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3 results on '"MESH : Health Knowledge, Attitudes, Practice"'

1. Impact of a region wide antimicrobial stewardship guideline on urinary tract infection prescription patterns

Author

Danièle Sekri, Xavier Bertrand, C. Slekovec, Nathalie Vernaz-Hegi, Bruno Hoen, Daniel Talon, J. Leroy, Jean-Pierre Faller, Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service des maladies infectieuses et tropicales, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Hôpital Jean Minjoz, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ), and Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques

Subjects
Health Knowledge, Attitudes, Practice, Antibiotics, MESH : Drug Prescriptions, MESH: Health Knowledge, Attitudes, Practice, MESH : Aged, MESH: Urinary Tract Infections, Toxicology, MESH: Regression Analysis, MESH : General Practitioners, MESH : Guideline Adherence, 0302 clinical medicine, MESH : Physician's Practice Patterns, Anti-Infective Agents, MESH : Regression Analysis, Medicine, Pharmacology (medical), MESH : Urinary Tract Infections, Practice Patterns, Physicians', MESH: Drug Utilization, 0303 health sciences, MESH: Program Evaluation, MESH : Education, Medical, Continuing, MESH: Middle Aged, 3. Good health, MESH : Practice Guidelines as Topic, [SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology, MESH: Young Adult, MESH: Guideline Adherence, MESH : Anti-Infective Agents, Regression Analysis, Education, Medical, Continuing, Guideline Adherence, medicine.medical_specialty, MESH : Fosfomycin, Attitude of Health Personnel, Urinary system, MESH: Attitude of Health Personnel, MESH : Young Adult, Pharmacy, Drug Prescriptions, 03 medical and health sciences, MESH : Adolescent, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Humans, MESH : Middle Aged, MESH : Norfloxacin, MESH: Physician's Practice Patterns, Norfloxacin, Aged, Pharmacology, MESH: Adolescent, MESH: Humans, 030306 microbiology, MESH : Humans, MESH: Adult, Guideline, MESH: Education, Medical, Continuing, Nitrofurantoin, MESH: Female, MESH : Attitude of Health Personnel, Pediatrics, Time Factors, MESH : Health Knowledge, Attitudes, Practice, Pharmaceutical Science, MESH : Drug Utilization, MESH: Fosfomycin, MESH: Practice Guidelines as Topic, MESH: Drug Prescriptions, [ SDV.MP ] Life Sciences [q-bio]/Microbiology and Parasitology, Antimicrobial stewardship, MESH : Female, 030212 general & internal medicine, MESH: Aged, MESH : Adult, Middle Aged, MESH: General Practitioners, MESH : Program Evaluation, Practice Guidelines as Topic, Urinary Tract Infections, MESH: Nitrofurantoin, Female, France, medicine.drug, MESH : Time Factors, Adult, MESH: Norfloxacin, Adolescent, medicine.drug_class, MESH: Anti-Infective Agents, Young Adult, Fosfomycin, General Practitioners, Internal medicine, MESH : Nitrofurantoin, Medical prescription, MESH : France, business.industry, MESH: Time Factors, Drug Utilization, MESH: France, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Program Evaluation
Abstract

International audience; BACKGROUND: Fluoroquinolones are frequently prescribed for non complicated urinary tract infection treatments and have a negative ecological impact. We aimed to substitute them by antibiotics with narrower activity spectrum in order to preserve fluoroquinolone activity in complicated hospital infections. OBJECTIVE: To assess the impact of a multi-modal approach that combines the dispatching of antibiotic prescription guidelines and voluntary attendance at educational sessions on general practitioners' (GP) antibiotic prescription habits. SETTING: This study was led in Franche-Comté, a French eastern region, where GPs were given a guideline recommending a restricted use of fluoroquinolones for urinary tract infections. METHOD: Segmented regression analysis of interrupted time series was used to assess changes in antibiotic prescription. MAIN OUTCOME MEASURE: The antibiotic prescription data of nitrofurantoin, fosfomycin-trometamol and fluoroquinolones for women aged 15-65 years were obtained from the regional agency of health insurance. RESULTS: Twenty months after intervention, the number of nitrofurantoin and fosfomycintrometamol prescriptions increased by 36.8% (95% CI: 30.6-42.2) and 28.5% (95% CI: 22.9-35.4), respectively, while that of norfloxacin decreased by 9.1% (95% CI: -15.3 to -3.5). CONCLUSION: This study suggests that the dispatch of the guideline on urinary tract infection had a moderate impact on antibiotic prescriptions.

Published
2012

2. PRALIMAP: study protocol for a high school-based, factorial cluster randomised interventional trial of three overweight and obesity prevention strategies

Author

Sabrina Tessier, Serge Briançon, Nelly Agrinier, Evelyne Aptel, E. Lecomte, Emilie Bonsergent, Jean-François Collin, Serge Hercberg, Karine Legrand, Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Service d'Epidémiologie et de Recherche Clinique, Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Unité de Recherche en Epidémiologie Nutritionnelle ( UREN ), Université Paris 13 ( UP13 ) -Institut National de la Recherche Agronomique ( INRA ) -Conservatoire National des Arts et Métiers [CNAM] ( CNAM ) -Université Sorbonne Paris Cité ( USPC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Conservatoire National des Arts et Métiers - Lorraine ( CNAM Lorraine ), Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Rectorat Nancy-Metz, Académie Nancy-Metz, The PRALIMAP trial received support from public and private sectors. Special acknowledgements are addressed to ARH Lorraine, Conseil Régional de Lorraine, DRASS de Lorraine, GRSP de Lorraine, Fondation Coeurs et Artères, Fondation Wyeth, Ministère de l'enseignement supérieur et de la recherche, Inca, IRESP, Régime local d'assurance maladie d'Alsace Lorraine and Urcam de Lorraine., PRALIMAP Trial Group, Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Unité de Recherche en Epidémiologie Nutritionnelle (UREN), Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Conservatoire National des Arts et Métiers [CNAM] (CNAM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Sorbonne Paris Cité (USPC)-Université Paris 13 (UP13)-Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Institut National de la Recherche Agronomique (INRA), BMC, Ed., Université Paris 13 (UP13)-Institut National de la Recherche Agronomique (INRA)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), and HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)

Subjects
Male, Health Knowledge, Attitudes, Practice, MESH : Health Knowledge, Attitudes, Practice, MESH: Health Knowledge, Attitudes, Practice, Medicine (miscellaneous), MESH : School Health Services, MESH : Overweight, Overweight, law.invention, MESH: Health Education, Study Protocol, MESH: Clinical Protocols, 0302 clinical medicine, Promotion (rank), Randomized controlled trial, Clinical Protocols, law, Medicine, Cluster Analysis, MESH: Obesity, MESH: School Health Services, Pharmacology (medical), MESH : Female, 030212 general & internal medicine, Cluster randomised controlled trial, Health Education, media_common, lcsh:R5-920, Practice, 4. Education, Health Knowledge, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, 3. Good health, MESH : Sample Size, Santé publique et épidémiologie, Health education, Female, MESH : Obesity, medicine.symptom, lcsh:Medicine (General), medicine.medical_specialty, Adolescent, media_common.quotation_subject, MESH : Male, 030209 endocrinology & metabolism, 03 medical and health sciences, Quality of life (healthcare), MESH : Health Education, MESH : Adolescent, Humans, MESH : Cluster Analysis, Attitudes, Obesity, Sample Size, School Health Services, MESH : Clinical Protocols, MESH: Overweight, MESH: Sample Size, MESH: Adolescent, MESH: Humans, business.industry, Public health, MESH : Humans, MESH: Cluster Analysis, MESH: Male, Health promotion, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Family medicine, Physical therapy, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female
Abstract

The PRALIMAP steering committee consists of Evelyne APTEL, Noémie ANGEL, Raphaëlle ANCELLIN, Françoise BAILLY, Lucette BARTHELEMY, Daouia BEZAZ, Serge BRIANCON, Jean-François COLLIN, Rozenn De LAVENNE, Evelyne DIETZ, Pascal ENRIETTO, Elisabeth FAVRE, Magali GENTIEU, Emmanuel GOUAULT, Michel HELFENSTEIN, Serge HERCBERG, François KURTZ, Patrick LAURE, Edith LECOMTE, Joëlle LIGHEZZOLO, Patrick MARX, Aline OSBERY, Marie-Odile PIQUEE, Pierre RENAUDIN, Gilles ROBERT, Anne SCHICHTEL, Anne VUILLEMIN, Elisabeth VILLEMIN, Mireille WUILLAUME.; International audience; BACKGROUND: Given the increase in overweight and obesity prevalence in adolescents in the last decade, effective prevention strategies for these conditions in adolescents are urgently needed. The PRALIMAP (Promotion de l'ALImentation et de l'Activité Physique) trial aims to evaluate the effectiveness for these conditions of 3 health promotion strategies--educational, screening and environmental--applied singly or in combination in high schools over a 2-year intervention period. METHODS: PRALIMAP is a stratified 2 × 2 × 2 factorial cluster randomised controlled trial including 24 state high schools in Lorraine, northeastern France, in 2 waves: 8 schools in 2006 (wave 1) and 16 in 2007 (wave 2). Students entering the selected high schools in the 4 academic years from 2006 to 2009 are eligible for data collection. Interventional strategies are organized over 2 academic years. The follow-up consists of 3 visits: at the entry of grade 10 (T0), grade 11 (T1) and grade 12 (T2). At T0, 5,458 (85.7%) adolescents participated. The educational strategy consists of nutritional lessons, working groups and a final party. The screening strategy consists in detecting overweight/obesity and eating disorders in adolescents and proposing, if necessary, an adapted care management program of 7 group educational sessions. The environmental strategy consists in improving dietary and physical activity offerings in high schools and facilities, especially catering. The main outcomes are body size evolution over time, nutritional behaviour and knowledge, health and quality of life. An evaluation process documents how each intervention strategy is implemented in the schools and estimates the dose of the intervention, allowing for a per protocol analysis after the main intention-to-treat analysis. DISCUSSION: PRALIMAP aims at improving the prevention and management of overweight and obesity in adolescents by translating current evidence into public health practice. Particular attention is paid to clustering, multiple factorials and long-term duration to address common pitfalls in health promotion trials. The results should inform how best to implement, in a school environment, effective nutrition prevention programs targeting adolescents who are at a point their lives when they develop responsibilities and empowerment for health attitude behaviours. TRIAL REGISTRATION: This trial is registered at ClinicalTrials.gov under NCT00814554.

Published
2010

3. Community surveys and risk factor analysis of human alveolar and cystic echinococcosis in Ningxia Hui Autonomous Region, China

Author

Belchis Boufana, Donald P. McManus, Dominique A. Vuitton, Gail M. Williams, Hao Wen, Tao Sun, Yumin Zhao, Xongzhou Liu, Ruiqi Liu, Jing Teng, Malcolm K. Jones, Patrick Giraudoux, Dazhong Shi, Brigitte Bartholomot, Jianzhong Zhang, Mark F. Danson, Xiaohui Feng, Yu Rong Yang, Akira Ito, Zhengzhi Li, Philip S. Craig, Qin Zhao, David Pleydell, Yunhai Wang, Rui Zhao, Ningxia Medical College, Molecular Parasitology Unit, Queensland Institute of Medical Research-University of Queensland [Brisbane]-Australian Centre for International and Tropical Health and Nutrition (ACITH), WHO Collaborating Center on Prevention and Treatment of Human Echinococcosis, SERF Unit, Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Department of Parasitology, Asahikawa Medical College, Biomedical Sciences Research Institute, University of Salford, University of Queensland [Brisbane]-The Queensland Institute of Medical Research-Australian Centre for International and Tropical Health and Nutrition ( ACITH ), Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Laboratoire Chrono-environnement ( LCE ), Université Bourgogne Franche-Comté ( UBFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Franche-Comté ( UFC ), Ningxia Medical University, Medical College, Queensland Institute of Medical Research, Xinjiang Medical University, Lanzhou Medical University, Université Bourgogne Franche-Comté [COMUE] (UBFC), Unité sous contrat biologie environnementale, and Institut National de la Recherche Agronomique (INRA)-Université de Franche-Comté (UFC)

Subjects
Male, Health Knowledge, Attitudes, Practice, Veterinary medicine, MESH : Prevalence, MESH: Health Knowledge, Attitudes, Practice, MESH: Risk Assessment, 0302 clinical medicine, MESH : Child, Surveys and Questionnaires, MESH: Child, MESH: Animals, Child, 0303 health sciences, MESH: Middle Aged, MESH : Infant, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Echinococcosis, MESH: Infant, MESH: China, 3. Good health, Child, Preschool, MESH : Residence Characteristics, surveillance, China, medicine.medical_specialty, Echinococcus multilocularis, Risk Assessment, 03 medical and health sciences, MESH : Adolescent, Humans, MESH : Middle Aged, Risk factor, MESH: Prevalence, chine, MESH: Adolescent, MESH: Echinococcus multilocularis, MESH: Humans, Echinococcus granulosus, MESH : Echinococcus granulosus, MESH: Questionnaires, MESH : Humans, MESH: Child, Preschool, Public Health, Environmental and Occupational Health, Infant, MESH: Adult, MESH: Rural Health, medicine.disease, MESH: Female, Demography, ECHINOCOCCUS MULTILOCULARIS, ECHINOCOCCUS GRANULOSUS, FACTEUR RISQUE, MESH : Health Knowledge, Attitudes, Practice, [SDV]Life Sciences [q-bio], Rural Health, MESH : Child, Preschool, MESH : Echinococcus multilocularis, MESH: Echinococcus granulosus, communauté, 030308 mycology & parasitology, Serology, MESH: Health Surveys, Residence Characteristics, Risk Factors, MESH: Risk Factors, MESH : Rural Health, Epidemiology, Prevalence, MESH : Female, MESH: Residence Characteristics, MESH : Risk Assessment, MESH: Echinococcosis, Pulmonary, biology, MESH: Infant, Newborn, asie, MESH : Questionnaires, santé humaine, Middle Aged, MESH : Adult, MESH : Risk Factors, Female, Risk assessment, Research Article, Adult, MESH : Echinococcosis, Pulmonary, Echinococcosis, Pulmonary, Adolescent, échinococcose kystique, MESH : Male, 030231 tropical medicine, MESH : Health Surveys, enquête, MESH : Infant, Newborn, medicine, Animals, MESH : China, business.industry, Infant, Newborn, biology.organism_classification, Health Surveys, MESH: Male, échinococcose alvéolaire, Tropical medicine, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Animals, business
Abstract

International audience; OBJECTIVE: To determine the true community prevalence of human cystic (CE) and alveolar (AE) echinococcosis (hydatid disease) in a highly endemic region in Ningxia Hui, China, by detecting asymptomatic cases. METHODS: Using hospital records and "AE-risk" landscape patterns we selected study communities predicted to be at risk of human echinococcosis in Guyuan, Longde and Xiji counties. We conducted community surveys of 4773 individuals from 26 villages in 2002 and 2003 using questionnaire analysis, ultrasound examination and serology. FINDINGS: Ultrasound and serology showed a range of prevalences for AE (0-8.1%; mean 2%) and CE (0-7.4%; mean 1.6%), with the highest prevalence in Xiji (2% for CE, 2.5% for AE). There were significant differences in the prevalence of CE, AE and total echinococcosis between the three counties and villages (with multiple degrees of freedom). While hospital records showed 96% of echinococcosis cases attributable to CE, our survey showed a higher prevalence of human AE (56%) compared to CE (44%). Questionnaire analysis revealed that key risk factors for infection were age and dog ownership for both CE and AE, and Hui ethnicity and being female for AE. Drinking well-water decreased the risk for both AE and CE. CONCLUSION: Echinococcosis continues to be a severe public health problem in this part of China because of unhygienic practices/habits and poor knowledge among the communities regarding this disease.

Published
2006

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