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1.
J Epidemiol Popul Health ; 72(2): 202380, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38574435

RESUMEN

BACKGROUND: The need for monitoring regularly physical fitness in youth is well established for public health issues. The aim of this study was to assess the validity and reliability of the International Fitness Scale questionnaire (IFIS) to assess physical fitness in French children in the school context. METHODS: A sample of 2 060 children (1054 boys), aged 10.6 ± 0.9 years, participated in the validation study while an independent sample of 366 children (175 boys), aged 9 to 11 years, participated in the assessment of reliability. Physical fitness was measured by a self-report of 5 questions with a 5-point Likert-scale (from very poor to very good) (IFIS), and also measured objectively by 4 field tests: cardiorespiratory fitness, muscular strength, speed/agility and flexibility. For the test-retest reliability assessment, children were instructed to complete the questionnaire twice, 1 week apart. RESULTS: For all physical fitness components studied, children reporting a good or a very good physical fitness in the IFIS had better results in objective measurements of physical fitness tests compared to children reporting a very poor to an average physical fitness (p<0.001) without or with adjustments for sex, age and weight status. The reliability coefficients were acceptable for all components of physical fitness (0.59-0.72). CONCLUSIONS: These results suggest that IFIS appears to be a useful instrument for teachers to estimate physical fitness levels of French children, possibly on a large scale.


Asunto(s)
Prueba de Esfuerzo , Aptitud Física , Adolescente , Niño , Humanos , Masculino , Capacidad Cardiovascular , Prueba de Esfuerzo/métodos , Fuerza Muscular , Reproducibilidad de los Resultados , Femenino
2.
J Surg Educ ; 81(2): 182-192, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38160113

RESUMEN

BACKGROUND: Surgical residents in France lack a clear pedagogical framework for achieving autonomy in the operating room. The progressive acquisition of surgical autonomy is a determining factor in the confidence of operators for their future independent practice. Currently, there is no autonomy scale commonly used in Europe. The objective of this study is to identify existing tools for quantifying the autonomy of residents and the factors that influence it. MATERIALS AND METHODS: We conducted a qualitative systematic review following the recommendations of the Systematic Review Without Meta-Analysis (SWiM) guidelines. Publications were extracted from the MEDLINE (PubMed), EMBASE, and PSYCINFO databases. All publications without date restrictions up to July 2022 were identified. RESULTS: Among the 231 identified publications, 21 met the inclusion criteria. Seventeen publications used a graded autonomy assessment tool by the student and/or the teacher, while 4 used evaluations by an observing third party. We found 8 different autonomy scales, with the Zwisch Scale representing 57.1% of the cases. Factors influencing autonomy were diverse, including the work context, experience, and gender of the resident and their teacher. DISCUSSION: We found heterogeneity in the tools used to "measure" the autonomy of a resident in the operating room. The SIMPL tool or the Zwisch Scale appear to be the most frequently used tools. The relationship between autonomy, performance, confidence, and knowledge may require multidimensional tools that encompass various areas of competence, but this could make their daily application more challenging. The factors influencing autonomy are numerous; and understanding them would improve teaching in the operating room. There is a significant lack of data on surgical autonomy in France, as well as a lack of evaluation in the field of gynecology-obstetrics worldwide.


Asunto(s)
Internado y Residencia , Quirófanos , Autonomía Profesional , Humanos , Competencia Clínica , Cirugía General/educación , Procesos Mentales
3.
Gait Posture ; 107: 155-161, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-37781901

RESUMEN

BACKGROUND: Using a machine learning algorithm, individuals can be accurately identified from their muscle activation patterns during gait, leading to the concept of individual muscle activation signatures. RESEARCH QUESTION: Are muscle activation signatures robust across different walking speeds? METHODS: We used an open dataset containing electromyographic (EMG) signals from 8 lower limb muscles in 50 asymptomatic adults walking at 5 speeds (extremely slow, very slow, slow, spontaneous, and fast). A machine learning approach classified the EMG profiles based on similar (intra-speed classification) or different (inter-speed classification) walking speeds as training and testing conditions. RESULTS: Intra-speed median classification rates of muscle activation profiles increased with walking speed, from 92 % for extremely slow, to 100 % for self-selected fast walking conditions. Inter-speed median classification rates increased when the speed of the training condition was closer to that of the testing condition. Higher median classification rates were found across slow, spontaneous, and fast walking speed conditions, from 56 % to 96 %, compared with classification rates involving extremely and very slow walking speed conditions, from 6 % to 62 %. SIGNIFICANCE: Our findings reveal that i) muscle activation signatures are detectable for a large range of walking speeds, even those involving different gait strategies (intra-speed median classification rates from 92 % to 100 %), and ii) muscle activation signatures observed during very low walking speeds are not consistent with those observed at higher speeds, suggesting a difference in motor control strategy. Caution should therefore be exercised when assessing gait deviations of a slow walking patient against a normative database obtained at higher speed. Identifying the robustness of individual muscle activation signatures across different movements could help in detecting changes in motor control, otherwise difficult to detect on classical time-varying EMG patterns.


Asunto(s)
Músculo Esquelético , Velocidad al Caminar , Adulto , Humanos , Músculo Esquelético/fisiología , Electromiografía , Marcha/fisiología , Caminata/fisiología
4.
Psychol Sport Exerc ; 67: 102410, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37665871

RESUMEN

This study investigated associations between executive functions (i.e., inhibition, working memory, cognitive flexibility) and individual differences in self-control and health behaviors. We examined whether executive functions predict physical activity, sedentary activity, and healthy and unhealthy diets, and whether trait self-control and self-control resources mediate these associations. Three hundred and eighty-five participants completed a questionnaire assessing trait self-control and self-control resources, physical activity, sedentary activity, and healthy and unhealthy diets. They also performed three randomly ordered cognitive tasks, a stop-signal task (i.e., inhibition), a letter memory task (i.e., updating), and a number-letter task (i.e., switching). Structural equation modeling revealed that self-control resources predicted positively physical activity (R2 = 0.08), negatively sedentary activity (R2 = 0.03) and positively healthy diet (R2 = 10). Moreover, trait self-control predicted positively healthy diet (R2 = 0.10) and negatively unhealthy diet (R2 = 0.19). Moreover, analyses revealed that switching significantly predicted self-control resources, and highlighted three totally mediated relations between this executive function and physical activity, sedentary activity and healthy diet. However, no evidence was found supporting associations between inhibition and updating, and health behaviors, or relations mediated by self-control for these executive functions. The findings suggest the importance of trait self-control and self-control resources for health behavior adoption and pave the way for studies exploring the role of the executive functions in an affective context. Open materials [https://osf.io/hpsjw/].


Asunto(s)
Función Ejecutiva , Autocontrol , Humanos , Conductas Relacionadas con la Salud , Ejercicio Físico , Memoria a Corto Plazo
5.
J ECT ; 39(4): 255-262, 2023 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-37310091

RESUMEN

OBJECTIVE: Electroconvulsive therapy (ECT) is an effective treatment for patients experiencing a major depressive episode, especially older ones. Identification of specific responses within early ECT sessions remains an issue of debate, however. Hence, this pilot study prospectively examined the outcome in terms of depressive signs, symptom by symptom, throughout a course of ECT, concentrating particularly on psychomotor retardation symptoms. METHODS: Nine patients were clinically evaluated several times during the ECT course, before the first session and then weekly (over 3-6 weeks, according to their evolution), by completing the Montgomery-Åsberg Depression Rating Scale (MADRS), the Mini-Mental State Examination test, and the French Retardation Rating Scale for Depression for assessing the severity of psychomotor retardation. RESULTS: Nonparametric Friedman tests showed significant positive changes in mood disorders during ECT in older depressive patients (mean, -27.3% of initial MADRS total score). Fast improvement in French Retardation Rating Scale for Depression score was observed at t1 (ie, after 3-4 ECT sessions), whereas a slightly delayed improvement in the MADRS scores was found at t2 (ie, after 5-6 ECT sessions). Moreover, the scores for items linked to the motor component of psychomotor retardation (eg, gait, postural control, fatigability) were the first to significantly decrease during the first 2 weeks of the ECT course compared with the cognitive component. CONCLUSIONS: Interestingly, participants' concentration on daily functional activities, their interest and fatigability, and their reported state of sadness were the first to progress, representing possible precursor signs of positive patient outcomes after ECT.


Asunto(s)
Trastorno Depresivo Mayor , Terapia Electroconvulsiva , Humanos , Anciano , Terapia Electroconvulsiva/efectos adversos , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Mayor/psicología , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento
7.
J Sports Med Phys Fitness ; 63(6): 697-706, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36800688

RESUMEN

BACKGROUND: The main objective of this study was to assess the association between age and physical fitness and motor fitness components according to BMI levels, in men and women separately, and to test if this association is different between BMI levels. METHODS: This cross-sectional study was based on a pre-existing database from the DiagnoHealth battery, a French series of physical fitness and motor fitness tests designed by the Institut des Rencontres de la Forme (IRFO; Wattignies, France). Analyses were perfomed on 6830 women (65.8%) and 3356 men (34.2%) aged from 50 to 80 years. In this French series several physical fitness and motor fitness components were measured: cardiorespiratory fitness (CRF), speed, upper muscular endurance, lower muscular endurance, lower body muscular strengh, agility, balance, and flexibility. From the results of these tests, a specific score named Quotient of Physical Condition was calculated. Associations between age and physical fitness and motor fitness components according to BMI levels were modelized using linear regression for quantitative components, and ordinal logistic regression for ordinal components. Analyses were performed separately for women and men. RESULTS: A significant association of age with physical fitness and motor fitness performance in each BMI levels were observed in women except for lower muscular endurance, muscular strength and flexibility in obese women. A significant association of age with physical fitness and motor fitness performance in each BMI levels were observed in men except for upper/lower muscular endurance and flexibility in obese men. CONCLUSIONS: The present results shown that most of physical fitness and motor fitness decrease with age in women and men. Lower muscular endurance, muscular strength and flexibility did not change in obese women, thereas upper/lower muscular endurance and flexibility did not change in obese men. This finding is particularly revelant for guiding prevention strategies for maintaining physical fitness and motor fitness performance, which is one of the most important component of healthy aging and wellbeing.


Asunto(s)
Capacidad Cardiovascular , Aptitud Física , Masculino , Humanos , Femenino , Índice de Masa Corporal , Estudios Transversales , Fuerza Muscular , Obesidad
8.
Aging Clin Exp Res ; 35(1): 101-106, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36269549

RESUMEN

BACKGROUND: Little is known about the association between executive function and the magnitude of improvement from personalised exercise interventions on gait performance among older-old adults. AIM: We examined whether the effectiveness of personalised intervention on gait performance is dependent on the patient's baseline dysexecutive syndrome, as assessed by the Frontal Assessment Battery. METHODS: A total of 175 older community-dwellers (83.57 ± 5.2 years; 70.2% female) were recruited from the day centre for after-care and rehabilitation in the Nantes Ambulatory Centre of the Clinical Gerontology (France), and were followed during a pre-post-intervention, single-arm retrospective design. The intervention consisted of an individual personalised rehabilitation program over a period of 7 weeks, with twice-weekly sessions (45 min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), Timed Up and Go test, and handgrip strength test were assessed. RESULTS: Using a pre-post analysis of covariance, a significant increase in dual-task gait speed while counting (+ 0.10 m/s; + 15%) and in dual-fluency gait speed (+ 0.06 m/s; + 10%), and in Timed Up and Go performance (- 2.9 s; + 17.8%) was observed after the rehabilitation program, regardless the baseline executive status. DISCUSSION: An individual personalized intervention is effective to improve mobility performance and the dual-task gait speed in older-old adults. The magnitude of those effects is independent of the patient's baseline characteristics including the executive function status. CONCLUSIONS: Even the most deficient baseline characteristics of patients should not be viewed as clinical barrier for implementing a beneficial individual intervention in high-risk older adults.


Asunto(s)
Fuerza de la Mano , Equilibrio Postural , Humanos , Femenino , Anciano , Masculino , Estudios Retrospectivos , Terapia por Ejercicio , Estudios de Tiempo y Movimiento , Marcha
9.
J Clin Med ; 11(24)2022 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-36556056

RESUMEN

Walk speed measured under dual-task conditions (neurocognitive tasks) could reflect patient performance in real-life. Rehabilitation programs are effective in increasing walk speed, but few studies have evaluated the associations between geriatric factors and rehabilitation efficacy under dual-task conditions. Our objective was to investigate the association between geriatric factors and an increase in dual-task walk speed (threshold of 0.1 m/s), after a multidisciplinary rehabilitation program. We performed a retrospective cohort study that included patients aged 75 years and over, who underwent a complete rehabilitation program and who had a neurocognitive assessment at baseline. The primary outcome was the increase in the dual-task (fluency verbal task) walking speed between pre- and post-rehabilitation assessments. In this study, 145 patients were included, with a mean age of 83.6 years old. After rehabilitation, dual-task walk speed increase in 62 (43%) patients. In multivariate analysis, the following factors were associated with an increase in dual-task walk speed: IADL (OR 2.50, 95% CI [1.26; 4.94], p = 0.009), vitamin D level (OR 0.83, 95% CI [0.72; 0.95], p = 0.008), severe sarcopenia (OR 0.00, 95% CI [0.00; 0.32], p = 0.016), depression (OR 15.85, 95% CI [1.32; 190.40], p = 0.029), number of drugs (OR 1.41, 95% CI [1.04; 1.92], p = 0.027), initial dual-fluency walk speed (OR 0.92, 95% CI [0.86; 0.98], p = 0.014) and time interval between initial and final assessments (OR 0.98, 95% CI [0.96; 1.00], p = 0.06). Identifying patients that are less resilient to rehabilitation may promote a centered-patient approach for an individualized and optimized rehabilitation care.

10.
Eur J Pediatr ; 181(11): 3955-3963, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36098850

RESUMEN

Numerous studies reported a significant decline in physical activity level in adolescents as a result of the COVID-19 lockdown. Physical fitness is recognized as a powerful marker of health in youth. The aim of this study was to evaluate the impact of the COVID-19 pandemic lockdown on health-related physical fitness in French adolescents. Two cross-sectional studies were performed comparing two different groups of French adolescents, before (sample 1) and after the first lockdown (sample 2). A total of 1231 adolescents (aged to 16.5 ± 1.5 years) participated in the two cross-sectional studies. Complete data for physical fitness and anthropometrics data were obtained. Adolescents from sample 2 showed lower physical fitness levels compared to adolescents from sample 1. Regarding physical fitness for boys and girls, physical fitness levels were significantly lower in both sex between adolescents from the sample 1 and adolescents from the sample 2, except for cardiorespiratory fitness and flexibility for boys and girls, respectively. The physical fitness global score was also significantly lower between adolescents from the sample 1 and 2 for boys (-9.8%, p < 0.01) and girls (-16.2%; p < 0.01), respectively. Overall, the higher difference was found for performance in the speed body displacement test (-30%). A difference of 12.8% and 25% was observed for boys and girls, respectively.   Conclusion: COVID-19 pandemic lockdown had a negative impact on physical fitness in French youth. This study highlights the need to develop, in a near future, prevention programmes in order to improve the physical fitness in youth. What is Known: • COVID-19 pandemic deeply impacted lifestyle habits. A worrying decrease of physical activity, associated to a dramatic increase of time spent in sedentary behaviors was found in many coutries. What is New: • Our study bring first data on the health-related physical fitness consequences due to lockdown in French adolescents. Our study demonstrate the negative impact of COVID-19 pandemic lockdown on health-related physical fitness in French adolescents.


Asunto(s)
COVID-19 , Adolescente , Anciano , COVID-19/epidemiología , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Estudios Transversales , Femenino , Humanos , Masculino , Pandemias , Aptitud Física
11.
BMC Res Notes ; 15(1): 208, 2022 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-35706045

RESUMEN

OBJECTIVE: Because the prevalence overweight and obesity remains high during adolescence in Europe, tracking weight status in children and adolescents is needed. We aimed to estimate French trends in the prevalence of weight status in children and adolescent from 2008 to 2018. RESULTS: The prevalence of overweight and obesity were higher in boys (P < 0.0001). Underweight was more prevalent in girls (P < 0.0001). In adolescents aged 16-17 years old, a stabilization was observed for overweight and obesity whereas the prevalence of underweight increased significantly in boys (P < 0.0001). For children and adolescents aged to 10-12 and 13-15 years old, the obesity and overweight decreased significantly while the underweight was increased for both sexes aged 10-12 years (P < 0.0001). Underweight increased in boys aged 13-15 years (P < 0.0001) while that a stagnation was observed in girls. These encouraging results show the permanent need to develop preventive strategies promoting an healthy active living in order to modify the lifestyle for adolescents with underweight, overweight or obesity.


Asunto(s)
Sobrepeso , Delgadez , Adolescente , Índice de Masa Corporal , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad/epidemiología , Sobrepeso/epidemiología , Prevalencia , Delgadez/epidemiología
12.
Brain Stimul ; 15(3): 870-880, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35609816

RESUMEN

BACKGROUND: Recently intermittent theta burst stimulation (iTBS) proved to be non-inferior to conventional repetitive transcranial magnetic stimulation (10 Hz rTMS) in unipolar depression after failure of one antidepressant trial, but to date no randomized control trial assessed the ability of iTBS to improve depression level and quality of life in more resistant features of depression with a long-term (6 month) follow-up in comparison to 10 Hz rTMS. OBJECTIVES/HYPOTHESIS: The aim of our study was to compare the efficacy of 10 Hz rTMS and iTBS in treatment-resistant unipolar depression on response rates (50% decrease of MADRS scores at one month from baseline) and change in quality of life during a 6-month follow-up. In addition, we investigated whether some clinical features at baseline were associated with the response in the different groups. METHOD: Sixty patients were randomized in a double-blind, controlled study at the University Hospital Center of Nantes, and received 20 sessions of either rTMS or iTBS applied to the left dorsolateral prefrontal cortex targeted by neuronavigation. Statistical analysis used Fischer's exact test and Chi-square test as appropriate, linear mixed model, and logistic regression (occurrence of depressive relapse and factors associated with the therapeutic response). RESULTS: Included patients showed in mean more than 3 antidepressants trials. Response rates were 36.7% and 33.3%, and remission rates were 18.5% and 14.8%, in the iTBS and 10 Hz rTMS groups respectively. Both groups showed a similar significant reduction in depression scores and quality of life improvement at 6 months. We did not find any clinical predictive factor of therapeutic response in this sample. CONCLUSION: Our study suggests the clinical interest of iTBS stimulation (which is more time saving and cost-effective as conventional rTMS) to provide long-lasting improvement of depression and quality of life in highly resistant unipolar depression.


Asunto(s)
Trastorno Depresivo Mayor , Estimulación Magnética Transcraneal , Antidepresivos , Trastorno Depresivo Mayor/terapia , Método Doble Ciego , Humanos , Corteza Prefrontal/fisiología , Calidad de Vida , Resultado del Tratamiento
14.
J Sports Med Phys Fitness ; 62(3): 404-411, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33687178

RESUMEN

BACKGROUND: While academic achievement has been associated with physical activity, the present work questions the potential association between the physical fitness level of adolescents and the type of school they attend, ranging from academic to technical schools. METHODS: The Diagnoform© Test was performed by 20,228 young French students from 76 schools (9196 females), mean age 15.8±1.8 years. This dataset includes two higher education institutions (N.=870), 37 general high schools (N.=13,125), 18 professional-oriented high schools (N.=3569), 5 agricultural high schools (N.=132), 2 vocational training centers (N.=202) and 12 rural vocational training centers (N.=1137). RESULTS: In higher education institutions and general high schools, girls showed better performances for all physical tests. A decreasing Quotient of overall Physical fitness Condition (QPC) was observed for both genders from urban higher education schools to rural and technical institutions (P<0.001). The proportion of total variance accounting for within institution variation is strong (intra-class correlation coefficients [ICC] 0.20 [0.15; 0.27] for QPC). CONCLUSIONS: The lower physical fitness level observed here among students from technical or training schools places them at higher risks for the development of future chronic diseases. These results suggest that specific interventions are needed depending on the educational setting.


Asunto(s)
Aptitud Física , Instituciones Académicas , Adolescente , Estudios Transversales , Ejercicio Físico , Femenino , Humanos , Masculino , Estudiantes
15.
Aging Clin Exp Res ; 33(10): 2821-2830, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33625687

RESUMEN

BACKGROUND: Studies have shown benefits of exercise interventions on preferred and fast gait speed in healthy older adults, but the impact of a personalised rehabilitation program targeting a large cohort of non-disabled older-old adults has rarely been examined. AIMS: The purpose was to determine whether personalised intervention-related improvements in gait and mobility performance in older-old adults were dependent on cognitive status and/or history of falls. METHODS: Based on a pre-post design, 483 older-old persons (mean age: 83.3 ± 5.1 years) were followed during a personalised rehabilitation program over a period of 7 weeks, with twice-weekly sessions (45 min each). Gait speed in four conditions (preferred, fast, and under two dual-task conditions), static postural sway, Timed Up and Go test, Five Times Sit to Stand test, the ability to rise from the floor, and handgrip strength test were assessed. RESULTS: Using a pre-post analysis of covariance, a significant increase in preferred gait speed (+ 20.1%), fast gait speed (+ 15.8%), and dual-task speed while counting (+ 13.4%) was observed after the rehabilitation, regardless of the baseline cognitive status and fall history. Similar improvements in TUG and maximal handgrip force were observed, with a significant reduction of performance time (-19.5%) or an increase of handgrip strength (+ 6.2%). DISCUSSION: Results suggest the effectiveness of personalised intervention to improve a battery of physical performance measures in older-old adults, even for the frailest participants. CONCLUSION: Implementing a personalised intervention for targeting the high-risk older-old adults in priority is critical regarding the clinically meaningful change in gait speed.


Asunto(s)
Fuerza de la Mano , Equilibrio Postural , Accidentes por Caídas/prevención & control , Anciano , Anciano de 80 o más Años , Terapia por Ejercicio , Marcha , Humanos , Estudios de Tiempo y Movimiento
16.
Cogn Process ; 22(2): 291-298, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33125609

RESUMEN

Some studies have suggested that postural balance improved after a single session of transcranial direct current stimulation (tDCS), whereas others have found minimal, if any, effects on postural performance. To address the issue of replication in tDCS studies, we re-tested the anodal tDCS effects of left dorsolateral prefrontal cortex while performing a dual-task by increasing the attentional demands associated with more challenging proprioceptive conditions. Twenty-four young adults (mean age: 21.3 ± 1.2 years) were randomly divided into two groups (a "real tDCS" vs. a "sham tDCS" group) were asked to maintain a quiet stance on a force platform. Eight trials were conducted, with eyes open and eyes closed, standing on a firm and foam surface and performing a simple and dual-task (backward counting). The postural performance was assessed by various centre-of-pressure parameters before and immediately after a 20-min tDCS session. No main effect of group and no interaction considering this factor were observed, regardless of the centre-of-pressure variables (all p values > 0.1). No evidence of a more efficient postural control emerged after a tDCS session. Beyond promising research on tDCS to maximize cognitive and behavioural enhancement, the current results indicate that caution needs to be taken when drawing firm conclusions, at least in young healthy adults.


Asunto(s)
Estimulación Transcraneal de Corriente Directa , Adulto , Humanos , Equilibrio Postural , Corteza Prefrontal , Adulto Joven
17.
Public Health Nutr ; 23(14): 2478-2484, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32456740

RESUMEN

OBJECTIVE: To assess the prevalence of underweight, overweight and obesity in French children from 2013 to 2017. DESIGN: Cross-sectional study performed in fourteen regions of France. Physical measures included weight, height and BMI. Underweight, overweight and obesity were defined according to age- and sex-specific BMI cut-off points from the International Obesity Task Force. SETTING: France. SUBJECTS: Children (10 159 boys, 9757 girls) from the voluntary, non-representative Diagnoform programme between 2013 and 2017, at the age of 4-12 years. RESULTS: The prevalence of overweight and obesity was higher in girls compared with boys (P < 0·001). Underweight was also more prevalent in girls (P < 0·05). Although there were no significant changes in the prevalence of obesity in boys or girls from 2013 to 2017, a significant decrease in overweight among boys and girls was found (P < 0·001) during the same time period. In contrast, the prevalence of underweight increased in girls and boys (from 10·0 to 20·0 %, P < 0·0001) between 2013 and 2017. CONCLUSIONS: Results of the current study show that the prevalence of obesity was stable, while the prevalence of overweight decreased significantly, despite high in French children. Findings suggest also that thinness is becoming an important phenomenon in children. Developing preventive and nutritional programmes in order to modify the lifestyle might help control underweight and obesity in children.


Asunto(s)
Sobrepeso , Obesidad Infantil , Delgadez , Índice de Masa Corporal , Niño , Preescolar , Estudios Transversales , Femenino , Francia/epidemiología , Humanos , Masculino , Sobrepeso/epidemiología , Obesidad Infantil/epidemiología , Prevalencia , Delgadez/epidemiología
18.
BMJ Open ; 10(1): e033376, 2020 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-31937653

RESUMEN

INTRODUCTION: Depression is among the most widespread psychiatric disorders in France. Psychiatric disorders are associated with considerable social costs, amounting to €22.6 billion for treatment and psychotropic medication in 2011. Treatment as usual (TAU), mainly consisting of pharmacotherapy and psychotherapy, is effective for only a third of patients and in most cases fails to prevent treatment resistance and chronicity. Transcranial direct current stimulation (tDCS) consists in a non-invasive and painless application of low-intensity electric current to the cerebral cortex through the scalp. Having proved effective in depressed patients, it could be used in combination with TAU to great advantage. The objective is to compare, for the first time ever, the cost-utility of tDCS-TAU and of TAU alone for the treatment of a depressive episode that has been refractory to one or two drug treatments. METHODS AND ANALYSIS: This paper, based on the DISCO study protocol, focuses on the design of a prospective, randomised, controlled, open-label multicentre economic study to be conducted in France. It will include 214 patients with unipolar or bipolar depression, assigning them to two parallel arms: group A (tDCS-TAU) and group B (TAU alone). The primary outcome is the incremental cost-effectiveness ratio, that is, the ratio of the difference in cost between each strategy to the difference in their effects. Their effects will be expressed as numbers of quality-adjusted life-years, determined through administration of the EuroQol Five-Dimension questionnaire over a 12-month period to patients (EQ-5D-5L). Expected benefits are the reduction of treatment resistance and suicidal ideation as well as social and professional costs of depression. Should depression-related costs fall significantly, tDCS might be considered an efficient treatment for depression. ETHICS AND DISSEMINATION: This protocol has been approved by a French ethics committee, the CPP--Est IV (Comité de Protection des Personnes-Strasbourg). Data are to be published in peer-reviewed medical journals. TRIAL REGISTRATION NUMBER: RCB 2018-A00474-51; NCT03758105.


Asunto(s)
Depresión/terapia , Estimulación Transcraneal de Corriente Directa/economía , Adulto , Análisis Costo-Beneficio , Depresión/economía , Inglaterra , Femenino , Estudios de Seguimiento , Humanos , Masculino , Estudios Prospectivos , Años de Vida Ajustados por Calidad de Vida
19.
J Gerontol B Psychol Sci Soc Sci ; 75(9): 1921-1929, 2020 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-31074828

RESUMEN

OBJECTIVES: We investigated whether performing step initiation during a proprioceptive perturbation would require greater perceptual or motor inhibitory control in older adults. METHOD: Fifty-two healthy adults (young: n = 26, mean age 22.5 years vs. older: n = 26, mean age 70.1 years) performed a stepping reaction time task, with different inhibition requirements (i.e., perceptual vs. motor inhibitory conflict), with two proprioceptive configurations: with and without application of Achilles tendon vibrations. RESULTS: Beyond a systematically greater stepping reaction time in older adults (p < .01), no difference was found between the perceptual versus motor inhibitory conflict resolution, regardless of age and proprioceptive configuration. Furthermore, slower reaction time was observed for young participants in the presence of Achilles tendon vibrations unlike older adults, who showed the same reactive stepping performance with or without vibrations (p < .05). DISCUSSION: These findings show that perceptual inhibition cannot be considered as specifically involved in the central processing of proprioceptive signals, at least not in active older adults. Rather than motor system malfunctioning or a reduced amount of proprioceptive afference, we propose that cortical-proprioceptive processing in older adults remains as effective as in young adults, regardless of the high attentional requirements for step responses.


Asunto(s)
Envejecimiento , Cognición , Inhibición Psicológica , Equilibrio Postural , Propiocepción , Tendón Calcáneo/fisiología , Anciano , Envejecimiento/fisiología , Envejecimiento/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Percepción , Desempeño Psicomotor , Tiempo de Reacción , Vibración
20.
Scand J Med Sci Sports ; 30(4): 690-699, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31778590

RESUMEN

The primary objective of this study was to establish sex- and age-specific physical fitness percentiles for French children. The secondary aim was to assess sex, weight status, and age differences for physical fitness levels in French children. A sample of 31 484 children (16 023 boys, 15 461 girls) aged 6-11 years participated in the Diagnoform programme. Cardiorespiratory fitness, muscular endurance, speed, flexibility, and agility were assessed in this national programme. Percentile values were estimated as a function of age stratified by sex using a parametric method providing smooth centile curves and explicit formulae for the centile estimates. Values from the 10th to the 90th percentile are reported. The influence of body weight according to sex on the physical fitness level was also examined using an analysis of covariance adjusted for age. Physical fitness levels were slightly better in boys, except for agility and flexibility, in which girls performed better (Cohen's coefficient, 0.20-0.45; P < .001). All physical fitness tests were significantly associated with age (P < .0001). In general, overweight and obese children had a significantly poorer physical fitness level compared with their normal-weight counterparts (P < .05). No difference was found between thin and normal-weight boys and girls, except for agility (P < .05). Reference values provide normative data for French children, and these data should be useful for identifying special needs for appropriate intervention programmes.


Asunto(s)
Capacidad Cardiovascular , Prueba de Esfuerzo/métodos , Fuerza Muscular , Rango del Movimiento Articular , Factores de Edad , Niño , Femenino , Francia , Voluntarios Sanos , Humanos , Masculino , Valores de Referencia , Factores Sexuales
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