Scientific publications portal of EHESP researchers
Not a member yet
5609 research outputs found
Sort by
Restricting the content of alcohol advertising and including text health warnings: A between‐group online experiment with a non‐probability adult sample in the United Kingdom
No full textInternational audienceBackground - Statutory options for restricting alcohol advertising include limiting it to product‐orientated information and requiring health warnings. We assess the impact of removing positive contextual factors from alcohol advertising and including a health warning among adults in the United Kingdom (UK). Methods - We conducted a 2 × 2 online between‐group experiment with adults (18+) ( n = 2421) recruited from a non‐probability research panel in the United Kingdom. Participants were randomized to see an alcohol (vodka) advertisement (advert) which varied by context (no context vs. imagery depicting positive social interactions around alcohol) and message (multiple text health warning vs. “drink responsibly”). The multiple text health warning, based on recent legislation in Ireland, comprised three separate warnings (liver disease, cancers, drinking during pregnancy) and a web address for alcohol‐related information and support. The “drink responsibly” control reflected the self‐regulatory messages commonly used by alcohol companies. Participants rated the advert on 7‐point scales for advert attractiveness, product appeal, trial intentions, perceived harm, and whether it made drinking alcohol seem enjoyable. Results - Removing the positive social context reduced positive advert and product reactions (difference in estimated marginal means [EMM]: −1.57 [makes drinking alcohol seem enjoyable] to −0.23 [intention to try]). Including the multiple text health warning also reduced positive advert and product reactions (difference in EMM: −0.55 [advert attractiveness] to −0.25 [intention to try]) and increased perceived product harm (difference in EMM: +0.25). There were no interactions between advert context and message for any outcome. Conclusions - Restricting content and including a multiple text health warning (compared to a “drink responsibly” message) may attenuate the persuasive impact of alcohol advertising and increase perceived product harm. Further research is needed to examine different degrees of content restrictions, alternative warning content and design, generalizability to different alcohol products and advert formats, and whether the impact of content controls varies among population subgroups
Revisiting the primary bias: the role of innumeracy in the misperception of prevalence of common illnesses
No full textInternational audienceAlthough people have been repeatedly found to underestimate frequencies of common illnesses and overestimate those of rare illnesses, not much is known about this consistent bias in risk perception, termed “primary bias” in the literature, as well as the origin of its variations among different subpopulations. To fill this gap, we designed and implemented a national survey to compare the perceived and actual prevalence of common illnesses, and to test the hypothesis that numeracy may play an important role in the accuracy of judgments of risk frequencies. Our data were collected through a large online survey conducted in France among a representative sample of the adult population (n = 3,245). The participants were asked to complete a 10-items numeracy scale and to estimate the prevalence of a variety of social conditions and common illnesses such as cancers or heart diseases in the French population by using a percentage scale. The analyses show that (1) participants tend to greatly overestimate the prevalence of conditions affecting small percentages of people, and underestimate those affecting a large percentage of them, (2) the Tversky and Kahneman’s probability weighting function provides an adequate model to represent the discrepancy between the perceived and actual prevalence of these illnesses, and (3) the magnitude of the primary bias varies principally as a function of the respondents’ numeracy. These results suggest that the primary bias that affects perceptions of prevalence of chronic diseases is not fundamentally different from those characterizing other types of probabilistic judgments investigated in the field of psychological and behavioral sciences. They also confirm that numeracy plays a considerable role in people’s ability to transform epidemiological observations from their social environment into more accurate estimates
Citizen science in environmental health research: A comparison with conventional approaches and creation of a guidance tool issued from the LILAS initiative
No full textInternational audienceContext: Public interest for citizen science (CS) in environmental health is growing. The goals of environmental health research projects are diverse, as are the methods used to reach these goals. Opportunities for greater implication of the civil society and related challenges differ at each step of such projects. These methodological aspects need to be widely shared and understood by all stakeholders. The LILAS initiative (acronym for "application of citizen science approaches such as LIving LAbS to research on environmental exposures and chronic risks") aimed to 1) favor a mutual understanding of the main issues and research methods in environmental health, of their stakes for different actors, but also of the requirements, strengths and limitations of these methods and to 2) identify expected benefits and points of attention related to stronger degrees of participation as part of environmental health research projects.Methods: The LILAS initiative gathered institutional researchers, academics and civil society representatives interested in environmental exposures. Five meetings allowed to collectively identify different types of environmental health research studies and reflect about the benefits, limitations, and methodological issues related to the introduction of growing citizen participation as part of such studies. An analytic table matrix summarizing these aspects was co-created and filled by participants, as a tool devoted to help stakeholders with the definition of future CS research projects in environmental health.Results: For different fields of research (e.g.: studies for assessment of environmental exposures, interventions on these exposures, quantitative risk assessment, epidemiological studies), the matrix lists expected benefits for various stakeholders, the fundamental principles of research methods and related practical constraints, but also advantages and limitations related to the use of CS or conventional research approaches.Conclusion: The LILAS initiative allowed to develop a tool which provides consolidated grounds for the co-creation of research projects on environmental exposures involving CS
Biocide and other semi-volatile organic compound concentrations in settled indoor dust of CRESPI daycare centers and implication for public health
No full textInternational audienceThis study investigates the presence of biocides and other semi-volatile organic compounds (SVOCs) in cleaning products used in daycare centers and health impact through ingestion of settled dust by young children. In Paris metropolitan, 106 daycares area were investigated between 2019-2022. Fifteen substances were analyzed in settled indoor dust by gas chromatography-tandem mass spectrometry. Detection rates and concentrations ranged from 5 to 100%, an
High-Efficacy Therapy Discontinuation vs Continuation in Patients 50 Years and Older With Nonactive MS
No full textInternational audienceImportance: A recent randomized clinical trial concluded that discontinuing medium-efficacy therapy might be a reasonable option for older patients with nonactive multiple sclerosis (MS), but there is a lack of data on discontinuing high-efficacy therapy (HET). In younger patients, the discontinuation of natalizumab and fingolimod is associated with a risk of rebound of disease activity.Objective: To determine whether discontinuing HET in patients 50 years and older with nonactive MS is associated with an increased risk of relapse compared with continuing HET.Design, setting, and participants: This observational cohort study used data from 38 referral centers from the French MS registry (Observatoire Français de la Sclérose en Plaques [OFSEP] database). Among 84704 patients in the database, data were extracted for 1857 patients 50 years and older with relapsing-remitting MS treated by HET and with no relapse or magnetic resonance imaging activity for at least 2 years. After verification of the medical records, 1620 patients were classified as having discontinued HET or having remained taking treatment and were matched 1:1 using a dynamic propensity score (including age, sex, disease phenotype, disability, treatment of interest, and time since last inflammatory activity). Patients were included from February 2008 to November 2021, with a mean (SD) follow-up of 5.1 (2.9) years. Data were extracted in June 2022.Exposures: Natalizumab, fingolimod, rituximab, and ocrelizumab.Main outcomes and measures: Time to first relapse.Results: Of 1620 included patients, 1175 (72.5%) were female, and the mean (SD) age was 54.7 (4.8) years. Among the 1452 in the HET continuation group and 168 in the HET discontinuation group, 154 patients in each group were matched using propensity scores (mean [SD] age, 57.7 [5.5] years; mean [SD] delay since the last inflammatory activity, 5.6 [3.8] years; mean [SD] follow-up duration after propensity score matching, 2.5 [2.1] years). Time to first relapse was significantly reduced in the HET discontinuation group compared with the HET continuation group (hazard ratio, 4.1; 95% CI, 2.0-8.5; P < .001) but differed between HETs, with a hazard ratio of 7.2 (95% CI, 2.1-24.5; P = .001) for natalizumab, 4.5 (95% CI, 1.3-15.5; P = .02) for fingolimod, and 1.1 (95% CI, 0.3-4.8; P = .85) for anti-CD20 therapy.Conclusion and relevance: As in younger patients, in patients 50 years and older with nonactive MS, the risk of relapse increased significantly after stopping HETs that impact immune cell trafficking (natalizumab and fingolimod). There was no significant increase in risk after stopping HETs that deplete B-cells (anti-CD20 therapy). This result may inform decisions about stopping HETs in clinical practice
Chapitre 13. Le management par la qualité
No full textInternational audienceLa qualité des soins est difficile à définir de façon générale car les objectifs visés, les ressources utilisées et les résultats attendus dépendent des situations pathologiques, des patients concernés et des contextes spécifiques. Il est cependant possible d’identifier différentes perspectives et de spécifier les dimensions générales attendues d’un système de management de la qualité. Cela constitue les objectifs de ce chapitre
Chapitre 3. Le financement des établissements et services
No full textInternational audienceLes établissements et services sanitaires, sociaux et médico-sociaux (ESSSMS) relèvent de la catégorie des services d’intérêt économique général (SIEG) qui se définissent comme des « services de nature économique que les États membres ou la communauté soumettent à des obligations spécifiques de service public en vertu d’un critère d’intérêt général ». Ces services peuvent être fournis directement par les autorités publiques ou par des entreprises, publiques ou privées mandatées à cet effet. Ainsi, au titre des missions d’intérêt général et d’utilité sociale que les autorités publiques confient aux ESSSMS, ces derniers se voient attribuer des concours financiers leur permettant de remplir ces missions. Conformément à la décision de la Commission européenne du 20 décembre 2011, ces compensations de service public doivent respecter les conditions suivantes : la mission de service public doit avoir été confiée au moyen d’un mandat, celui-ci prend la forme, dans le secteur sanitaire et médio-social, d’une procédure d’autorisation couplée au contrat pluriannuel d’objectifs et de moyens (CPOM) ; - le montant de la compensation ne doit pas excéder ce qui est nécessaire pour couvrir les coûts occasionnés par l’exécution des obligations de service public. Le mandat doit comprendre à ce titre les paramètres de calcul de ces coûts et expliciter selon quelles modalités la collectivité publique entend financer le prestataire,- un contrôle doit s’opérer en outre sur les compensations accordées pour s’assurer qu’elles n’entraînent pas de surcompensation notamment à l’issue du mandat.Les activités soumises à autorisation au titre du Code de la santé publique (CSP) ou au titre du Code de l’action sociale et des familles (CASF) sont financées par dépenses de transfert pour la durée de l’autorisation. Les autres activités du secteur sanitaire, social et médico-social sont financées par subventions (le secteur social est considéré comme « non protégé » du fait du caractère discrétionnaire de l’attribution desdites subventions)
Perturbateurs endocriniens : vers une meilleure prévention des expositions
No full textInternational audienceDepuis le début du 20e siècle, l’usage des substances chimiques dans la vie quotidienne n’a fait que croître. À l’échelle de la planète, on recense aujourd’hui plus de 100 millions de substances chimiques différentes et on estime à 100 000 leur nombre sur le marché européen. Métaux, hydrocarbures, produits de combustion, solvants, plastifiants, pesticides, etc. : l’usage des produits du quotidien, les activités et les comportements humains nous exposent à toutes ces substances de manière continuelle. Ces expositions, cumulées à d’autres facteurs de risques, participent à l’accroissement des maladies chroniques actuelles.Cet ouvrage est conçu pour permettre de comprendre les enjeux liés aux substances chimiques, en particulier les perturbateurs endocriniens, molécules qui agissent dans le corps en altérant le système hormonal. Structuré en 19 fiches, il propose des outils pratiques permettant de repérer ces substances chimiques dans le quotidien, d’analyser les situations les plus à risque, et d’agir en matière de prévention pour la réduction des expositions de la population.➜ L’ouvrage s’adresse spécifiquement aux professionnels de santé qui dans leur pratique quotidienne sont amenés à conseiller citoyens et patients sur cette thématique pouvant apparaître comme anxiogène
Représentations et attitudes des Français face aux goûts sucrés – première étude de l’Observatoire des comportements et goûts sucrés. Synthèse du workshop SFN en partenariat avec Cultures Sucre donné en visioconférence le mardi 28 mars 2023
No full textNational audienceOn connaît encore trop peu les interactions complexes et permanentes qui vont motiver à la consommation ou non aux goûts sucrés, dans toute leur diversité. La SFN, avec le soutien financier de Cultures Sucre, a organisé un webinaire sur les premières avancées de l’Observatoire des comportements et goûts sucrés, sur la compréhension des perceptions et comportements alimentaires et sur leur éventuelle mise en pratique dans la prise en charge du patient. Cette session s’est tenue en digital le 28 mars 2023. L’intégralité des conférences est disponible gratuitement sur le site de la SFN à l’adresse suivante : https://sfnutrition.fr/workshop-de-la-sfn/. Nous en présentons ici une synthèse
