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Background: Media coverage of Lyme disease (LD) has led to an increase in consultations for presumed LD in Europe. However, LD is confirmed in only 10%-20% of patients, with a significant number remaining in a diagnostic dead-end.Objectives: To reach a deeper understanding of how patients themselves contribute to the diagnostic process. To describe the genesis of the LD hypothesis in care pathways.Methods: In 2019, 30 patients from a prospective cohort consulting in the infectious diseases department at University Hospital in Marseille for presumed LD were recruited for semistructured interviews. The inclusion criteria were: suffering from subjective symptoms for 6 months, no clinical or paraclinical argument suggesting current LD. The patients' medical trajectories were collected using a biographical approach.Results: The diagnosis of LD was primarily triggered by identification with personal testimonies found on the Internet. Most of patients were leading their own diagnostic investigation. The majority of participants were convinced they had LD despite the lack of medical evidence and the scepticism of their referring GP.Conclusion: GPs should first systematically explore patients' aetiologic representations in order to improve adherence to the diagnosis especially in the management of medically unexplained symptoms. Long COVID-19 syndrome challenge offers an opportunity to promote active patient involvement in diagnosis. [ABSTRACT FROM AUTHOR]

Background: Worldwide, millions of deaths each year are attributed to alcohol. We sought to examine French people's beliefs about the risks of alcohol, their correlates, and their associations with alcohol use. Methods: Data came from the 2010 Baromè tre Cancer survey, a random cross-sectional telephone survey of the French general population (n = 3359 individuals aged 15-75 years). Using principal component analysis of seven beliefs about alcohol risks, we built two scores (one assessing risk denial based on self-confidence and the other risk relativization). Two multiple linear regressions explored these scores' socio-demographic and perceived information level correlates. Multiple logistic regressions tested the associations of these scores with daily drinking and with heavy episodic drinking (HED). Results: About 60% of the respondents acknowledged that alcohol increases the risk of cancer, and 89% felt well-informed about the risks of alcohol. Beliefs that may promote risk denial were frequent (e.g. 72% agreed that soda and hamburgers are as bad as alcohol for your health). Both risk denial and risk relativization scores were higher among men, older respondents and those of low socioeconomic status. The probability of daily drinking increased with the risk relativization score and that of HED with both scores. Conclusions: Beliefs that can help people to deny the cancer risks due to alcohol use are common in France and may exist in many other countries where alcoholic beverages have been an integral part of the culture. These results can be used to redesign public information campaigns about the risks of alcohol. [ABSTRACT FROM AUTHOR]

Background: Tobacco control policies have succeeded in reducing tobacco use, but the negative correlation between smoking prevalence and socioeconomic status (SES) has increased. This study focused on the relationships between time preferences, SES, and smoking behaviour, attitudes and risk awareness. Methods: A cross-sectional telephone survey was conducted in France in 2008 on a representative national sample of people aged 18–75 (N = 2000, including 621 smokers) years. Two scales measuring planning horizon and impulsivity and various indicators of SES were introduced into the logistic regressions performed on smoking status and smokers’ attitudes to anti-smoking campaigns, quitting attempts, attempts to quit or smoke less, fear of smoking-related cancer and risk perception. Results: Indicators of lower SES and smoking status were correlated with present time orientation and impulsivity. On modelling smoking status, time orientation and lower SES were found to be significant predictors. Among smokers, lower SES and present time orientation were predictive of smoking-related outcomes: little personal concern with anti-tobacco campaigns, not reporting recent behavioural changes, not expressing personal fear of smoking-related cancer and low risk awareness. When time-related preferences were introduced into the analysis, the effects of several lower SES indicators (especially a low educational level) became non-significant. Conclusion: The relationship between SES and smoking behaviour, attitudes and beliefs may be partly mediated by time preferences. Time preference is strongly correlated with smoking status, risk perceptions and attitudes towards anti-smoking campaigns. Tobacco control policies should include messages targeting present time-oriented smokers and/or interventions designed to enhance more future-oriented attitudes among smokers. [ABSTRACT FROM AUTHOR]

Introduction A discussion about sexuality should become a routine part of the personalized care pathway for patients with cancer. Aim To assess rates of patient discussion about sexuality with health care providers after cancer. Methods We used data from the representative French nationwide 2012 VICAN survey, which included 4,349 adults 18 to 82 years old who were still alive 2 years after diagnosis at 12 cancer sites. Main Outcome Measures Self-reported rates of discussion about sexuality with health care providers were assessed, and associated factors were tested after systematic adjustment for a sexual health indicator (created from six items of the Relationship and Sexuality Scale). Results Of 4,181 respondents to the question on a discussion about sexuality, 54.7% reported that nobody had proposed a discussion to them, 21.9% did not want any discussion, and 23.4% had had a discussion. Women had less discussion about sexuality with health care providers (11.1% vs 36.7% of men, P < .001) and were more likely to request a discussion at their own initiative (62.9% vs 48.0% of men, P < .001). Discussion about sexuality was more frequent with patients with prostate (56.3%) and cervical (39.6%) cancer, but increasing age was associated with a greater reluctance to discuss this issue (odds ratio = 1.17, 95% CI = 1.04–1.2). The likelihood of discussion increased with severe sexual problems, radiotherapy, general sequelae, having an information-seeker profile, previous professional psychological help, and initial treatment in private centers. Patients initially wishing for psychological help were more likely to desire a discussion about sexuality. Conclusion Sexuality receives little attention in French patients with cancer. Inequalities in the discussion about sexuality were observed in relation to the type of care center where the patient was initially managed. Information on supportive interventions, including more systematic referral for professional psychological help, should be developed to facilitate discussion and should be offered to all patients, irrespective of severity of sexual problems, age, sex, cancer site, and care center. [ABSTRACT FROM AUTHOR]