Bottlenecks in the provision of antenatal care: rural settled and mobile pastoralist communities in Chad.

OBJECTIVE: To assess antenatal care (ANC) coverage and analyse constraining factors for service delivery to rural settled and mobile populations in two districts in Chad. METHOD: Data from cross-sectional household and health facility surveys in the two Chadian rural health districts were analysed. First, contact coverage of ANC services in the study area was estimated from household data as the proportion of women who visited health facilities to obtain ANC during their last pregnancy. Second, bottlenecks in the provision of this service were explored by calibrating a multiplicative model of ANC contact coverage to household and health facility data. The model allowed quantification of the magnitude by which coverage decreased as it progressed through the health system. Sensitivity analysis was applied to account for uncertainty around the estimated coverage factors. RESULTS: Direct estimates revealed that ANC contact coverage decreased as the number of required visits increased: 79% of rural settled mothers and 46% of mobile pastoralist mothers visited a health facility to obtain ANC at least once (ANC 1). Among mobile pastoralists, only 20% of pregnant women attended ANC at least three times compared to 63% of rural settled women. Availability, accessibility, affordability and acceptability contributed to reductions in service coverage in both populations. For mobile pastoralists, acceptability was clearly the most important factor. ANC 1 contact coverage resulting from the model is 50% for rural settled and 30% for mobile pastoralists. CONCLUSION: Antenatal care coverage was low in rural districts of Chad, particularly for mobile pastoralists. Acceptability largely explained the prevailing difference between the two population groups.

[Food consumption in children and youth: effect of sedentary activities]. / Impact des activités sédentaires sur la prise alimentaire des jeunes.

Sedentary behavior has progressed with modern society, generating very low levels of energy expenditure and subsequent body weight disorders (obesity). There is also evidence that the absence of physical activity associated with short sleep time and watching television or playing video games leads to poor eating habits and favors high-energy intake. These findings have generally been reported in adults, with a few studies including data on children and adolescents. This brief review summarizes the current literature regarding the impact of such activities on food consumption and eating behavior in children and adolescents. There appears to be an uncoupling effect dissociating these activities from the sensation of hunger and thus energy intake. Children and adolescents seem to increase their energy intake during and after such activities without any alteration of their subjective appetite. In addition to considering the impact of sedentary behavior and physical activity level, future public health recommendations should also focus on associated nutritional adaptations (energy balance).

The influence of habitual breaks in sedentary time on cardiovagal baroreflex function.

Sedentary time has recently been included in the 24-h activity guidelines. However, the impact of habitual sedentary patterns on autonomic cardiovascular regulation are unclear. We tested the hypothesis that more sedentary time and fewer sedentary breaks were associated with lower cardiovagal baroreflex sensitivity. More frequent sedentary breaks, but not total sedentary time, was independently and positively associated with vagally mediated blood pressure control. Breaking up sedentary time could be more important than total sedentary time for cardiovascular health. Novelty: Breaks in sedentary time is an independent predictor of cardiovagal baroreflex sensitivity, with more frequent breaks associated with better vagally mediated blood pressure regulation.

[Effect of activities profile variations on health-related quality of life among breast cancer patients: Secondary exploratory analysis from PASAPAS study data]. / Effet de l'évolution du profil d'activité quotidienne sur la qualité de vie chez des femmes atteintes de cancers du sein : analyse exploratoire secondaire des données de l'étude PASAPAS.

INTRODUCTION: Lifestyle changes in breast cancer patients, by physical activity increasing, are becoming a main objective in supportive care. The objective of this study was to explore the impact of the daily activity profile evolution on the quality of life among this public. METHODS: Sixty patients (18 to 75 years) with non-metastatic breast cancer were randomized to a 2:1 ratio (physical activity intervention; control) in the PASAPAS randomized clinical trial. Multiple linear regression analyzes were computed to explain quality of life scores 6 months after the start of adjuvant therapy. Variables retained were the baseline quality of life scores, the anxiety trait, the randomization arm, the variations of time spent in different physical activity classes ([3-4 [MET, [4-6 [MET, ≥6 MET) and in sedentary behaviors. RESULTS: Only the decrease in time spent in sedentary behaviors really appeared as a predictor of the quality of physical life. Participation in the intervention group appeared as a predictor of quality of mental life. DISCUSSION: Results plead in favor of sedentary life style decrease as part of the objectives of care program for women with breast cancer. It also highlights the need of collective supervised sessions implemented by competent staff. This research also suggests that the dynamics of daily activity profile variations should be studied further in association to quality of life.

[Comparative study of repolarization in professional footballers and in sedentary black senegalese]. / Etude comparative de la repolarisation chez le footballeur de haut niveau et le sedentaire noirs senegalais.

The objective of this work is to study the EKG of Senegalese black football players in comparison with sedentary adults of the same age by focusing on repolarization.100 high-level football players and 50 Senegalese black sedentary adults have each had 12 classic recordings.The ST segment elevation or depression presented no significant difference between both groups. Without taking into account the amplitude of the T wave, the frequency of the negative T waves in each recording was significantly higher in the soccer player's than in the sedentary group.Early repolarization is more frequent in the sportsmen's compared to the sedentary but without significant statistical difference. As for the QTc interval, no significant difference between the two groups was noted.

L'objectif de ce travail est d'étudier l'ECG de footballeurs noirs sénégalais en comparaison avec des sédentaires de même âge en se focalisant sur la repolarisation.Cent footballeurs de haut niveau et 50 sédentaires noirs sénégalais ont bénéficié chacun d'un enregistrement de 12 dérivations classiques.Le segment ST sus décalé ou sous décalé ne présentait aucune différence significative chez les deux groupes.Sans tenir compte de l'amplitude de l'onde T, la fréquence des ondes T négatives dans chacune des dérivations était significativement plus élevée chez les footballeurs que chez les témoins.La repolarisation précoce est plus fréquente chez les sportifs par rapport aux sédentaires mais sans différence statistique significative. Quant à l'intervalle QT corrigé, nous n'avons pas noté de différence significative entre les deux groupes.