Strengthening students' well-being and nutritional balance in Grand Est (France): "Lycéen Bouge" program intervention logic / Renforcement du bien-être et de la nutrition des lycéens : la logique d'intervention du programme « Lycéen Bouge ¼

Introduction: As part of a national health policy to fight excess weight and obesity, the "Lycéen Bouge" program aims to fight against social inequalities in health among adolescents by improving their well-being and nutritional balance. The aim of this article is to present the intervention logic of this program and to identify the key functions that are essential for the project to function properly and to be transferable. Method: Data was collected through interviews with project officers, observation sessions in several high schools. A documentary analysis was also carried out. The data was then analyzed thematically, in a collaborative process with the project leader, in order to develop the program logic model. Results: The analysis and development of the logic model identified the program's objectives and components, as well as six key functions. The key functions identified concern the format and co-construction of activities, local partnerships, high-school volunteering, social skills training and project length. Conclusion: In some respects, the program differs from the literature and the evidence and could therefore draw on it for improvement. These include the involvement of beneficiaries and the implementation of a comprehensive approach and a gender-sensitive approach, which would make it possible to reach more students.

Introduction: Dans le cadre d'une politique nationale de lutte contre le surpoids et l'obésité, le programme « Lycéen Bouge ¼ vise à combattre les inégalités sociales de santé chez les adolescents, en améliorant leur bien-être et leur équilibre nutritionnel. Cet article a pour objectif de présenter la logique d'intervention de ce programme, et d'en identifier les fonctions clés, indispensables au bon fonctionnement du programme et à son éventuelle transférabilité. Méthode: Les données ont été recueillies à travers des entretiens auprès des chargés de projet et des séances d'observation des activités au sein de plusieurs lycées. Une analyse documentaire a également été réalisée. Les données ont ensuite été analysées par thématiques, dans une démarche collaborative avec le porteur de projet, afin d'élaborer le modèle logique du programme. Résultats: Le travail d'analyse et d'élaboration du modèle logique a permis d'identifier les objectifs et les composantes du programme, ainsi que six fonctions clés. Les fonctions clés identifiées concernent le format et la co-construction des activités, les partenariats locaux, le volontariat des établissements, la formation aux compétences psychosociales (CPS) et la durabilité du projet. Discussion: Sur certains points, le programme se démarque de ce que l'on trouve dans la littérature et les données probantes, et pourrait donc s'en inspirer pour s'améliorer. Il s'agit notamment de l'implication des bénéficiaires et de la mise en place d'une approche globale et sensible au genre, qui permettraient de toucher plus d'élèves.

Thyroid cancers in children and adolescents in France: Incidence, survival and clinical management over the 2000-2018 period.

INTRODUCTION: Thyroid cancer is the first cause of endocrine malignancy among children. Over the past decades, an increase in the incidence rates (IR) has been observed around the world. Our study aimed to describe epidemiology, therapeutic management and survival rates of children and adolescents with thyroid cancer in France. METHODS: A population-based study was conducted between 2000 and 2018 in children and adolescents less than 17 years with a diagnostic of thyroid cancer. RESULTS: A total of 774 thyroid cancers were included: 579 papillary (PTC), 83 follicular (FTC), and 111 medullary carcinomas (MTC). PTC are more frequent in females and in adolescents whereas MTC mainly concerned children, mostly with a familial predisposition. Almost all patients underwent thyroidectomy, completed for most patients with PTC and FTC by radioiodine therapy. Cervical dissection was performed more frequently in patients having PTC and MTC compared to those with FTC. Between 2000 and 2018, thyroid cancers IR in children fluctuated between 1.3 and 3.2 per million, without any significant trend. The median follow-up time was 11.3 years in children, and 5.7 years in adolescents. The 5year-OS was greater than 98.5%. CONCLUSIONS: Population-based studies are crucial for better understanding and delineation of best management of rare diseases as thyroid cancers in pediatric and adolescent population. Considering the very favorable survival, a stratification should be proposed between cases at low risk and cases at high risk of relapse, in order to consider a strategy of therapeutic de-escalation in the most favorable cases.

Characteristics of patients with knee and/or hip osteoarthritis undergoing spa treatment: the prospective KHOALA cohort study.

Knee and hip osteoarthritis (KHOA) are a source of functional impairment. With aging, the management of osteoarthritis (OA) is a major issue in the search for improved quality of life. Spa treatment provides short- and mid-term symptom relief without serious side effects. This study aimed to identify characteristics of patients with KHOA associated with use of spa treatment. The prospective KHOALA cohort included 878 adults aged 40 to 75 years with symptomatic KHOA. We separately analyzed knee and hip OA data and compared patients who never had spa treatment with those who had at least one or multiple treatments during 5 years of follow-up in terms of socio-demographic characteristics, clinical data, quality of life (OAKHQOL, SF-36), physical activity (MAQ), functional impairment (WOMAC), and health care consumption (pharmacological and non-pharmacological treatments). Factors associated with at least one or multiple spa treatments were evaluated with regression logistic models. In all, 607 (69.1%) patients had knee OA (KOA), 222 (25.3%) hip OA (HOA) and 49 (5.6%) both, 91 (13.9%) with KOA, and 33 (12.2%) with HOA had at least one spa treatment. In the KOA cohort, the probability of at least one, two, or three spa treatments was increased with older age (odds ratio = 1.6 [95% confidence interval 1.2-2.2], 1.8 [1.2-2.8], 2.4 [1.4-4.2], respectively), greater use of physiotherapy (OR = 3.9 [2.1-7.1], 2.7 [1.3-5.6], 2.5 [1.1-5.9]), having a prosthesis (OR = 2.1 [1.2-3.8], 2.2 [1.1-4.3], 2.5 [1.1-5.5]), and low MAQ score (OR = 0.7 [0.6-0.9], 0.7 [0.5-1.0], 0.7 [0.5-1.0]). In the HOA cohort, female sex was associated with at least one (OR = 3.0 [1.1-8.0]) or two (OR = 5.1 [1.2-22.5]) spa treatments. In this cohort of KHOA, repeated spa treatment over 5 years was strongly associated with older age, greater use of physiotherapy and presence of a prothesis with KOA and female sex with HOA. This study may help to better understand spa treatment determinants in OA.