Santé des villes, santé des champs

En Auvergne, le canton de Montaigut en Combrailles est marqué par un niveau de précarité inquiétant qui touche en priorité les personnes âgées, les jeunes actifs, les familles monoparentales, les agriculteurs ainsi que les demandeurs d’asile. Une situation qui se cristallise bien souvent autour de l’accès aux soins et que l’on retrouve malheureusement en d’autres parties du territoire français. Depuis quelques mois, l’antenne auvergnate de la délégation lyonnaise de Médecins du Monde a lancé un projet pilote visant informer les populations précaires, à appuyer les dispositifs et professionnels locaux et, à terme, à nourrir un témoignage sur cette précarité encore mal connue

Permanence of the information given during oncogenetic counseling to persons at familial risk of breast/ovarian and/or colon cancer

How long counselees retain the information given during their genetic consultation is of major importance. To address this issue, we conducted a survey among the 3500 families that have been offered genetic counseling at our Center since 1988. In August 2007, we mailed a questionnaire to a representative subset of 579 persons belonging to breast/ovarian or colon cancer families seen in the last 10 years, either carrying an identified mutation or not. Targeted topics included the meaning of hereditary predisposition, the medical prevention related to the familial risk, the steps to undertake for a new family member to enter the genetic testing program and general knowledge of hereditary predisposition to cancer. A total of 91 randomized non-respondents were sent a second, more inciting letter, in order to assess any non-response bias. Overall, 337 questionnaires were collected: response rate was 58%. Standardized average knowledge was 7.28±1.52 of 10. Scores were lowest concerning medical prevention. The level of knowledge decreased with age (P<10−6), but increased with educational level (P<10−5) and mutation status (P=0.01). Surprisingly, no erosion of patients' knowledge over the time was observed (P=0.41). Among persons at hereditary risk of colon cancer, the level of knowledge tended to improve with time, in contrast to the breast/ovarian group (P=0.017). Among persons with a familial risk of breast/ovarian or colon cancer, a renewal of oncogenetic counseling does not seem necessary to maintain the level of specific knowledge. Measures to help patients follow their medical prevention, as organizing or checking their medical examinations, seem indicated

Effect of Work-Related Sedentary Time on Overall Health Profile in Active vs. Inactive Office Workers

Objective: While public health strategies are developed to fight sedentary behaviors and promote physical activity, some professional activities, and especially tertiary ones, have been pointed out for their highly sedentary nature. Although workplace physical activity programs are increasingly proposed by companies to their employees in order to increase their physical activity levels, sitting and screen time remain extremely high. The main aim of this work was to compare health indicators between active and inactive tertiary employees with similar high levels of sedentariness. Secondly, we questioned the effects of a 5-month workplace physical activity program on overall health indicators among initially active and inactive tertiary employees.Methods: Anthropometric measurements, body composition (bio-impedance), physical fitness (cardiorespiratory and musculoskeletal fitness) and health-related quality of life and perception of health status (self-reported questionnaires) were assessed among 193 active and inactive tertiary employees before (T0) and after a 5-month workplace physical activity intervention (T1), composed of 2 physical sessions per week.Results: Significant improvements were found in performance of push-ups (p &lt; 0.001), back muscle strength (p &lt; 0.001) fat mass (p &lt; 0.01) and waist circumference (p &lt; 0.05) in active compared with inactive employees both at baseline and at the end of the program. Health perception (p &lt; 0.001) was significantly different between groups at T0 but not at T1. However, no significant difference was observed for fat-free mass, BMI, workplace well-being and lower and upper limbs muscle strength. The variations between T0 and T1 demonstrate that, while all the studied parameters progressed positively during the 5-month program, health perception (p &lt; 0.001), back muscle strength (p &lt; 0.05) and BMI (tendency) showed a significantly higher progression in the inactive compared with the active group.Conclusion: Health indicators might not be improved among active tertiary employees compared with inactive ones, which might be due to the high level of sedentariness characterizing their occupational task.Structured on-site physical activity programs can improve health in both initially active and inactive employees

Pour une thanatologie puérile

International audienc

La mort du côté des psychanalystes

International audienc

Informer la famille : émotions et attitudes du consultant en oncogénétique pour risque familial de cancer sein/ovaire ou côlon

International audienceBackground > Transmission of oncogenetic information (TOI) by probands to their families is of major importance to organize medical prevention in his family. Little is known about the difficulties that the proband faces when he tries to endorse his "duty to warn''. Methods > To characterize the barriers to TOI, a survey was performed, previously to the bioethic law of 2011, on a representative sample of 337 counselees seen in the last 10 years at the Centre Jean-Perrin Oncogenetics Department. A questionnaire comprising 97 items was prepared by experts and validated by a group of patients and health professionals. Nineteen Lickert-scale questions specially concerned TOI.Results > Analysis found two dimensions, one of emotions and one concerning communication attitudes. Both dimensions were negatively correlated (r = –0.34, P Cancer and its treatments seem to deeply affect patient's relatives and limit his capacity to involve his family into the oncogenetic inquiry. Measures are suggested to help ex-patients improve TOI

Health and Fitness Benefits But Low Adherence Rate

Objective:The aim of this study was to assess the effects of a 10-month structured physical activity intervention implemented within the workplace on overall health indicators among tertiary (office workers) employees.Methods: In this quasi-experimental study, 224 employees followed a 10-month worksite physical activity program. Overall health was assessed at baseline, after 5 months, and by the end of the intervention.Results: Fat mass percentage decreased significantly. There was a time effect favoring push-ups, abdominal strength, flexibility, heart rate postexercise, heart rate +30 seconds, and heart rate +60 seconds postexercise. Anxiety, depression, and eating habits also improved. In total, 45% of participants completed the whole intervention. Conclusion: Although a structured on-site physical activity program supports improved health indicators, adherence remains a concern and requires specialists to develop new strategies

Effect of Work-Related Sedentary Time on Overall Health Profile in Active vs. Inactive Office Workers

Effect of Work-Related Sedentary Time on Overall Health Profile in Active vs. Inactive Office Worker