générale de la Sécurité Sociale’ using the national database system for care expenditure reimbursement, and asked to designate the main person caring for them. Sixty-two caregivers (mean age 59.3 years; 40 women and 22 men) responded face to face, to a questionnaire including 20 items measuring eight aspects of health capability (physical functioning, psychological functioning, lifestyle value, self-efficacy towards the use of health services, family support, social capital, material conditions/sense of security, and satisfaction with the interactions with health services). Using a Bayesian approach, significance values were estimated by comparing the test values to the posterior distribution of the parameters. Structural equation modelling with standard deviations was applied. Results: Female family caregivers had lower scores than men in physical and psychological functioning. Family caregivers with the lowest incomes had the least lifestyle value, social capital and material conditions/security. Self-efficacy towards health services increased with age. The material conditions/sense of security factor was positively correlated with almost all the others. The items that impacted health capability factors the most were - for physical functioning – fatigue, and - for family support - feeling abandoned by the family. Conclusions: During the chronic phase, relationships between risk behaviours can help guide social and health decision-makers to determine their priorities in improving the lives of family caregivers. Enhancing health capability involves implementing programs that relieve family caregivers physically, and foster family networking around the person being cared for. Special attention should also be paid to the socially disadvantaged in order to fight inequalities in health capability. [less ▲]

Detailed reference viewed: 119 (8 UL)
Full Text
Peer Reviewed
See detailA social gradient in fatal opioids and cocaine related overdoses?
Origer, Alain; Le Bihan, Etienne UL; Baumann, Michèle UL

in PLoS ONE (2015), 4(10(5)),

To determine the existence of a social gradient in fatal overdose cases related to non-prescribed opioids and cocaine use, recorded in Luxembourg between 1994 and 2011. METHODS: Overdose cases were ... [more ▼]

To determine the existence of a social gradient in fatal overdose cases related to non-prescribed opioids and cocaine use, recorded in Luxembourg between 1994 and 2011. METHODS: Overdose cases were individually matched with four controls in a nested case-control study design, according to sex, year of birth, drug administration route and duration of drug use. The study sample, composed of 272 cases and 1,056 controls, was stratified according to a Social Inequality Accumulation Score (SIAS), based on educational attainment, employment, income, financial situation of subjects and the professional status of their father or legal guardian. Least squares linear regression analysis on overdose mortality rates and ridit scores were applied to determine the Relative Index of Inequality (RII) of the study sample. RESULTS: A negative linear relationship between the overdose mortality rate and the relative socioeconomic position was observed. We found a difference in mortality of 29.22 overdose deaths per 100 drug users in the lowest socioeconomic group compared to the most advantaged group. In terms of the Relative Inequality Index, the overdose mortality rate of opioid and cocaine users with lowest socioeconomic profiles was 9.88 times as high as that of their peers from the highest socioeconomic group (95% CI 6.49-13.26). CONCLUSIONS: Our findings suggest the existence of a marked social gradient in opioids and cocaine related overdose fatalities. Harm reduction services should integrate socially supportive offers, not only because of their general aim of social (re)integration but crucially in order to meet their most important objective, that is to reduce drug-related mortality [less ▲]

Detailed reference viewed: 115 (10 UL)
Full Text
Peer Reviewed
See detailDoctor-patient communication on nutrition and the related secondary preventive behaviours
Baumann, Michèle UL; Le Bihan, Etienne UL; Lorentz, Nathalie et al

in Cardiology (2015), 132

Doctor-patient relationship impacts on the compliance. For hypercholesterolemia, diabetes, overweight and obesity, our study’s aim was to analyse the associations between the quality of communication ... [more ▼]

Doctor-patient relationship impacts on the compliance. For hypercholesterolemia, diabetes, overweight and obesity, our study’s aim was to analyse the associations between the quality of communication, evaluated in 2013, and patients’ adherence to their general practitioner (GP)’s nutritional advice, between 2008 and 2013. Methods. Five years after a coronary angiography performed by the National Institute of Cardiac Surgery and Interventional Cardiology in Luxembourg, 4391 patients were contacted. 1289 completed a self-rating questionnaire assessing the GP’Com-5 items scale (Cronbach 0.87). The variables were analysed with a multiple logistic regression model. Results. Patients declared that they reduced or stopped their consumption 71.9% of fat, 62.8% of sugar and 65% increased their consumption of fruits and vegetables. Around 37% of the patients reported having made changes to their risk behaviours following the advice of their doctor. An increased consumption of fruits and vegetables was linked with the quality of doctor-patient communication when patients were overweight (odd ratio = 1.081, IC 95%, [1.013-1.155]), obesity (OR = 1.130 [1.056-1.209]), hypercholesterolemia (OR = 1.102 [1.033–1.175]) and diabetes (OR = 1.103 [1.029-1.181]). The reduction or cessation of sugar consumption was associated with the quality of physician-patient communication when the patient was overweight (OR = 1.093 [1.020-1.170]), and more so obese (OR = 1.106 [1.031-1.187]). The same held true for patients with hypercholesterolemia (OR = 1.103 [1.031-1.180]) or diabetes (OR = 1.173 [1.088-1.265]). Conclusion. In prevention of secondary CVDs, doctor-patient communication is a relevant determinant in obtaining a favourable behavioural outcome, especially with the consumption of fresh fruit and vegetables. [less ▲]

Detailed reference viewed: 160 (16 UL)
Full Text
Peer Reviewed
See detailLife satisfaction, cardiovascular risk factors, unhealthy behaviours and socioeconomic inequality, 5 years after coronary angiography.
Baumann, Michèle UL; Tchicaya, Anastase; Vanderpool, kyle et al

in BMC Public Health (2015), (15), 668-678

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions, but ... [more ▼]

Five years after coronary angiography, life satisfaction (LS) among patients may be related to incidents of cardiovascular diseases, risk factors and unhealthy behaviours and socioeconomic conditions, but their respective influence remains unclear. Our aim is to analyze LS and its relationships with those factors. Methods. Among the 4,391 patients initially contacted, 547 deaths were reported and 209 had an invalid address. In 2013-2014, 3,635 patients who underwent coronary angiography in 2008-2009 at the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg were asked to complete a self-administered questionnaire assessing LS [1-10] and other variables. Data were analysed via multiple regression models adjusted initially on age, sex and income, and for a second time with the addition of all CVRF. Results. LS of 1,289 volunteers (69.2 years) was 7.3/10. Most were men, Luxembourgish, employees and manual workers, had secondary education and an income of 36,000 euros or more per year. LS was lowest in female patients, and those with a low to middle income. Patients who lived in a couple had the best LS. Patients with a history in the previous 5 years of physical inactivity (regression coefficient: -0.903), angina pectoris (rc -0.843), obesity (rc -0.512), diabetes, or hypercholesterolemia, were more likely to have lower LS. The previous associations were mostly maintained on the second analysis, with the exceptions of diabetes and obesity. In addition, patients who stopped smoking because of peer pressure (rc -0.011) had a lower LS. Conclusions. The finding that LS was lowest among female patients calls for further research on symptoms, and potential risk factors. Also, certain patient profiles are linked with low LS: ‘inclined abstainers’ who intended to modify their behaviours, but could not do so, and ‘disinclined abstainers’ who had no intention of changing and were insufficiently concerned to do so. Patients who stopped smoking and perceived it as unpleasant also had low LS. ‘Disinclined actors’ were those patients who had to adjust their lifestyles, but were ambivalent about their intentions and the behaviour, which they continued. Health promotion programs would benefit from targeting factors that moderate the unfavourable intention-behaviour relationship and can help enhance LS. [less ▲]

Detailed reference viewed: 152 (8 UL)
Full Text
Peer Reviewed
See detailLife satisfaction, five-years after a coronary angiography, between physical exercise and socio-economic inequalities.
Baumann, Michèle UL; Le Bihan, Etienne UL; Lorentz, Nathalie et al

in Pracana, Clara (Ed.) Health Psychology (2015)

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim ... [more ▼]

Five-years after undergoing a coronary angiography, socioeconomic status and health related behaviours are known to affect life satisfaction (LS), but their respective influence remains unclear. Our aim was to analyze patients’ LS and its relationships with cardiovascular diseases, risk factors and preventive behaviours developed in the last 5 years and socioeconomic conditions. Methods: Based on records from the National Institute of Cardiac Surgery and Cardiological Intervention in Luxembourg, 3632 survivors who underwent coronary angiography between 2008 and 2009 were contacted in 2013 by letter to complete a self-questionnaire assessing LS [1-10] and other cofounder factors. Data were analysed via multiple regression models. Results. Life satisfaction of 1289 volunteers (69.2 years) was 7.3/10. Majority were men, Luxembourgish, secondary education level, employees and manual workers, and those with an income of 36000 euros or more per year. Being a woman, not living in couple and having a low middle income were negatively associated with the LS level. Patients who suffered in the last 5 years from angina pectoris, diabetes, hypercholesterolemia, obesity, or who stopped smoking because of the disease were more likely to have lower LS, in contrast to those who participate in regular physical activity or exercise. Conclusions: Patients’ LS indicator was lower than the national life satisfaction in Luxembourg (7.8/10) which was higher than that from the European (7.0 for EU-27). Coaching patients with interventions that foster healthy attitudes can help sustain rehabilitation and enhance life satisfaction, adding beyond a reduction of socioeconomic inequalities. [less ▲]

Detailed reference viewed: 86 (4 UL)
Full Text
Peer Reviewed
See detailThe Luxembourg Teacher Databank 1845-1939. Academic Research into the Social History of the Luxembourg Primary School Teaching Staff
Voss, Peter UL; Le Bihan, Etienne UL

in Lausen, Berthold; Krolak-Schwerdt, Sabine; Böhmer, Matthias (Eds.) Data Science, Learning by Latent Structures, and Knowledge Discovery (2015)

From 1845 to 1939 the pedagogical journal Der Luxemburger Schulbote published a comprehensive annual directory of the primary school teaching staff of the Grand Duchy. On the basis of this directory, we ... [more ▼]

From 1845 to 1939 the pedagogical journal Der Luxemburger Schulbote published a comprehensive annual directory of the primary school teaching staff of the Grand Duchy. On the basis of this directory, we have established a databank encompassing 75,000 entries relating to a total of approx. 4,700 primary school teachers, both male and female, who taught in the Grand Duchy during this period. With the assistance of IBM SPSS Statistics, we have been able to process the data and compile a collective biography or prosopography that provides a profound insight into the development of an occupational group over a period of nearly 100 years at a local, regional and national level. This paper presents an analysis of initial research findings relating to the number of teaching staff, length of service and the level of qualification and mobility among teaching staff for the first half of this period from 1845 to 1895. [less ▲]

Detailed reference viewed: 128 (15 UL)
Full Text
Peer Reviewed
See detailSocial and economic inequalities in fatal opioid and cocaine related overdoses in Luxembourg: A case–control study
Origer, Alain UL; Le Bihan, Etienne UL; Baumann, Michèle UL

in International Journal of Drug Policy (2014), 25

Background: To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Methods: Cross-examination of national ... [more ▼]

Background: To investigate social and economic inequalities in fatal overdose cases related to opioid and cocaine use, recorded in Luxembourg between 1994 and 2011. Methods: Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence in a nested case–control study design. Overdose cases were individually matched with four controls, when available, according to sex, year of birth, drug administration route and duration of drug use. 272 cases vs 1056 controls were analysed. Conditional logistic regression analysis was performed to assess the respective impact of a series of socioeconomic variables. Results: Being professionally active [OR = 0.66 (95% CI 0.45–0.99)], reporting salary as main legal income source [OR = 0.42 (95% CI 0.26–0.67)] and education attainment higher than primary school [OR = 0.50 (95% CI 0.34–0.73)] revealed to be protective factors, whereas the professional status of the father or legal guardian of victims was not significantly associated to fatal overdoses. Conclusions: Socioeconomic inequalities in drug users impact on the occurrence of fatal overdoses. Compared to their peers, users of illicit drugs with lower socioeconomic profiles show increased odds of dying from overdose. However, actual and self-referred socioeconomic characteristics of drug users, such as educational attainment and employment, may have a greater predictive value of overdose mortality than the parental socioeconomic status. Education, vocational training and socio-professional reintegration should be part of drug-related mortality prevention policies. [less ▲]

Detailed reference viewed: 497 (135 UL)
Full Text
Peer Reviewed
See detailAssociations between quality of life and socioeconomic factors, functional impairments and dissatisfaction with received information and home-care services among survivors living at home two years after stroke onset
Baumann, Michèle UL; Le Bihan, Etienne UL; Chau, Kénora et al

in BMC Neurology (2014), 14

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors ... [more ▼]

Quality of life (QoL) assessment is important when monitoring over time the recovery of stroke-survivors living at home. This study explores the associations between QoL and socioeconomic factors, functional impairments and self-reported dissatisfaction with received information and home-care services among survivors two years after stroke onset. This problem remains partially addressed though optimal information and services may improve survivors' QoL. Methods Stroke-survivors admitted to all hospitals in Luxembourg 18 months or more previously were identified using the only care-expenditure-reimbursement national system database. The clinical diagnosis was confirmed. Ninety four patients aged 65 years and living at home were interviewed to gather socioeconomic characteristics, functional impairments, dissatisfaction with information and home-care services, and QoL (using the Newcastle Stroke-Specific QoL, newsqol) assessing 11 domains. Data were analyzed using multiple linear regression models. Results About 50% of survivors had low education and lower income. Functional impairments were common: sensory (45%), motor (35%), memory (32%), language (31%), and vision (20%). Survivors with education (<12th grade) or lower income had low values for most newsqol domains (sex-age-adjusted regression coefficient saRC, i.e. mean difference, between -23 and -8). Patients who were working had better values for pain, mental feelings and sleep domains than did retired people (saRC between -3.9 and 4.2). Various functional impairments were associated with markedly low values of nearly all domains (saRC between -33.5 and -7.5) and motor, language, memory and sensory impairments had the highest impact. The survivors' perceived QoL was markedly low, especially for the domains of interpersonal relationship, sleep, cognition, mental feelings, and pain. Various QoL domains were strongly related to dissatisfaction with information about stroke and its consequences/changes over time, accuracy of information obtained, help received, coordination between services, and the possibility of receiving help when necessary (saRC reaching -30). Conclusions Stroke-survivors had major alterations in QoL that reflected depressive symptoms, which should be appropriately treated. These findings may help with the development of public policies aiming at improving QoL among stroke survivors. The newsqol could be used routinely to measure the recovery of survivors over time and their needs in terms of information, help and care services [less ▲]

Detailed reference viewed: 518 (126 UL)
Full Text
Peer Reviewed
See detailAssociations between Psycho-Educational Determinants and Dynamic Career Attitudes among undergradutes students
Karavdic, Senad UL; Karathanasi, Chrysoula UL; Le Bihan, Etienne UL et al

in Pracana, Clara (Ed.) Psychology Applications & Developments - Advances in Psychology and Psychological Trends Series (2014)

Monitoring and assessment of career attitudes are critical for the student’s preparation for an adapted university-to-work transition. This problem remains partially addressed though optimal services ... [more ▼]

Monitoring and assessment of career attitudes are critical for the student’s preparation for an adapted university-to-work transition. This problem remains partially addressed though optimal services proposed by universities which may enhance students’ generic career capabilities. Our study explored the relationships between the psycho-educational and socio-demographic factors, and the perception of their career attitudes. Bachelor students in social sciences, engineering, applied management from University of Luxembourg were invited to complete a paper pencil questionnaire. Data were analyzed using correlation and multiple linear regression models. Of 278 students, 124 participated. The majority studied applied management, were women, unemployed and with six months or less of job experiences. The search for work self-efficacy score is linked to the employability soft-skills and job search techniques scores which are, in parallel, with the quality of life autonomy associated to the dynamic career attitudes. Greater are employability, search for work and quality of life autonomy, the higher are dynamic career attitudes. Students who were in their final academic year also had greater career capabilities. These findings may help to elaborate interventions aiming at improving psycho-educational determinants. It must be stimulated at the entry to university with appropriately collaborative supports, pedagogical workshops and interpersonal trainings. [less ▲]

Detailed reference viewed: 140 (24 UL)