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1.
Eur J Pediatr ; 182(3): 1019-1028, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36542162

RESUMO

Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries, but its determinants are poorly understood. Their identification is necessary to design target actions that can improve vaccination uptake. Our aim was to assess the determinants of incomplete vaccination in two-year-old children in France. Among the 18,329 children included in the 2011 ELFE French nationwide population-based birth cohort, we selected those for whom vaccination status was available at age two years. Incomplete vaccination was defined as ≥ 1 missing dose of recommended vaccines. Potential determinants of incomplete vaccination were identified by using logistic regression, taking into account attrition and missing data. Of the 5,740 (31.3%) children analyzed, 46.5% (95% confidence interval [CI] 44.7-48.0) were incompletely vaccinated. Factors independently associated with incomplete vaccination were having older siblings (adjusted odds ratio 1.18, 95% CI [1.03-1.34] and 1.28 [1.06-1.54] for one and ≥ 2 siblings, respectively, vs. 0), residing in an isolated area (1.92 [1.36-2.75] vs. an urban area), parents not following health recommendations or using alternative medicines (1.81 [1.41-2.34] and 1.23 [1.04-1.46], respectively, vs. parents confident in institutions and following heath recommendations), not being visited by a maternal and child protection service nurse during the child's first two months (1.19 [1.03-1.38] vs. ≥ 1 visit), and being followed by a general practitioner (2.87 [2.52-3.26] vs. a pediatrician). CONCLUSIONS: Incomplete vaccination was highly prevalent in the studied pediatric population and was associated with several socio-demographic, parental, and healthcare service characteristics. These findings may help in designing targeted corrective actions. WHAT IS KNOWN: • Incomplete vaccination in the pediatric population is a growing public health issue in high-income countries. • The partial understanding of the determinants of incomplete vaccination precludes the design of effective targeted corrective actions. WHAT IS NEW: • High prevalence of incomplete vaccination at age two years in France. • Incomplete vaccination was independently associated with several socio-demographic, parental, and healthcare service characteristics.


Assuntos
Coorte de Nascimento , Vacinação , Criança , Humanos , Pré-Escolar , Pais , Família , França
2.
Reprod Biomed Online ; 32(6): 626-34, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27068240

RESUMO

To assess the impact of endometriosis on obstetric outcomes and to determine whether the severity, location and surgical treatment of the disease before the pregnancy had an impact on the prevalence of these disorders, a monocentric, case-control study was performed. In total, 113 pregnancies obtained by assisted reproductive treatment among patients with endometriosis were matched with control selected among assisted reproductive treatment pregnancies due to male infertility. The main result measures were pregnancy outcome at the obstetrical and neo-natal levels. The incidence of first trimester bleeding, pre-eclampsia, premature delivery threat, pelvic pain and Caesarean section was significantly higher (P < 0.05) in women with endometriosis. Except for gestational diabetes and intrauterine growth restriction (IUGR), the severity, location of lesions and surgical treatment of endometriosis did not have an impact on either pregnancy outcome or risk of obstetric complications. The IUGR is mainly due to deep locations and the revised American Fertility Society (rAFS) stages III-IV. Newborns with a mother suffering from endometriosis are at greater risk of being premature, smaller for their gestational age and more frequently hospitalized than the control group. Deep location of endometriosis is associated with more prematurity, hospitalization and smaller birthweight than ovarian locations.


Assuntos
Endometriose/terapia , Infertilidade Feminina/terapia , Dor Pélvica/terapia , Técnicas de Reprodução Assistida , Adulto , Estudos de Casos e Controles , Cesárea , Endometriose/complicações , Feminino , Humanos , Incidência , Recém-Nascido Prematuro , Infertilidade Feminina/complicações , Infertilidade Masculina/terapia , Masculino , Dor Pélvica/complicações , Pré-Eclâmpsia , Gravidez , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Estudos Retrospectivos , Inquéritos e Questionários
3.
J Consult Clin Psychol ; 91(4): 221-233, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36521131

RESUMO

OBJECTIVE: Assess the efficacy of integrative couple treatment for pathological gambling (ICT-PG) in comparison to treatment provided in an individual approach. METHOD: Eighty couples were assigned randomly to ICT-PG (n = 44, Mage = 42.2, SD [13.4], n male gamblers = 29) or individual treatment (n = 36, Mage = 39.9 SD [13.0], n male gamblers = 31) with follow-ups at 4- and 10-months postadmission regarding the severity of gambling, the individual and couple's well-being. Linear mixed and generalized estimating equation models for repeated measures were applied to take into account the dependency of observations. Protocol was preregistered at www. CLINICALTRIALS: gov (ID: NCT02240485). RESULTS: Participants in both treatments generally improved over time with reductions on gambling expanses from an initial $4,000-$600 in a 90-day period following treatment, without difference across treatment conditions in money spent on gambling or frequency of gambling. However, on different indices of gambling severity, the participants in ICT-PG showed more improvement at follow-ups, with better control capacity (OR = 2.57, p < .0129) and greater reduction in gambling craving (OR = 5.83, p < .0001) and erroneous cognitions (OR = 2.63, p < .0063). The couple treatment was associated with a better individual well-being (e.g., less depression for partners, OR = 5.53; p < .0351, and gamblers, OR = 2.37; p < .0334) and couple well-being (e.g., better dyadic satisfaction for partners, OR = 2.02; p < .0057, and gamblers, OR = 3.07; p < .0212). CONCLUSIONS: The results underline the necessity to provide a greater diversity of treatment for gamblers and their partner. Further research should focus on identifying active components of ICT-PG and widen its provision to gamblers with concurrent addiction disorders. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Jogo de Azar , Humanos , Masculino , Adulto , Jogo de Azar/terapia , Seguimentos
4.
Can Commun Dis Rep ; 47(4): 232-236, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-34035671

RESUMO

This article, the second in a series on the six National Collaborating Centres for Public Health, focuses on the National Collaborating Centre for Healthy Public Policy (NCCHPP), a centre of expertise, and knowledge synthesis and sharing that supports public health actors in Canada in their efforts to develop and promote healthy public policy. The article briefly describes the NCCHPP's mandate and programming, noting some of the resources that are particularly relevant in the current coronavirus disease 2019 (COVID-19) context. It then discusses how the NCCHPP's programming has been adapted to meet the changing needs of public health actors throughout the pandemic. These needs have been strongly tied to decisions aimed at containing the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and mitigating its immediate impacts in various societal sectors since the beginning of the crisis. Needs have also gradually emerged related to how public health is expected to help inform the development of public policies that will allow us to "build back better" societies as we recover from the pandemic. The article concludes by discussing the orientation of the NCCHPP's future work as we emerge from the COVID-19 crisis.

5.
Sex Health ; 15(2): 160-166, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29544600

RESUMO

Background Men who have sex with men (MSM) have distinctive substance use (SU), which is more often linked to a sexual context than it is for their heterosexual peers. Screening of MSM's SU, its sexual contexts and the associated risks, is of clinical and public health concern. This paper aims to describe the preliminary development of a screening tool for health-risk sexual behaviours related to SU and to make recommendations for its potential use. METHODS: Community-based participatory research and transdisciplinary approaches guided the development process. The Links SU-Sex screening tool is the result of the integration of findings from a scoping review and from four meetings among SU and sexual health experts (n=19), consisting of researchers, community stakeholders, as well as substance-using MSM. RESULTS: The Links SU-Sex questionnaire consists of 64 items divided into 13 components that focus on the links between SU and sexual health. It addresses the contexts in which SU occurs, its frequency, its perceived influence, as well as MSM's concerns about these various links. In accordance with current knowledge, the interpretation of the instrument offers feedback that is based on the respondents' answers to the various components assessed. CONCLUSIONS: The Links SU-Sex represents a potential screening tool that rests on a robust development process supporting its content validity that aims to identify MSM at risk or with concerns surrounding the influence of their SU on their sexual health. The psychometric qualities and the interpretation validity both remain to be established.


Assuntos
Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/métodos , Medição de Risco/métodos , Comportamento Sexual/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Pesquisa Qualitativa , Assunção de Riscos , Inquéritos e Questionários
6.
Front Psychol ; 8: 2344, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29416520

RESUMO

Context: Couple treatment for pathological gambling is an innovative strategy. There are some results supporting its potential effectiveness, but little is known about the subjective experiences of the participants. Objective: The aim of this article is to document the experiences of gamblers and their partners participating in one of two treatments, namely individual or couple. Method: In a study aiming to evaluate the efficacy of the Integrative Couple Treatment for Pathological Gambling (ICT-PG), couples who were entering specialized treatment for the addiction of one member who was a pathological gambler were randomly assigned to individual or ICT-PG. Nine months after their admission to treatment, gamblers and partners (n = 21 couples; n = 13 ICT-PG; n = 8 individual treatment) were interviewed in semi-structured interviews. A sequenced thematization method was used to extract the major themes. Results: This study highlighted five major themes in the therapeutic process noted by the gamblers and their partners mainly after the couple treatment but also partly through the individual therapy. These were: (1) the gamblers' anxiety about having to reveal their gambling problems in couple therapy; (2) the wish to develop a mutually beneficial understanding of gambling and its effects on the partners in the two types of treatments; (3) the transformation of negative attributions through a more effective intra-couple communication fostered by the couple therapy; (4) the partners' contribution to changes in gambling behavior and prevention of relapses, which were both better supported in couple therapy; and (5) the interpersonal nature of gambling and its connections with the couples' relationship. However, gamblers who were in individual treatment were more likely to mention that their partners' involvement was not necessary. Participants likewise made a few recommendations about the conditions underlying the choice of one treatment method or the other. Discussion: Participants reported satisfaction with both treatment models, but their experience was more positive in couple treatment. Complementary benefits emerged from each form of treatment, which points to future treatments involving both types. Future research should explore both the couple processes associated with attempts to stop pathological gambling and the various ways of involving partners in the gamblers' treatment.

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