[Prevalence of asthma among adults in France, data from the Constances cohort study]. / Prévalence de l'asthme chez l'adulte en France, données de la cohorte Constances.

INTRODUCTION: The objectives of our study were to estimate the prevalence of asthma in adults in France and to study the effects of gender on the associations of asthma with the corpulence and socio-economic characteristics of individuals. METHODS: We estimated the prevalence of current asthma (asthma attack in the past 12 months or current treatment for asthma) from data collected at inclusion in the Constances cohort study in 2013-2014. Analyses were performed separately in men and women, using robust Poisson regression for multivariate analysis. RESULTS: Using data from 34,100 participants in the cohort (men: 47.7 %; mean age: 44.6 years), the prevalence of current asthma was estimated to be 5.8 % (5.1 % in men, 6.4 % in women). The risk of asthma was increased in women with high body mass index (BMI) or waist circumference. In men, only a high waist circumference was associated with an increased risk of asthma. An association with low socioeconomic status was observed only among women. CONCLUSION: The associations of asthma with corpulence and socioeconomic status differed between men and women. Additional analyses should provide a better understanding of the mechanisms responsible for these differences.

Norms for standard neuropsychological tests from the French CONSTANCES cohort.

BACKGROUND AND PURPOSE: Neuropsychological testing plays a key role in various clinical contexts. Even though a substantial number of adults suffer neurological disorders such as early-onset dementia, stroke, traumatic brain injury or multiple sclerosis, most normative data do not include persons below 65. The aim of this study was to produce updated norms for the Mini-Mental State Examination, the Free and Cued Selective Reminding Test, the Trail Making Test, verbal fluency tasks and the Digit Symbol Substitution Test for middle-aged and older adults. METHODS: The sample consisted of 51 879 participants aged 45-70 years from the CONSTANCES study. Norms are presented in percentiles stratified on age, education and gender. RESULTS: The results illustrated the effect of age in all tests considered. For tests involving speed processing, the impact of age was observed including in tight age range categories (5 years). The results also showed the well-known effect of education and an effect of gender in tests involving verbal memory and speed processing. CONCLUSIONS: The norms provided allow the variability of the cognitive performances of middle-aged to older populations to be understood, with a high precision in age categories. The tests considered are broadly used in neuropsychological practice and should be helpful in a variety of clinical contexts.

Social productivity and depressive symptoms in early old age-results from the GAZEL study.

OBJECTIVES: We test associations of frequency of performing three types of socially productive activities (voluntary work, informal help and caring for a person) with depressive symptoms in older people. Are depressive symptoms negatively associated with frequency in all three types or rather in those activities that are characterized by a high degree of autonomy and perceived control? METHODS: Data on social activities and frequency of performance were collected in the frame of the annual follow-up of the French GAZEL cohort study in 2005. Depressive symptoms were measured by the CES-D scale. Perceived control was assessed by two items of a quality of life measure (CASP-19). Total of 14477 respondents aged 52-66 years completed a standardized questionnaire. Linear regression models were calculated adjusting for important confounders including self-rated health assessed during the previous year. RESULTS: In activities characterized by high autonomy (in particular voluntary work) a negative association of frequency with depressive symptoms was observed, whereas the reverse effect was found in the type of activity with low autonomy (care for a person). Perceived control mediated in part the association of frequency of activity with depressive symptoms. CONCLUSION: Being often socially productive in early old age may contribute to well-being to the extent that autonomy and perceived control are given.

[Characterisation and measurement of social position in epidemiologic studies]. / Caractérisation et mesure de la situation sociale dans les études épidémiologiques.

BACKGROUND: The terms "socioeconomic status", "socioeconomic position", "social classes" ... are widely used in epidemiology. They refer to various aspects of social position which is associated with many aspects of health. The position of individuals in the social hierarchy is multidimensional, i.e. defined by various socioeconomic factors. They can be individual (for example educational level, employment status, and occupation), household related (for example household income) or neighbourhood related (for example unemployment rate in the district of residence). These various factors can be associated with health at different periods during the life course, via a number of mechanisms, and they can possibly interact with one another. No socioeconomic indicator is better than the others or adequate in all study contexts. AIM AND METHODS: This paper presents a description of various socioeconomic indicators, and describes what they measure, and the advantages and limits of each of them. CONCLUSION: No indicator can be recommended in particular. Within the limit of available variables, the most relevant measurement depends on many elements, such as the study population and the aspect of health being investigated.

Occupational mobility and risk factors in working men: selection, causality or both? Results from the GAZEL study.

OBJECTIVE: To explore the relation between risk factors (RF) and occupational mobility in working men. SETTING: 20 000 volunteers working at the French National Electricity and Gas Company (GAZEL cohort). PARTICIPANTS: Men aged 43 to 53 years in 1992. DESIGN: Three designs were used for analysis. (1) The association between occupational mobility experienced before 1992 and RF reported at that date was analysed among 10 383 men. (2) The predictive role of RF on occupational mobility over 1992-1999 was studied in a subsample of 4715 men. (3) Reciprocally, occupational mobility in 1985-1992 was analysed in relation to RF changes over 1993-1999. MAIN OUTCOME MEASURES: Self reported smoking status, excessive alcohol consumption, arterial hypertension, and overweight. Occupational mobility defined by any upward transition between senior executives and professionals/middle executives/employees, and workers. RESULTS: (1) Cross sectionally, non-mobile men as their entry into the company had a higher risk of being smokers, excessive alcohol drinkers, and overweight in 1992 than mobile men. (2) Longitudinally, smokers and excessive alcohol drinkers in 1992 had a higher risk of non-mobility than, respectively, non-smokers and non-excessive alcohol drinkers. (3) Non-mobile men in 1985-1992 had a higher risk of becoming smokers, excessive alcohol drinkers, and hypertensive in 1993-1999 than upwardly mobile men. CONCLUSION: These results suggest a complex relation between RF and occupational mobility. A high level of RF, particularly health behaviours, might account for a selection process reducing upward occupational mobility. In turn, a lack of upward occupational mobility might be associated with an increased incidence of RF.

Studies on the potential of microparticles entrapping pDNA-poly(aminoacids) complexes as vaccine delivery systems.

Poly(D,L-lactide-co-glycolide) (PLGA) microparticles containing plasmid DNA (pDNA) have potential uses as vaccine delivery systems. Nevertheless, the established double emulsion and solvent evaporation method used to produce them is characterised by a low encapsulation efficiency (about 20%) and nicks the supercoiled DNA. The aim of this work was to develop an encapsulation process to optimise the overall encapsulation efficiency and the supercoiled DNA content, to obtain a carrier suitable for mucosal delivery of DNA vaccines. Our strategy was to reduce the global negative charge of DNA which was unfavourable to its incorporation into the polymer by condensing it with cationic poly(aminoacids) which were previously reported to improve cell transfection. In this study, after characterisation of the compaction of DNA plasmid encoding for a Green Fluorescent Protein, we demonstrated that resulting complexes were successfully encapsulated into PLGA microparticles presenting a mean size around 4.5 microns. The preliminary step of complexation enhances the yield of the process by a factor 4.1 and protects the supercoiled form. In a bacteria transformation assay, we demonstrated that extracted pDNA (naked or complexed) remained in a transcriptionally active form after encapsulation. Bovine macrophages in culture phagocytosed microparticles loaded with uncomplexed/complexed with poly(L-lysine) pDNA. The production of the Green Fluorescent Protein demonstrated that these carriers could deliver intact and functional plasmid DNA probably by escaping from lysosomal degradation.

Do cardiovascular risk factors in men depend on their spouses' occupational category?

OBJECTIVE: To analyse the relationships between major cardiovascular risk factors in French men and their spouses' occupational category (OC), taking their own OC into account. DESIGN: A large sample of volunteers working in the French National Electricity and Gas Company (GAZEL). As a check of the robustness, the same analysis was performed in a population-based survey (French multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) registers). SETTING: Any site of the company in France. Representative sample from the population of the three registers (Lille, Strasbourg, Toulouse). PARTICIPANTS: 9486 and 534 men respectively, in working activity, living in couple and aged 40 to 50 years. MAIN OUTCOME MEASURES: Self-reported arterial hypertension, diabetes, hypercholesterolemia, leisure time sedentary lifestyle, smoking status, body mass index (BMI) and alcohol consumption. RESULTS: In the GAZEL study, diabetes, smoking status, and alcohol consumption in men were associated with their own OC. In contrast, spouses' OC was independently associated with men's hypertension, hypercholesterolemia, sedentary lifestyle, and BMI: men whose spouses were unoccupied or workers have higher risk factors levels. In the MONICA study, the results were mostly comparable, at least for hypercholesterolemia, sedentary lifestyle, smoking status and alcohol consumption. CONCLUSION: Spouses' OC was independently associated with several cardiovascular risk factors in men. These results might indicate that socioeconomic status of the couple, and not only individual characteristics, should be taken into account for a better understanding of cardiovascular risk.

Age, working conditions, and sleep disorders: a longitudinal analysis in the French cohort E.S.T.E.V.

STUDY OBJECTIVES: To investigate the effects of occupational factors on both the incidence and the disappearance of sleep disorders after a five-year follow-up period. DESIGN: A prospective longitudinal investigation E.S.T.E.V. carried out in 1990 and 1995. SETTING: Seven regions of France. SUBJECTS: A random sample of employed men and women born in 1938, 1943, 1948, and 1953. In 1990, 21,378 subjects were interviewed (87% of those contacted), and 88% were interviewed again in 1995. MEASURES: Sleep disorders (SD), objectifiable and psychosocial working conditions. RESULTS: Prevalence of SD increased with age and were more frequent among women than men in every age group. Incidence of SD varied little with age, but their disappearance decreased with age. After adjustment for age and sex, SD in 1995 were found to be associated both with objectifiable working conditions and with psychosocial aspects of the way work is experienced. Among objectifiable occupational risk factors, shift work, work week often longer than 48 hours, and exposure to vibrations appeared to be the principal risk factors for SD. Among psychosocial occupational factors, finding it difficult or irksome to have to hurry appeared to be the principal risk factor. CONCLUSIONS: Taking into account the adjustments for health criteria, sociodemographic characteristics, and leisure activities, these results suggest useful courses of action for prevention which, it seems to us, must not be only limited to objectifiable working conditions. Issues about work organization, while clearly difficult to resolve, must also be taken into account.