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Real-life use of bone-targeting agents for bone metastases in France between 2009 and 2018: Results of the OPTIMOS study
No full textInternational audienceAim: To determine the use of bone-targeting agents (BTAs) in clinical practice in France and the occurrence of skeletal-related events (SREs) in cancer patients with bone metastases.Methods: This study analysed data, recorded prospectively in a French National Health Insurance database, for patients who had a first diagnosis of bone metastases between 2009 and 2018.Results: A total of 6,663 patients were analysed (mean age 69.7 ± 13.2 years, 53.2 % male) corresponding to 2,363 bone metastases only patients and 4,300 patients with SREs at inclusion. The most frequent primary cancers were breast (15.8 %), prostate (13.4 %), lung (12.6 %) and digestive cancer (10.6 %). Six-hundred and twenty-one patients (9.3 %) were treated with BTAs (52.7 % with denosumab). Median [IQR] time between inclusion and BTA initiation was similar with denosumab (3.3 months [1.2-7.9]) and bisphosphonates (3.3 months [1.2-8.7]). Patients with a SRE at inclusion and early BTA initiation (≤3 months) had a significative lower incidence of a second SRE at 12 months than those with late initiation (13.6 % [95 %CI: 8.1-20.4] vs. 21.6 % [14.8-29.2] respectively; p < 0.001).Conclusion: BTAs are underused in bone metastases patients in France. There is an urgent need to optimise bone metastases management in accordance with ESMO 2020 guidelines
Veille
No full textNational audienceVeille juridique et normative, novembre - décembre 2025: assurance agricole, code de procédure pénale
Behavioural and electrophysiological (event-related potential) determinants of decision-making in individuals with a smoking habit
No full textInternational audienceIntroduction Individuals with a smoking habit or with other addictions display deficits in decision-making, which are suggested to contribute to the perpetuation of their compulsive behaviour. In individuals with a smoking habit (ISH), performance in the Iowa Gambling Task (IGT), which operationalises real-life decision making under uncertainty, is worsened by both exposure to craving-inducing cigarette-related cues and abstinence. However, the behavioural and neurophysiological nature of “baseline” decision-making in ISH, the impairment of which may reflect a general insight deficit, related to an increased reliance on implicit motivational mechanisms, such as incentive habits, in controlling behaviour, has not been fully elucidated. Methods Here, we sought to characterise the behavioural and electrophysiological (Event-Related Potentials, ERPs) determinants of “baseline” decision-making, as assessed in the IGT, in 20 ISH compared to 20 control participants. Neurophysiological processes related to option evaluation, response selection and feedback integration were assessed as the pre-outcome N500 (480–520 ms), the DNP and the post-outcome FRN & fP300 (450–700 ms) ERPs across five blocks of 60 trials during which the selection of advantageous decks, an index of decision making in the IGT, was recorded. Results While ISH did not perform significantly less well than controls overall under these baseline conditions, they displayed only half the improvement in decision making shown by controls over the session, and they engaged different neurophysiological processes. While the N500 amplitude was more negative for non-risky than for risky choices across groups, it was slightly smaller in ISH than in controls. Similarly, while the amplitude of the FRP was greater for negative than for positive outcomes across groups, in ISH, this contrast was inversely proportional to the severity of the smoking habit, as assessed with the Fagerström test. Discussion These findings together identify biobehavioural determinants of decision making in individuals with a smoking habit that may represent an endophenotype of the impaired insight that characterises individuals with a substance use disorder
Violences sexuelles, sexistes & bien-être animal : un télescopage ?
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Expériences du cancer chez les adolescents et jeunes adultes (AJA) et leurs proches – parents et fratrie : étude qualitative des vécus individuels et relationnels
No full textInternational audienceAbstract: Cancer among adolescents and young adults (AYA), aged 15 to 24, arises at a time of profound developmental, identity and relational transformations. The onset of a serious illness at this time of transition affects not only the young patient, but also the entire family group, which undergoes a major psychological and organisational ordeal. Few qualitative studies have explored the whole family experience, including the various family members.Aims: The aim of this research is to understand the subjective experience and psychic reorganisations at work within families faced with the cancer of an adolescent or young adult. It explores the processes of mutual support, the reshaping of family roles, and the containing function played by the family and institutions.Methods: A qualitative study based on an inductive methodology was conducted between 2019 and 2021 with 57 participants: 29 AJAs with cancer, 17 mothers, 9 fathers and 3 siblings. Semi-structured individual interviews were conducted, transcribed in full and subjected to reflective thematic analysis in accordance with the principles of Braun & Clarke. The approach adopted was that of a practitioner-researcher, based on a clinical psychoanalytical reading.Results: Reflective thematic analysis identified five themes among AYA, five themes among parents, and three themes among siblings. The results highlight that AYAs are faced with the possibility of death at an early age, have physical and psychological experiences marked by treatment, and have an increased need for parental support. Among parents and siblings, the results describe significant suffering and mobilisation around the sick AYA, marked by helpful and supportive behaviour, contributing to a reorganisation of family relationships and dynamics.Conclusion: This study highlights how young adults experience cancer within a system of nested containers, linking individual, family and institutional psychological frameworks. The results emphasise the structuring role of this linkage in supporting the psychological continuity of young people and their loved ones as they face the traumatic ordeal of illness.Résumé : Le cancer chez les adolescents et jeunes adultes (AJA), âgés de 15 à 24 ans, survient à une période de profondes transformations développementales, identitaires et relationnelles. L’irruption de la maladie grave tel que le cancer dans ce temps de transition affecte non seulement le jeune malade, mais engage l’ensemble du groupe familial dans une épreuve psychique et organisationnelle majeure. Peu d’études qualitatives ont exploré l’expérience familiale dans sa globalité, en incluant les différents membres de la famille.Objectifs : Cette recherche vise à comprendre l’expérience subjective et les réorganisations psychiques à l’œuvre au sein des familles confrontées au cancer d’un adolescent ou d’un jeune adulte. Elle explore les processus de soutien mutuel, les remaniements des rôles familiaux, ainsi que la fonction contenante jouée par la famille et les institutions.Méthodes : Une étude qualitative fondée sur une méthodologie inductive a été conduite entre 2019 et 2021 auprès de 57 participants : 29 AJA atteints de cancer, 17 mères, 9 pères et 3 membres de la fratrie. Des entretiens individuels semi-directifs ont été menés, retranscrits intégralement et soumis à une analyse thématique réflexive. L’approche mobilise une posture de chercheur en psychologie et s’appuie sur une lecture clinique psychanalytique.Résultats : L’analyse thématique réflexive a permis d’identifier cinq thèmes chez les AJA, cinq thèmes chez les parents et trois thèmes chez la fratrie. Les résultats mettent en évidence chez les AJA une confrontation précoce à la possibilité de la mort, un vécu corporel et psychique marqué par les traitements, ainsi qu’un besoin accru d’étayage parental. Chez les parents et la fratrie, les résultats décrivent une souffrance importante et mobilisation autour de l’AJA malade, marquée par des conduites d’aide et de soutien, participant à une réorganisation des relations et de la dynamique familiale.Conclusion : Cette étude met en lumière l’organisation de l’expérience du cancer chez les AJA au sein d’un système de contenants emboîtés, articulant les enveloppes psychiques individuelles, familiales et institutionnelles. Les résultats soulignent le rôle structurant de cette articulation pour soutenir la continuité psychique des jeunes et de leurs proches face à l’épreuve traumatique de la maladie
Adolescence, guerre, trauma : enjeux cliniques de l’interprétariat et perspectives psychothérapeutiques. A propos d’une adolescente ukrainienne en exil.
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Navigating Paradoxes in Sustainable SME Internationalization
No full textInternational audiencePurpose This study aims to investigate the role of sustainability in the internationalization strategies of small and medium-sized enterprises (SMEs). This study explores the paradoxes faced by SMEs aiming to balance social, environmental and economic goals. This study focuses on the tensions encountered by sustainability-oriented entrepreneurs in international markets. Design/methodology/approach The study uses an exploratory qualitative methodology, using semi-structured interviews with SME managers, consultants and support providers in France, providing in-depth insights into how different sustainability orientations influence international strategies, including market selection, entry modes and strategic planning organization. Findings The findings highlight various sustainability behaviors in entrepreneurs, ranging from one-dimensional focus to holistic approaches, which shape international CSR in SMEs. The study examines the tensions of balancing sustainability adoption with adaptation to international markets, highlighting how sustainability-oriented SMEs expand internationally and navigate these challenges. Research limitations/implications This study complements research on specific factors that contribute to the survival and international growth of sustainability-oriented firms, highlighting the behaviors of sustainability-driven SMEs and strategic outcomes. Limitations include a small sample size and a single cultural context. Future studies aimed at deepening our understanding will explore firms across industries and countries, including entrepreneurial cognition factors and longitudinal views. Originality/value Few studies combine Sustainable and International Entrepreneurship to examine SME internationalization. This research contributes to the emerging literature on responsible SME internationalization, offering new insights into how these SMEs strategically manage sustainability paradoxes