Health professionals and the early detection of head and neck cancers: a population-based study in a high incidence area.

BACKGROUND: In the context of early detection of head and neck cancers (HNC), the aim of this study was to describe how people sought medical consultation during the year prior to diagnosis and the impact on the stage of the cancer. METHODS: Patients over 20 years old with a diagnosis of HNC in 2010 were included from four French cancer registries. The medical data were matched with data regarding uptake of healthcare issued from French National Health Insurance General Regime. RESULTS: In 86.0 % of cases, patients had consulted a general practitioner (GP) and 21.1 % a dentist. Consulting a GP at least once during the year preceding diagnosis was unrelated to Charlson index, age, sex, département, quintile of deprivation of place of residence. Patients from the 'quite privileged', 'quite underprivileged' and 'underprivileged' quintiles consulted a dentist more frequently than those from the 'very underprivileged' quintile (p = 0.007). The stage was less advanced for patients who had consulted a GP (OR = 0.42 [0.18-0.99]) - with a dose-response effect. CONCLUSIONS: In view of the frequency of consultations, the existence of a significant association between consultations and a localised stage at diagnosis and the absence of a socio-economic association, early detection of HNC by GPs would seem to be the most appropriate way.

[Prescription of psychotropic medicines to pregnant women in Nord-Pas-de-Calais, France]. / La prescription de psychotropes durant la grossesse dans le Nord-Pas-de-Calais.

AIM: Prescription of psychotropic medicines carries risks to pregnancy. It is therefore appropriate to measure the prescription rate of these compounds in pregnant women. METHOD: We studied the prescription rate for psychotropic agents to pregnant women from the Cnamts medicines reimbursement data and we compared this to prescriptions in non-pregnant women in the same age group. RESULTS: There is a fall in the use of psychotropic agents in women during pregnancy compared to a non-pregnant population of the same age. Pregnant women receive 2.17 times less psychotropic agents. Nevertheless, approximately one out of every twenty women is prescribed a proprietary product with known risk to the neonate and four out of a thousand are prescribed a proprietary product which carries a risk of malformation during the first trimester. CONCLUSION: Medical practice takes account of embryo-fetal risk in prescribing psychotropic agents in general although more communication is needed about the risk of some compounds during pregnancy.

DIVIS: a semantic DIstance to improve the VISualisation of heterogeneous phenotypic datasets.

BACKGROUND: Thanks to the wider spread of high-throughput experimental techniques, biologists are accumulating large amounts of datasets which often mix quantitative and qualitative variables and are not always complete, in particular when they regard phenotypic traits. In order to get a first insight into these datasets and reduce the data matrices size scientists often rely on multivariate analysis techniques. However such approaches are not always easily practicable in particular when faced with mixed datasets. Moreover displaying large numbers of individuals leads to cluttered visualisations which are difficult to interpret. RESULTS: We introduced a new methodology to overcome these limits. Its main feature is a new semantic distance tailored for both quantitative and qualitative variables which allows for a realistic representation of the relationships between individuals (phenotypic descriptions in our case). This semantic distance is based on ontologies which are engineered to represent real-life knowledge regarding the underlying variables. For easier handling by biologists, we incorporated its use into a complete tool, from raw data file to visualisation. Following the distance calculation, the next steps performed by the tool consist in (i) grouping similar individuals, (ii) representing each group by emblematic individuals we call archetypes and (iii) building sparse visualisations based on these archetypes. Our approach was implemented as a Python pipeline and applied to a rosebush dataset including passport and phenotypic data. CONCLUSIONS: The introduction of our new semantic distance and of the archetype concept allowed us to build a comprehensive representation of an incomplete dataset characterised by a large proportion of qualitative data. The methodology described here could have wider use beyond information characterizing organisms or species and beyond plant science. Indeed we could apply the same approach to any mixed dataset.

Experiencing a significant win and its sociodemographic and motivational predictors: A comparative analysis of pure-chance gamblers from Poland and France.

Research on the relationship between wins and gambling behavior often focuses on winning considerably large amounts of money. It seems, however, that it is not the amount of the win, but the significance that the player assigns to the win, that exerts a decisive influence on gambling behavior. Therefore, in this study we adopted the concept of significant win: a win perceived by gamblers as important to them. The research aimed to discover what kind of wins are experienced as significant and what factors explain experiencing wins as significant. This study, conducted in Poland (N = 3,143) and France (N = 5,692), also had a comparative goal: discovering intercultural differences in experiencing significant wins. A computer-assisted web survey was administered to gamblers who engaged in pure-chance gambling, where the participant does not influence the outcome of the gamble after the initial bet is placed-selected from representative samples in both countries. We used logistic regression models to examine predictors of significant win experience in both countries and the differences between the countries. The results demonstrated that Polish gamblers more frequently considered a win significant when it was accompanied by strong, often negative emotions and was higher in monetary value normalized in terms of average monthly personal income, than French gamblers. French gamblers more frequently associated a significant win with a positive experience. The common predictors of a significant win experience in both countries were: being in debt, experiencing the win of a close person, gambling in a game of pure chance other than lotteries, more systematic pursuit of gambling, self-enhancement motivation, and coping motivation to gamble. Age at initiation into gambling was a significant predictor only in the French sample, whereas a financial motivation was a significant predictor in the Polish one. The results confirmed that the subjective perception of gambling wins is only partially related to the amounts of wins, which has practical implications for planning prevention strategies.

[Recourse to psychotropic medication in the Nord - Pas-de-Calais Region (France)]. / Le recours aux médicaments psychotropes dans le Nord - Pas-de-Calais (France).

The prescriptions for psychoactive drugs presented to the Health Insurance system for reimbursement of charges are a source of information about some psychological illnesses and disorders in the context of the overuse of these drugs in France. In Nord - Pas-de-Calais Region, out of a total of 5 070 160 prescriptions in 2007, 576 493 individuals benefited from at least one such drug. Over the period of the study, 15.6% of the population of the region covered took at least one psychotropic medication. The rate of use was 11.7% for benzodiazepines, 7.6% for anti-depressants, 1.8% for anti-psychotics, 0.5% for treatment of alcohol dependence and 0.3% for opiate substitution therapy (OST). For the first three of these classes rate of use increased steadily with age. It was invariably much higher in women than in men. Men were treated more frequently for alcoholism and heroin dependency; the proportion taking medication initially increased with age (up to 40-49 years for alcohol dependency and 30-39 years for OST), before falling thereafter.

[Influential factors in regular and intensive use of psychoactive drugs]. / Les facteurs qui influencent la consommation intensive et régulière de médicaments psychotropes.

The article attempts to construct a typology to the use of psychoactive drugs and the study of the various factors linked to their use, whether heavy or regular. The results draw on the exploitation of databases containing medicines presented for reimbursement by medical insurance in the Nord - Pas-de-Calais region. In 2007 and 2008, 20.7% of the insured population (764,650 people) benefited from reimbursements for this type of medication. Among the beneficiaries, about a third (30.5%) had an intense consummation. Age, the CMUs benefits and the fact that a person is or not followed by a psychiatrist are the most influential variables on the intensity and the regularity of intake. The observed regularity of the recourse to benzodiazepines does not conform with the current recommendations.